Epidemiology by Leon Gordis

Chapter 1 Reading Guide

Epidemiology: the study of how disease is distributed in populations and the factors that
influence or determine this distribution.
The study of the distribution and determinants of health-related states or events in
specified populations and the application of this study to control of health problems.

5 Objectives of Epidemiology:

1. To identify the etiology or cause of a disease and the relevant risk factors. To
intervene to reduce morbidity and mortality from the disease.
2. To determine the extent of disease fond in the community.
3. To study the natural history and prognosis of disease.
4. To evaluate both existing and newly developed preventive and therapeutic
measures and modes of health care delivery.
5. To provide the foundation for developing public policy relating to environmental
problems, genetic issues, and other considerations regarding disease prevention
and health promotion.

Types of Prevention:
Primary: preventing the initial development of a disease
Secondary: Early detection of existing disease to reduce severity and complications
Tertiary: reducing the impact of the disease

Why is epidemiology important in clinical practice?

The practice of medicine is dependent on population data. The process of diagnosis is
population-based.

Epidemiologic Approach:
The first step is determine whether there is an association exists between expose to a
factor or a characteristic of a person and the development of the disease in question.

Hill’s criteria for causation:

1. Temporality
2. Strength
3. Dose-response relationship
4. Consistency
5. Plausibility
6. Experimental
7. Specific
8. Coherence
9. Alternative Explanation
Epidemiology by Leon Gordis

Using Observations to Improve Public Health

1. Semmelweis & Childbed Fever- noticed that medical students that came in contact
with cadavers and then women, was highly associated with childbed fever. So implemented
a policy that required physicians to wash their hands and brush under their fingernails
after they finished the autopsies and before they came in contact with nay of the patients.

2. Jenner & Smallpox- noticed that milkmaids didn’t catch smallpox because of their
exposure to cowpox. Therefore helped find the vaccine of smallpox, which is a mild form of
cowpox.

3. Snow & Cholera- John Snow was one of the first Epidemiologists, and he showed that
cholera was water-borne, and debunked the (then-popular) Miasma theory.