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PUBLIC CARE 210.pptx
- 1. PUBLIC HEALTH CARE210 UNIT: ONE
- 2. Course Content •UNIT1: INTRODUCTION TOEPIDEMIOLOGY 1.1 Concept of Epidemiology 1.2 Definitions 1.3 Terminologies 1.4 Objectives
- 3. DEFINITION OF PUBLICHEALTH • PUBLIC HEALTH is defined as a community effort to protect, maintain and improve health of a population. • PUBLIC HEALTH has been defined as the “science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, community and individuals.
- 4. DEFINITION OF PUBLICHEALTH • C.E.A. Winslow in 1923 defined Public Health as the science and art OF PREVENTING disease, PROLONGING life, and PROMOTING Physical Health And Efficiency Through Organized Community Efforts For The Sanitation Of The Environment, The Control Of Community Infections, The Education Of The Individual In Principles Of Personal Hygiene, The Organization Of Medical And Nursing Services For The Early Diagnosis And Preventive Treatment Disease, And The Development Of The Social Machinery Which Will Ensure To Every Individual In The Community A Standard Of Living Adequate For The Maintenance Of Health.
- 5. Major Disciplines inPublic Health 1. . Nutrition 2. Reproductive health 3. Environmental Health 4. Health Promotion and Health Education 5. Epidemiology 6. Health Economics 7. Biostatistics
- 6. CONCEPT OF EPIDEMIOLOGY •Epidemiology is a fundamental science of public health. Epidemiologists are concerned not only with death, illness and disability, but also with more positive health states and, most importantly, with the means to improve health. • The term “disease” encompasses all unfavourable health changes, including injuries and mental health.
- 7. CONT… • A focusof an epidemiological study is the population defined in geographical or other terms; for example, a specific group of hospital patients or factory workers could be the unit of study. A common population used in epidemiology is one selected from a specific area or country at a specific time. This forms the base for defining subgroups with respect to sex, age group or ethnicity.
- 8. CONT… • Public health,broadly speaking, refers to collective actions to improve population health. Epidemiology, one of the tools for improving public health, is used in several ways. Early studies in epidemiology were concerned with the causes (etiology) of communicable diseases, and such work continues to be essential since it can lead to the identification of preventive methods. In this sense, epidemiology is a basic medical science with the goal of improving the health of populations, and especially the health of the disadvantaged (Bonita et al. 2006).
- 9. INTRODUCTION TO EPIDEMIOLOGY •Definition • Epi = upon • Demo = people • Logy = the study or knowledge • Epidemiology = the science which deals with what falls upon people….. • Bridge between biomedical, social and behavioral sciences
- 10. Modern Definition ofEpidemiology • Study of the occurrence and distribution of health related diseases or events in specified populations, including the study of the determinants influencing such states, and the application of this knowledge to control the health problem (Porta M, Last J, Greenland S. A Dictionary of Epidemiology, 2008)
- 11. Modern Definition ofEpidemiology • Epidemiology as defined by Last is’ • the study of the distribution and determinants of health- related states or events in a specified population, and the application of the study to the prevention and control of health problems.
- 12. Definition of Epidemiology... •This broad definition of epidemiology can be further elaborated as follows; • Study: includes-surveillance, observations, hypothesis testing, analytic research and experiments • Distribution: refers to analysis of – Times, persons, places and classes of people affected.
- 13. Definition of Epidemiology... •Specified population: include those with identifiable characteristics, such as occupational groups. • Application to prevention and control-The aims of public health- to promote, protect and restore health.
- 14. Purposes of Epidemiology 1.To investigate nature / extent of health related phenomena in the community / identify priorities 2. To study natural history and prognosis of health-related problems 3. To identify causes and risk factors 4. To recommend / assist in application of /evaluate best interventions (preventive and therapeutic measures) 5. To provide foundation for public policy
- 15. Broad Types ofEpidemiology • DESCRIPTIVE EPIDEMIOLOGY Examining the distribution of a disease in a population, and observing the basic features of its distribution in terms of time, place, and person.. We try to formulate hypothesis, look into associations ? Typical study design: community health survey (synonyms: cross-sectional, Descriptive study)
- 16. Broad Types ofEpidemiology • ANALYTIC EPIDEMIOLOGY Testing a specific hypothesis about the relationship of a disease to a specific cause, by conducting an epidemiologic study that relates the exposure of interest to the outcome of interest (Cause- effect relationship) Typical study designs: cohort, case-control, experimental design
- 17. CONT….. Descriptive Epidemiology IsA Necessary Antecedent of Analytic Epidemiology To undertake an analytic epidemiologic study you must first: • Know where to look • Know what to control for • Be able to formulate / test hypotheses compatible with a-priori lab / field evidence
- 18. Basic Triad ofDescriptive Epidemiology • THE THREE ESSENTIAL CHARACTERISTICS OF DISEASE WE LOOK FOR IN DESCRIPTIVE EPIDEMIOLOGY ARE: • PERSON • PLACE • TIME
- 19. Cont …… Personal Characteristics(whom) • Age • Gender • Socio-economic status (education, occupation, income) • Marital status • Ethnicity/race/genetic profile • Behavior / habits
- 20. Cont ….. •Place (where?) • Geographically restricted or widespread(outbreak, epidemic, pandemic)? Off-shore (tsunami…) • Climate effects (temperature, humidity, combined effects..) • Urban / sub-urban-squatter / rural • Relation to environmental exposure (water, food supply, etc) • Multiple clusters or one?
