1st SEMESTER | 2022-2023
LESSON 7: HISTORY OF EPIDEMIOLOGY & PUBLIC HEALTH
LECTURER: Mr. Junjie Zuasula, MD, PHSAE, CTTS
TOPIC OUTLINE
EPIDEMIOLOGY
PUBLIC HEALTH
EPIDEMIOLOGIC METHODOLOGIES
OBJECTIVES OF EPIDEMIOLOGY
USES OF EPIDEMIOLOGY
BRANCHES OF EPIDEMIOLOGY
EPIDEMIOLOGY
➢ The word “epidemiology” has its roots in
the Greek language. Sylabically:
o epi = upon / around /
surrounding (as in “epidermis”)
o demos = the people (as in
“democracy”)
o logy = “to speak of,” “to study”
What is Epidemiology?
➢ According to WHO, Epidemiology is the
study of the distribution and
determinants of health-related states or
events (incl. disease), and the
application of this study to the control of
such events/diseases and other health
problems.
➢ According to Dr. John Last, it is the study
of the distribution and determinants of
health-related states or events in a
specific population and the application
of this study to the control of health
problems.
➢ You can see that there is a very subtle
difference. In Dr. Last’s definition, he
added another element and that is
“who are being affected” which would
be the specific population. Dr. Last’s
definition is much more comprehensive
because it is important to identify the
individuals or the population that is
being affected or where those health
events are occurring.
TAGUIBAO | BSMT 2D
OCTOBER 24, 2022
PUBLIC HEALTH
What is Health?
➢ There is no single definition of health.
➢ The standard definition though is the
absence of disease.
➢ WHO definition: Health is the physical,
mental, and social well-being, not
merely the absence of disease. You
have several dimensions of health which
is the physical, mental and the social
dimensions. If you are healthy and not
sick along these dimensions, most likely
you are in good health.
➢ As a cornerstone of public health and
medicine, epidemiology is a very
important pillar. Without epidemiology,
public health programs will never exist
as an organization.
What is Public Health?
➢ According to Winslow, it is the science
and art of preventing disease,
prolonging life and promoting health
through organized efforts and informed
choices of society, organizations, public
and private, communities and
individuals. it is concerned with threats to
health based on population health
analysis.
➢ It is very important to remember in this
definition that public health is an
organized effort and that it is not
bestowed in the society. You have to
ask the people in the community
whether they would prefer such an
intervention or not and if so, what would
be their choice/s. They need to be
informed of their choices and as to what
is going to happen especially in this day
and age, safety and security of data is
concerned. With all the research going
on, you have to have informed consent.
➢ There are several core disciplines in
public health which comprise of several
public health practice:
 o Epidemiology and Biostatistics –
backbone of public health
o Health administration
o Behavioral sciences
o Environmental health sciences
OBJECTIVES OF EPIDEMIOLOGY
EPIDEMIOLOGIC METHODOLOGIES
➢ There are several reasons why we study
➢ In order to provide evidence, there are
several methods that we need to use
under epidemiology. We have:
1. DESCRIPTIVE STUDIES
- Can be used to study the
distribution of health-related
events
- E.g., disease surveillance,
surveys
- All you have to do is gather data
and provide descriptive
summaries of the data like the
proportion of males, proportion
of females, gender distribution,
age-group distribution,
measure of central tendency
for quantitative variables, and
the proportion of responses if
ever you are doing surveys.
- This kind of methodology
provide data on WHAT (the
disease, illness, sickness) is
being studied, WHO (person,
gender) are being studied,
WHERE (residence) they are
located, WHEN (time) they are
being studied. The most
important among the four is the
who, where, and when which
are called “epidemiologic
variables.”
2. ANALYTICAL STUDIES
- If you analyze groups or analyze
further the data from the
descriptive studies, then you
conduct this kind of study.
- This takes care of knowing the
determinants of health-related
events.
- In this area, you may want to
conduct comparisons between
the groups who felt ill
compared to those who did not
TAGUIBAO | BSMT 2D
get sick, then quantify their risk
factors to know this risk factor is
a determinant of that particular
health event.
epidemiology:
o Identify the cause / etiology of
a disease and the relevant risk
factors – when we say
“relevant risk factors” this is
where the epidemiological
determinants will come through
based on the definition.
o Determine the extent of the
health event found in the
community – how large is the
geographical area that is being
affected by a certain health
event? What is the number of
cities that has a greater number
of cases?
o Study the natural history and
prognosis of the disease – this is
important if you are a clinician
where you want to know
whether your patient is
improving or not in order for you
to decide whether you need to
do more test or if its already the
endgame. If you are an
epidemiologist, it will tell you
whether the particular outbreak
of a certain contagion can be
transmitted through airborne, or
if that disease entity has lifetime
immunity or not and there is a
challenge of being reinfected
naturally.
o Evaluate both existing and
newly developed preventive
and therapeutic measures – in
the COVID-19, once we start
randomize clinical trials in the
community, we will now be
able to measure how effective
the vaccine is in terms of the
vaccine efficacy.
 o Provide foundation for
developing public policies
relating to environmental
problems, genetic issues and
other considerations regarding
disease prevention and health
promotion.

