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PUBH 4040 > 1: History & Scope of Epidemiology > Flashcards

1: History & Scope of Epidemiology Flashcards

1
Q

Epidemiology derived from Greek words:

A

epi- on, upon, or befall
demos- the people
logos- the study
The study of what befalls the population

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2
Q

Definition of Epidemiology

A

concerned with the distribution and determinants of health and diseases, morbidity, injuries, disability and mortality in populations

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3
Q

Define Determinants

A

factors or events that are capable of bringing about a change in health. The search for causes and other factors of health-related states or events

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4
Q

Examples of Determinants
Health-related states or events-
Search for Determinants-

A

Health-related states or events: Disease states (biologic and chemical agents) and Conditions associated with Health (physical activity, nutrition, environmental poisoning, seat belt use, use of health services, etc)
Search for Determinants: Anthrax outbreak, Hantavirus outbreak, etc.

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5
Q

Define Distribution

A

study of frequency and pattern of health events in the population

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6
Q

Define Distribution Frequency

A

number, and number relation to the population

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7
Q

Define Distribution Pattern

A

the health-related state or event by person, place, and time characteristics

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8
Q

Disease Distribution Examples

A
  • CHD death rates and stroker higher in African-Americans than other races
  • HIV rates in UT from 2000-2010 40x higher in African-born immigrants than Caucasian males
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9
Q

Define Morbidity

A

designates illness

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10
Q

Define Mortality

A

refers to deaths that occur in a population or other group

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11
Q

Aims and Levels of Epidemiology

A
  1. DESCRIBE the health status of populations
  2. EXPLAIN the etiology of disease
  3. PREDICT the occurrence of disease
  4. CONTROL the occurrence of disease (intervention/prevention)
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12
Q

Central activity of epidemiology

A

quantification

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13
Q

Epidemic

A

a spike in cases from what you would expect to see

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14
Q

Endemic

A

what you would expect to see in a population

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15
Q

Infectious Disease Epidemic qualifications

A
  1. a single case of a long absent communicable disease
  2. first invasion of a communicable disease
  3. two cases of such a disease associated in time and place
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16
Q

Infectious Disease Triangle

A

Center: TIME
Top: ENVIRONMENT
Left: HOST
Right: AGENT

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17
Q

Pandemic

A

an epidemic on a worldwide scale. large numbers of persons may be affected and a disease may cross international borders

18
Q

Pandemic example

A

flu, HIV

19
Q

ascertainment of epidemics

A

surveillance and epidemic threshold

20
Q

define surveillance

A
  1. The systematic collection of data pertaining to the occurrence of specific diseases.
  2. analysis and interpretation of these data
  3. dissemination of disease-related information
21
Q

cancer incidence

A

the number of people who get cancer

22
Q

Epidemic Threshold

A

The minimum number of cases (or deaths) that would support the conclusion that an epidemic was underway. may adjust based on what is expected

23
Q

historical epidemiological antecedents

A
  1. environment and disease
  2. the black death
  3. use of mortality counts
  4. smallpox vaccination
  5. natural experiments
  6. identification of specific agents of disease
  7. 1918 influenza pandemic
24
Q

Hippocrates

A
  • Father of medicine and first epidemiologist
  • suggested disease might be associated with the physical environment (malaria and swampy water)
  • represented a movement away from supernatural explanations of disease causation
25
Q
  1. Environment and Disease
A

Hippocrates

26
Q
  1. The Black Death
A

1346-1352. claimed 1/4-1/3 of population of Europe

27
Q
  1. Use of Mortality Counts
A

John Graunt

28
Q

John Graunt

A
  • Recorded how many persons per year died of what kind of event or disease
  • Developed and calculated life tables and life expectancy
  • Divided deaths into two types of causes: acute & chronic
29
Q
  1. Smallpox Vaccination
A

Edward Jenner: invented vaccination for smallpox

30
Q
  1. Use of Natural Experiments
A

John Snow: two water companies supplied water. when one moved its source of water to a less polluted portion of the river, Snow noted how that effected the next cholera outbreak

31
Q

John Snow

A
  • 1st current day epidemiologist
  • English physician and anesthesiologist
  • linked cholera epidemic to contaminated water supplies
  • used spot map of cases and tabulation of fatal attacks and deaths
32
Q

Natural Experiment definition

A

The epidemiologist does not manipulate a risk factor but rather observes the changes in an outcome as the result of a naturally occurring situation.

33
Q
  1. Identification of specific agents of disease
A

Ignaz Semmelweis, William Farr, and Robert Koch

34
Q

Ignaz Semmelweis

A
  • “savior of mothers”

- early pioneer of antiseptic procedures

35
Q

Examples of Contemporary Natural Experiments

A

Seat Belts Law, Tobacco Tax

36
Q

William Farr

A
  • provided foundation for classification of diseases

- examined linkage between mortality rates and population density

37
Q

Robert Koch

A

-established the Germ Theory

38
Q

Koch’s Postulates

A
  1. microorganism must be observed in every case of the disease
  2. microorganism must be isolated and grown in pure culture
  3. pure culture must, when inoculated into a susceptible animal, reproduce the disease
  4. microorganism must be observed in, and recovered from, diseased animal
39
Q

1918 Influenza Pandemic

A
  • killed 50-100 million worldwide
  • 2.5% case-fatality rate (vs 0.1% for other flue)
  • deaths most frequent among age 20-40
40
Q

recent applications of epidemiology

A
  • Framingham Heart Study (since 1948, investigates coronary heart disease risk factors)
  • Smoking and lung cancer (Doll and Peto’s study of British doctors’ smoking)
  • AIDS
  • chemical spills
  • breast cancer screening
  • secondhand smoke
41
Q

Applications of Epidemiology (6 broad categories)

A
  1. Infectious Diseases
  2. Environmental Health
  3. Chronic Diseases
  4. Lifestyle and Health Promotion
  5. Psychiatric and Social Epidemiology
  6. Molecular and Genetic Epidemiology

PUBH 4040 (12 decks)

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