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Community Test 2
 Chapter 4 Epidemiology
 
Age adjusted rates
: (also known as standardization of rates) method of reducing biaswhen there are differences in the age distributions of two populations being compared.Determines the rate for specific subgroups of a population and using a denominator that reflects only the subgroup removes age related bias. P. 56 
Analytic epidemiology
: method that investigates the causes of disease by determiningwhy a disease rate is lower in one population group than in another. 
Descriptive epidemiology
: a form of epidemiology that describes a disease accordingto its person, place, or time related to amount and distribution of disease.
Crude rates
: rates that summarize the occurrence of births (crude birth rate), deaths(crude death rates), or diseases (crude disease rates) in the general population. Thenumerator is the number of events, and the denominator is the average population sizeor the population size at midyear (usually July 1) multiplied by a constant. Can appear distorted because risk is not accounted for. 
Epidemiological triangle
: an organized method of inquiry to derive an explanation of disease which analyzes three elements: agent, host, and environment. 
Wheel model
: Biological > Social> Physical environments around >Host w/ Geneticcore
Web of causation
: a model that can be used to illustrate complex interrelationships of factors interacting with each other to influence the risk for, or distribution of, healthoutcomes.
Surveillance
: ongoing collection of community health information
 
Incidence
: occurrence of new cases of a disease or condition in a community over a period of time relative to the size of the population at risk for that condition in thattime period: # new cases at point in time X 1000Population at risk at same point in time-particularly good for acute disease-may be the most sensitive indicator of the changing health of a community
Prevalence:
# existing cases a point in time X 1000Population at same point in time-often used in cross-sectional studies
Prospective studies:
monitor a group of disease free individuals to determine if andwhen disease occurs. These individuals, or the
cohort
, share a common experiencewithin a defined time period. It summarizes data collected over time by the incidencerates of new cases or 
relative risk 
= incidence rate among exposedIncidence rate among unexposed- (also called longitudinal, cohort, or incidence studies) they are advantageous because they obtain more reliable information about the cause of disease than do other study methods
Retrospective studies:
compare individuals with a particular condition or disease withthose who don’t have it. They determine whether cases, or a diseased group, differ intheir exposure to a specific factor or characteristic relative to controls, or a non-diseased group. Data collection extends back in time to determine previous exposure or risk factors. A greater proportion of exposed cases than controls suggests a relationship between the disease and the risk factor.
Experimental studies:
a type of analytic study. Investigations apply experimentalmethods to test treatment and prevention strategies. The investigator randomly assignssubjects at risk for a particular disease to an experimental group or a control group.Both groups are observed for occurrence of disease over time, but only theexperimental group receives intervention.
Cross-sectional:
(prevalence) examines relationships between potential causal factorsand disease at a specific time. Limitations in discovering etiology factors. Hypothesisgenerating studies.
*Person place and time:*
researcher try to identify common characteristics of peoplesuffering from a disease and compare them with common characteristics of people whoare healthy. (eg: age, wealth, health) They look to see if location/ living environment of the ill is a common factor. Researchers also evaluate common time factors. p. 51
Specificity:
extent to which a screening tool can correctly identify those who
don’t
have a disease
 
Sensitivity:
extent to which a screening tool can correctly identify those who
do
havea disease correctly Morbidity & mortality 
Chapter 11 Politics
 
Coalitions:
two or more groups join to maximize resources, thus increasing their impact and improving their chances of success in achieving a common goal. 
Epidemiological transition
: the change in patterns of illness and death from acute tochronic conditions influenced by improvements in a country's economic status. 
WHO
: an international agency of the UN founded after World War II to promotehealth around the world. 
*POLICY* p.187
Public policy refers to decisions made by legislative, executive, or judicial branches at the local, state, or federal levels of government.Compliance by states to
federal program standards
is voluntary, but the advantage of the revenue, which states don’t get if they don’t comply, is generally enough incentiveto have states participate.
Common law
is the body of law derived from judicial decisions rather than fromstatutes or constitutions.CDC Developed, developing, and underdeveloped
Tobacco pandemic
: established in 2003 under the auspices of the World HealthOrganization, it is the first legal instrument designed to reduce tobacco-related deathsand disease around the world. Among its many measures, the treaty requires countriesto impose restrictions on tobacco advertising, sponsorship, and promotion; establishnew packaging and labeling of tobacco products; establish clean indoor air controls;and strengthen legislation to clamp down on tobacco smuggling. 
Political action committee (PAC):
$ often funds lobbyists to go to the legislature.Political action committees are nonpartisan entities that promote the election of candidates believed to be sympathetic to their interests. 
ANA
: writes standards for nursing. Umbrella for state nursing organizations 
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