COLEGIO SAN AGUSTIN-BACOLOD

COLLEGE OF HEALTH AND ALLIED PROGRAMS (CHAP)

MEDICAL TECHNOLOGY PROGRAM

MSTAT 100

BASICS OF
EPIDEMIOLOGY

An Introduction
Part 2

MS. DESIREE D. DIEL, RN,MAN

MSTAT 100 INSTRUCTOR
USES

According to Epidemiologist J.LN. MORRIS who published the list

of 7 principal uses of Epidemiology
° HISTORICAL USE

° COMMUNITY DIAGNOSIS
® HEALTH SERVICE USE

° RISK ASSESSMENT

® DISEASE CAUSALITY USE

re

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LI HISTORICAL USE

™ study the history of the health of population’.

= documents the patterns, types and causes of

morbidity and mortality

™ since 1900s, developed countries mortality

shifted from infectious disease to
communicable to chronic conditions

e.g. 1918-Sp anish Flu

I1980—HIV

2005—heart disease, cancer and stroke increasing

EPIDEMIOLOGIC TRANSITION

-shift in the patterns of morbidity and mortality overtime

related to infectious and communicable diseases to
chronic and degenerative diseases

DEMOGRAPHIC TRANSITION
- shift from high birth rates and death rates
STAGE OF EPIDEMIOLOGIC TRANSITION

PESTILENCE & FAMINE RECEDING PANDEMICS DEGENERATIVE & MAN- DELAYED DEGENERATIVE
Te MADE DISEASES DISEASES & EMERGING
— INFECTIONS (HYBRISTIC}
CRUDE BIRTH
RATE
NATURAL
CAUSES
CRUDE DEATH
NS CS
STAGE OF DEMOGRAPHIC TRANSITION
PRE EARLY LATE POST

SOURCE: Reprinted trom Roskett IRH. Population and Health: An Introduction to

Epidemiology,” 2ns ed., Population Bulletin, vol. 54, no. 4, p. 9. Washington,
D.C: Population Reference Bureau, December 1999, Reprinted with permission of
Population Reterence Bureau.
_] COMMUNITY DIAGNOSIS

™ diagnose the health of the community and the condition of

the people

“= measure the dimensions and distribution of ill-health in terms

of incidence, prevalence, disability and mortality

= set health problems in perspective and define their relative

importance

“identify groups needing special attention

Characteristics of a community
“age

“sex distribution

“racial/ethnic makeup
“socioeconomic status

“employment & unemployment rates

“access to healthcare services
“population density

“residential mobility
Outcomes of the characteristics

“life expectancy
“social conditions

“patterns of morbidity and mortality

Ee

irr
LJ HEALTH SERVICE USE

° ASSESSMENT, EVALUATION AND

RESEARCH

° OPERATIONAL RESEARCH- study of the

placement of health services ina
community and the optimum utilization of
such services
HEALTH SERVICE USE (con'‘t...)

* cost issues vs. quality of services delivered

to maximize cost effectiveness

* relevant through disease management

(reducing healthcare costs by providing
integrated care for chronic conditions e.g.
heart disease, DM and HPN)
LJ RISK ASSESSMENT

* estimate the individuals’ risks of

disease, accident, or defect and the
chances of avoiding them
RISK ASSESSMENT (con'’t...)

RISK — probability that an event will occur

RISK FACTOR- an exposure that is. associated with a

disease, morbidity, mortality or adverse health outcome

® E.g. cigarette smoking increases risk in developing lung cancer

RISK ASSESSMENT- quantitative measurement of

risks through EPI studies
_] DISEASE CAUSALITY USE

Osearch for causes of health, diseases and other health outcomes---

important uses of EPI

> Epidemiologists quantify health outcomes by using statistics,

formulate hypotheses, and explore causal relationships
between exposures and health outcomes

Ocompute the experience of groups defined by their composition,

inheritance and experience, their behaviors and environments
Special concern is CAUSALITY (associations or cause-&-effect
associations)

E.g.
contaminated food such as tomatoes caused an outbreak of
Gl disease
Water/street food (kwek-kwek) caused the spread of
amoeba disease
Cigarette smoking among teenagers subsequently develops
lung cancer in later years
Special concern of the EPI is CAUSALITY (associations or cause-&-effect
associations)
E.g.
Consumption of high-level sugar diet can develop diabetes type 2
Absentee parenting can develop delinquent behaviors among
children
What are the characteristics of bullies and bullied students in a
JHS?
What interventions will be effective in preventing bullying incidents
in school?
APPLICATION OF EPI

OHealth education
OHealth promotion, prevention
OHealth care administration
OTropical medicine
OEnvironmental health
TRIANGLE OF EPIDEMIOLOGY

(BASIC & USED INCOMMUNICABLE DISEASE)

y N
AGENT

"cause of the disease

e.g biological -microorganisms (infectious disease)

chemical — petroleum, acid (burn)
conditions- accidents (injuries, fall)

physical — radiation, heat (burn)

MTT eT at i t ee
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® An organism, usually human or an animal, that ha: vuis a

disease

® May or may not get the disease

* Provides sustenance and lodging for the pathogen

PATHOGEN- disease-causing microorganisms or related disease

ENVIRONMENT

* favorable surroundings and conditions external to

the human or animal (host) that cause or allow
disease transmission

® this includes:
* biological
© cultural

* physical
TIME

Incubation periods, life expectancy of the host or the

pathogen , and the duration of the course of the disease

Inlcudes:

severity of illness- in relation to period of illness, towards

recovery or death

delays in time from infection to symptoms, duration and

threshold of an epidemic ina population (epidemic curve)
ADVANCED TRIANGLE OF EPIDEMIOLOGY

CAUSATIVE
FACTORS . faa

GROUPS OR POPULATIONS & ne cNAVIOR

THEIR CHARACTERISTICS CULTURE

PHYSIOLOGICAL FACTORS
HOST ECOLOGICAL ELEMENTS
EPIDEMIOLOGIST’s GOAL:

BREAK ONE of the 4 ELEMENTS

to
BREAK the spread of an OUTBREAK

.
HOW ? PP

ROCESSING...

*ALTER
°*CHANGE
*REMOVE
EPI AS A LIBERAL ARTS

> Interdisciplinary science

OMathematics and biostatistics - quantitative body

OHistory- historical accounts of the disease and early epi

® methods/studies

OSociology - social determinants of disease

EPI AS A LIBERAL ARTS

> INTERDISCIPLINARY SCIENCE

ODemography & geography - population structures and

location of disease
© Outbreaks

OBehavioral sciences —__- model of disease; design of health

promotion
° Programs

O Law - examining evidences to establish causality;

® legal basis for health policy
SKILLS ACQUIRED THROUGH
TRAINING IN EPI

° Use Scientific Method

* Enhancement of Critical Thinking

° Use of Quantitative and Computer Methods

°* COMMUNICATION SKILLS

* basic requirement in order to effectively communicate

the epidemiological data that will help a society be:

v educated

Y control diseases/implement interventions

Y craft policy

aeraltate actions

GOAL: all to improve the health status of a

population
® Inculcation of Aesthetic values

* Appreciation of epi history and previous studies

that will enrich the literature and understanding in
resolving present issue/s
ETHICS IN EPIDEMIOLOGY

L] Minimizing risks and protecting the welfare of research

subjects

_) Obtaining the informed consent of participants

_) Submitting proposed studies for ethical review
__) Maintaining public trust

LL] Meeting obligations to communities