USES OF EPIDEMIOLOGY
o Historical study of community health – in
relation to the determinants of health
o Estimating the risk and chances of
“As you can see in the X-axis, that is the time
getting ill
expressed in years of smoking. And in the Y-axis,
o Measure effectiveness of health services
you have your measure of the risk specifically
– if you want to know how effective the
the relative risk. In this graph, the exposure is
vaccine of the particular viral disease is
smoking specifically the number of years a
after doing a community campaign
person is smoking among men. And the
o Completing the clinical picture of a
outcome is lung cancer. There are three lines
disease – if you are a medical
shown in the graph: light blue, navy blue, and
professional training in the medical field,
dark blue. The light blue represents those who
then you will conduct case series or
have been smoking atleast 20 cigarette sticks a
case report and discuss the case
day, the navy blue is >20 cigarette sticks a day,
thoroughly and somehow complete a
and the dark blue is those men smoking <10
clinical picture of a particular disease.
cigrette sticks a day. Regardless of how many
o To identify new syndromes / diseases –
sticks a man is smoking, it will still increase his risk
for example is the way we discovered
of dying from lung cancer. But more so, if that
this pandemic. It is due to a new novel
person smokes >20 sticks a day compared to
Coronavirus, another addition to the
those <20 sticks, the risk of dying from cancer is
huge family of Coronavirus.
MORE, with 40 as the risk compared to those
o Search for causes (paramount for
smoking less. Biostatistics is used to compute for
prevention) – in relation to the
the relative risk. Epidemiology comes in to
prevention of a particular disease
interpret the data and somehow interpolate it to
the population.”

“As you can see among Nunavut men, have

higher lung cancer incidents compared to other
lifestyle related diseases and this is followed by
Canadian Men, etc. If you have noticed, lung
cancer tops circulatory disease in the Nunavut

TAGUIBAO | BSMT 2D
tribe in general. Whereas circulatory disease
tops other lifestyle related mortalities in Canada.
The risk of dying is expressed as the rate of
mortality per 100,000 population.”
“In the US, 443,000 deaths were studied and most
of the deaths were attributable to either lung
cancer, followed by ischemic heart disease
which is then followed by COPD. This is a pie
chart, and each of the wedge is a portion of the
whole which is 100%.”
“Among African men, it tops all other races in
terms of cancer death rate which is around 295.3
per 100,000 population. Regardless, in totality,
comparing it to white men, Asian/pacific
islander, African American women tops cancer
deaths as well with 177.7 per 100,000
population.”
TAGUIBAO | BSMT 2D
“This is fresh data of our COVID situation here in
Region 7. This is our epidemic curve of VSMMC
from the early stages of the pandemic, the left to
Sep 8. It is still not confident enough that we have
flattened the curve. We have 1,636 confirmed
COVID cases in VSMMC and of which we have
358 deaths so far. This is cumulative data which
is part of descriptive epidemiology. Who are
being affected? The community. What is being
described? The confirmed COVID-19 patients
admitted in VSMMC from March to Sep.”
“This is another descriptive epidemiology. As you
can see, we have decreasing trend of positivity
rate. The positivity rate is computed as the
number of tests positive swabs submitted to the
molecular lab. The blue bars represents the daily
tests done and the red bars represents the daily
positive tests then we compute the daily
positivity rate which is the number of swabs
positive over the total number of swabs tested
multiplied to 100.”
 BRANCHES OF EPIDEMIOLOGY
➢ There are several branches of
epidemiology:

1. FIELD EPIDEMIOLOGY
- Investigate outbreaks,
pandemics, epidemics.
- Doing surveys, observational
studies, monitor and evaluate
public health interventions and
somehow influence the
creation and development of
public health policies.
- This is basically RESEARCH.
- As a field epidemiologist, you
should have a very good
background in medicine.
2. CLINICAL EPIDEMIOLOGY
- Deals with drug trials, evidence
based-practice, drug
effectiveness and efficacy,
diagnostic and therapeutic
decisions
3. OCCUPATIONAL EPIDEMIOLOGY
- Deals with ergonomics,
incidence of health events in
the workplace
- Deals with huge corporation
such as a manufacturing
institution, a company, etc.
4. ENVIRONMENTAL EPIDEMIOLOGY
- Deals with climate change,
exposure to toxic substances in
the water, air, soil, and perhaps
intervening public health
policies.
➢ Being an epidemiologist, you have to
deal with all these different branches. He
or She should have a good grasp of all
these sub-specialties in epidemiology.

TAGUIBAO | BSMT 2D