FOUNDATIONS Nature of Epidemiologic
Approaches
Epidemiology
* The goal of epidemiology is to study
the frequency of occurrence of health-
- The study of factors that affect the
health and cause diseases in related events, majority to the causes
and determinants of disease patterns in
populations.
populations.
- The backbone of disease prevention.
 Systemic investigation can identify
- The systematic study of the distribution causal (contributory) and preventive
factors – an observational science.
patterns and determinants of health,
diseases and conditions in a population
for the purpose of promoting wellness  Does population exposure to X
increases the risk of disease Z?
and preventing diseases or disease-
causing conditions.
 Are dietary supplements (X, Y, Z)
beneficial in lowering the risk of
*The objective is to provide effective
solutions for controlling diseases and disease?
preventive measures to populations that
are at risk. Epidemiologic Classification
Epidemiology  Descriptive – attempts to describe
patterns (tabulations or summaries of
Multiple Causation Theory: polls or surveys) of disease according to
spatial and temporal information about
the members of a population.
 Analytical – attempts to explain and
predict the state of a population’s health.
The goal is to summarize the
Web of Causation: relationship between exposure and
disease incidence by comparing two
measures of disease frequency.
Descriptive vs Analytical
Ecological Triad:
Ecological Triad
Approaches to Epidemiology (use to
analyze and determine factors that
affect rates of a particular disease)
1. Case control studies
– Individuals with and without the
disease of interest are recruited from the
same population, and their prior histories
of exposure to potential causative and
protective factors are compared.
- Relatively short term (2-5 years) -
Less expensive
2. Cohort studies
– Population with known levels of
exposure to potential causative and
protective factors is recruited and
followed over time to determine who
gets and who does not get the disease
of interest.
- Relatively long term (5-20 years) -
More expensive.
Patterns of Disease Occurrence
1. Sporadic – intermittent occurrence or
on-and-off presence of disease.
2. Endemic – continuous or constant
occurrence of a disease in certain area.
3. Epidemic – sudden increase in the
number of cases in short period of time
in certain area.
4. Pandemic – worldwide epidemic or
global outbreak.
Epidemiologic Process
1. Determine the nature, extent and
scope of the problem.
a. Establishing the epidemic – present
prevalence of the disease and incidence
of the disease
b. Appraisal of facts – involves
studying the characteristics of epidemic
in terms of the distribution patterns
involving: Person – demographic data,
Place, Time – onset of outbreak.
2. Formulate hypothesis – collect and
analyze data to test the hypothesis
3. Testing the hypothesis – conducting
a diagnostic exam to prove the source of
the disease.
4. Making conclusion and
recommendations – emphasizing the
significant results of investigation.
5. Plan for control of spread of the
disease by suggesting what can be done
to stop the epidemic.
6. Implement the control program
7. Evaluate the control program
8. Make appropriate report as basis for
diagnostic purposes, preventive or pre-
emptive actions to prevent the
reoccurrence of the same disease or
condition and research activities.
Agriculture and Health
 Population health is strongly
influenced by society and environment.
 Agriculture is one of the social and
environmental determinants of health.
 Agriculture is essential for good health
— it produces the world’s food, fibre,
and materials for shelter, and can
produce medicinal
plants; it is also an important source of
livelihood for many of the poor in
developing countries.
 Agriculture also can lead to poor
health – linked to the main causes of
death and disease — malnutrition,
infectious diseases and chronic
diseases.
 Importance of examining agriculture -
presents not only opportunities for
improving health but also risks to health.
 Bidirectional relationship: agriculture
influences health and health influences
agriculture.
 In agricultural communities, poor
health reduces income and productivity,
further decreasing people’s ability to
address poor health and inhibiting
economic development more broadly,
while in the population at large,
malnutrition and disease patterns
influence market demand for agricultural
products.
Conceptual framework of the links
between agriculture and health
In the other direction, health affects
people’s abilities, needs and desires to
consume different amounts and types of
food, which in turn affects demand from
agricultural systems and the types of
products.
Technology and Health
 Technological developments changes
healthcare dramatically.
 New drugs and treatments, new
devices, new equipment and
machine, new social media support for
healthcare, and etc.
 Technology automates and extends
things that previously had to be done by
people.
 Patients generate huge amounts of
information – patient records– from X-
rays to blood test results. Replacing
paper with computerized summaries
make patient care easier and more
efficient.
years, meaning humans are said to have
a lifespan of 122 years.
 People will have only one life span
while life expectancy changes as you
grow older, and as you face different
risks.
 Many infants and young children in
America used to die due to infections.
High infant and child mortality kept life
expectancy (which is usually expressed
as life expectancy from birth) low until
well into the 20th century, but once
people passed those vulnerable early
years, the life expectancy was much
higher. For instance, the life expectancy
for a female born in 1900 was about 48
years old, but if she reached age 20, her
life expectancy was over 60, and at age
40, her life expectancy was nearly 70.
 We can calculate an average life span
of people in a group if we have birth and
death dates for its members.

Links on agricultural producers  Social media, patient power, mobile

 Link is via income– farmers and
workers earn income from agriculture 
ability to purchase and gain access to
food, water, land and health-related
services  determines their overall
health status.
 Links is via labor – labor affects
energy expenditure and the time
available for child care and food
preparation. Farming exposes producers
to a range of occupational health
hazards.
 Links is via labour – amount and
type of agricultural employment 
migration and the search for alternative
income sources  the spread of and
exposure to disease (e.g., HIV/AIDS)
 Links is via access to health-related
services and food –malnutrition and
poor health  affecting their capacity to
work and generate food and income 
malnutrition and poor health.
health and education stopping people
going to hospital and empowering
people to care for themselves and their
families.
 Healthcare sensors can be readily
bought off the internet, and it is easy for
technically-minded people today to build
sophisticated equipment (to hack) to
collect and analyses any personal or
clinical data using their own computers.
Life Expectancy vs Life Span
Life Expectancy
 refers to the number of years a person
is expected to live, based on the
statistical average.
 statistical average is calculated based
on a population overall, including those
who die shortly during childbirth, shortly
after childbirth, during adolescence or
adulthood, those who die in war and
those who live well into old age.

 Links is via environmental change -  Influenced by factors such as gender,

livestock production animals are
associated with different zoonoses (e.g.,
working with dairy cows and sheep is a
risk factor for brucellosis).  Health 
agricultural systems – poor health 
reduces the ability of producers to
innovate, invest in and operationalize
changes in agricultural systems —
including changes that promote health.
 Major output — (unsafe) food
contaminated during agricultural
production — can carry foodborne
illnesses and affects nutrition.
 Example: pathogens on raw fruits and
vegetables may be the result of irrigation
with inadequately treated wastewater,
and aflatoxins may be present in staple
crops.
race, exposure to pollution, education
status, race, income level and
healthcare access.
 Influenced also by modifiable lifestyle
factors such as exercise, alcohol status,
smoking status and diet.
 Therefore, life expectancy is highly
variable from one individual to another.
Life Span
 refers to the maximum number of
years that a person can potentially
expect to live based on the greatest
number of years anyone from the same
data set has lived.
 Example: the oldest documented age
reached by any living individual is 122