1: History & Scope of Epidemiology

Question 1

Epidemiology derived from Greek words:

Answer 1

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

Question 2

Definition of Epidemiology

Answer 2

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

Question 3

Define Determinants

Answer 3

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

Question 4

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

Answer 4

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.

Question 5

Define Distribution

Answer 5

study of frequency and pattern of health events in the population

Question 6

Define Distribution Frequency

Answer 6

number, and number relation to the population

Question 7

Define Distribution Pattern

Answer 7

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

Question 8

Disease Distribution Examples

Answer 8

• 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

Question 9

Define Morbidity

Answer 9

designates illness

Question 10

Define Mortality

Answer 10

refers to deaths that occur in a population or other group

Question 11

Aims and Levels of Epidemiology

Answer 11

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)

Question 12

Central activity of epidemiology

Answer 12

quantification

Question 13

Epidemic

Answer 13

a spike in cases from what you would expect to see

Question 14

Endemic

Answer 14

what you would expect to see in a population

Question 15

Infectious Disease Epidemic qualifications

Answer 15

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

Question 16

Infectious Disease Triangle

Answer 16

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

Question 17

Pandemic

Answer 17

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

Question 18

Pandemic example

Answer 18

flu, HIV

Question 19

ascertainment of epidemics

Answer 19

surveillance and epidemic threshold

Question 20

define surveillance

Answer 20

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

Question 21

cancer incidence

Answer 21

the number of people who get cancer

Question 22

Epidemic Threshold

Answer 22

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

Question 23

historical epidemiological antecedents

Answer 23

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

Question 24

Hippocrates

Answer 24

• 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

Question 25

1. Environment and Disease

Answer 25

Hippocrates

Question 26

2. The Black Death

Answer 26

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

Question 27

3. Use of Mortality Counts

Answer 27

John Graunt

Question 28

John Graunt

Answer 28

- 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

Question 29

4. Smallpox Vaccination

Answer 29

Edward Jenner: invented vaccination for smallpox

Question 30

5. Use of Natural Experiments

Answer 30

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

Question 31

John Snow

Answer 31

- 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

Question 32

Natural Experiment definition

Answer 32

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

Question 33

6. Identification of specific agents of disease

Answer 33

Ignaz Semmelweis, William Farr, and Robert Koch

Question 34

Ignaz Semmelweis

Answer 34

- "savior of mothers" | - early pioneer of antiseptic procedures

Question 35

Examples of Contemporary Natural Experiments

Answer 35

Seat Belts Law, Tobacco Tax

Question 36

William Farr

Answer 36

- provided foundation for classification of diseases | - examined linkage between mortality rates and population density

Question 37

Robert Koch

Answer 37

-established the Germ Theory

Question 38

Koch's Postulates

Answer 38

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

Question 39

1918 Influenza Pandemic

Answer 39

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

Question 40

recent applications of epidemiology

Answer 40

- 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

Question 41

Applications of Epidemiology (6 broad categories)

Answer 41

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