- 21. Cont …. •Time (when?) • Changing or stable? • Clustered (epidemic) or evenly distributed (endemic)? • Time-trends: Point source, propagated, seasonal, secular, combinations
- 22. Basic triad ofanalytical epidemiology THE THREE PHENOMENA ASSESSED IN ANALYTIC EPIDEMIOLOGY ARE: • HOST HOST • AGENT • ENVIRONMEN ENVIRONMENT AGENT
- 23. Cont … Agents • Biological(micro-organisms) • Physical (temperature, radiation, trauma, others) • Chemical (acids, alkalis, poisons, tobacco, others) • Environmental (nutrients in diet, allergens, others) • Psychological experiences
- 24. Cont …. Host Factors •Genetic endowment • Immunologic status • Personal characteristics • Personal behavior • Definitive versus intermediate (in vector-borne diseases)
- 25. Cont …. Environment • Livingconditions (housing, crowding, water supply, refuse, sewage, etc) • Atmosphere / climate • Modes of communication: phenomena in the environment that bring host and agent together, such as: vector, vehicle, reservoir, etc)
- 26. What is Epidemiology •Key messages (Things to remember) • Epidemiology is a fundamental science of public health • Epidemiology has made major contributions to improving population health • Epidemiology is essential to the process of identifying and mapping emerging diseases
- 27. Historical context Origins • Epidemiologyoriginates from Hippocrates observations more than 2000 years ago that environmental factors influence the occurrence of disease. • However, it was not until the 19th Century that the distribution of disease in specific human population groups was measured to any large extent. • This wok not only marked the formal beginnings of epidemiology but also some of its most spectacular achievements
- 28. • The findingsby John snow that the risk of cholera in London was related to the drinking water supplied by a particular company provides a well-known example • Snow’s epidemiology studies were one aspect of a wide ranging series of investigations that examined related physical, chemical, biological, sociological and political processes.
- 29. • Comparing ratesof disease in subgroups of the human population became common practice in the late C19th and early C20th . • This approach was initially applied to the control of communicable diseases but proved to be useful way of linking environmental conditions or agents to specific diseases. • In the second half of the twentieth century, • These methods were applied to chronic non communicable diseases such as heart diseases and cancer, especially in the middle and high- income countries.
- 30. Recent developments inEpidemiology • Epidemiology in modern form is a relatively new discipline and uses quantitative methods to study diseases in human populations, to form prevention and control efforts. e.g. Richard Doll and Andrew Hill studied the relation between tobacco use and lung cancer beginning in the 1950s.
- 31. Definitions of epidemiologicalterms • Disease: A pattern of response by a living organism to some form of invasion by a foreign substance or injury which causes an alteration of the organisms normal functioning. An abnormal state in which the body is not capable of responding to or carrying on its normally required functions. • Pathogens: Organisms such as bacteria, viruses, or parasites that are capable of producing diseases. • Pathogenesis: the development, production, or process of generating a disease • Pathogenic: Disease causing or producing • Pathogenicity: Potential ability and strength of a pathogenic substance to cause disease • Invasiveness: the ability to get into a susceptible host and cause a disease within the host. The capacity of a microorganism to enter into and grow in or upon tissues of a host
- 32. Definitions of epidemiologicalterms • Infective disease: Disease which the pathogen or agent has the capability to enter, survive, and multiply in the host • Virulence: the extent of pathogenicity or strength of different organisms, the capacity and strength of the disease to produce severe and fatal cases of illness • Epidemic: Occurrence of one specific disease from a single source, in a group population, community or geographical area in excess of the usual level of expectancy. The occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular time • Endemic: The constant presence of a disease or infectious agent within a given geographic area or population group. The ongoing, usual prevalence of or constant presence of a disease within such area in a given population
- 33. Definitions of epidemiologicalterms • Epidemic period: A time when the number of cases of disease reported is greater than expected • Hyperendemic: Persistent level of disease beyond or above the expected prevalence. A disease that is constantly present at high incidence and or prevalence rate • Pandemic: Epidemic that is widespread across a country, continent or large pop, possible worldwide. eg. HIV/AIDS. An epidemic occurring over a very wide area (several countries or continents) and usually affecting a large proportion of a population
- 34. ASSIGNMENT ONE • DiscussRichard Doll and Andrew Hill study of the relation between tobacco use and lung cancer beginning in the 1950s. • Instructions: • 5 Pages including the references • Typed font 12 and spacing 1.5 • New Times Roman • Due date :