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CHN2 NCM

Nursing (Cañada College)

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Is the science which deals with the study of the human population’s size, composition and
distribution in space.
NCM 113 CHN 2 Module Content:
Sources of Data
UNIT 2 Health Statistics and Epidemiology  Census is defined as an official and periodic enumeration of population. Demographic,
A. Tools economic and social data are collected from specified population group.
1. Demography
 Sources of Data  Sample Survey . instead of census , demographic information collected from a sample of
 Population Size a given population.
 Composition
 Distribution  Registration system are those that collected by the civil registrar’s office deal with
 recording of vital events in the community. Vital events refer to births, deaths, marriages,
2. Health Indicators divorce and the like. Other registration systems can also be used to describe specific
 crude ]Birth Rate characteristics of the population.
 Crude Death Rate
 Infant Mortality Rate Population Size
 Maternal Mortality Rate Refers to the number of people in a given place or area at a given time.
 Specific Rate of Mortality
 Leading Causes of Morbidity Composition
 Life Expectancy When the population is characterized in relation to certain variables such as age, sex,
occupation or educational level.
B. Philippine Health Situation
1. Demographic Profile Distribution
2. Health Profile It shows how people are distributed in a specific geographic location.

C. Epidemiology and the Nurse

1. Definitions and Related Terms B.PHILIPPINE HEALTH SITUATION
2. Natural Life History of Disease 1. Demographic Profile
3. Epidemiological Triangle 2.Health Profile
4. Epidemiological Process and Investigation

ACTIVITY No. 1 : Interactive Discussion

MODULE 2 LECTURE:DISCUSSION :
Instruction: Please answer the following questions.
UNIT 2 Health Statistics and Epidemiology
 What do you think is the importance of Statistical Epidemiology in community
A. TOOLS health assessment?
Tools in measuring and analyzing community health problems were applied to form part of our  What do you want to learn about statistical Epidemiology?
assessment tools in diagnosis of community health nursing problem.  Prepare your written reaction.
 Search and read for an article about Health Statistics and Epidemiology and
1. Demography prepare for activities 2 and 3.
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 Maternal Mortality Rate

LECTURE DISCUSSION : Measures the risk of dying from causes related to pregnancy, childbirth and
2. HEALTH INDICATORS puerperium. It is an index of the obstetrical care needed and received by women in a
community
The commonly used measures of health status reflects disease and mortality, rather than .
health itself. Total no. Of deaths from maternal causes registered for a given year
MMR =
Mortality rate data are widely used to describe the health status of population. --------------------------------------------------------------------------------------------------x100
Typically period life tables are constructed applying age-specific death rates of a given 0
population for a given year to a hypothetical cohort of 100,000 newborns. Total no. Of live births registered of same year

 Crude Birth Rate  Specific Rate of Mortality

A measure of one characteristic of the natural growth or increase of a population Describes more accurately the risk of exposure of certain classes or groups to
particular diseases. To understand the forces of mortality, the rates should be made
Total no. Of live births registered in a given calendar year specific provided the data are available for both population and the event in their
CBR = ------------------------------------------------------------------------------x1000 specification.
Estimated population of same year
 Leading Causes of Morbidity
 Crude Death Rate Cause Specific Death Rate
A measure of one mortality from all causes which may result in a decrease population.
Measures the no. Of deaths in specific cause registered in a a given year
Total no. of deaths registered in a given calendar year CSDR =
CDR = ------------------------------------------------------------------------------- x 1000 --------------------------------------------------------------------------------------------------x100
Estimated population as of same year 0
Estimated population as of the same year

 Infant Mortality Rate  Life Expectancy

Measures the risk of dying during the 1st year of life. It is a good index of the general
health condition of a community since it reflects the changes in the environment and
medical condition of a community.
Total no. Of death under 1 year of age registered in a given calendar year
IMR =
-----------------------------------------------------------------------------------------------------x1
000 B.PHILIPPINE HEALTH SITUATION
Total no. Of registered live births of same calendar year
is calculated by constructing a life table. A life table incorporates data on age-specific
death rates for the population in question, which requires enumeration data for the number
of people, and the number of deaths at each age for that population.
Life expectancy at birth is the total person-years lived beyond exact age 0 (newborns -
column 5 - Tx) divided by the number of newborns (100,000)
1. Demographic Profile
2.Health Profile

Instruction:

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List down the Health Indicators and explain how you will integrate these in prevention 8. Responsible for inventory and maintenance of epidemiology and surveillance unit (ESU)
and control of disease in the community. Please use the Neo LMS assignment to answer equipment.
this activity.
1. Natural Life History of Disease
C.EPIDEMIOLOGY AND THE NURSE
Describing the natural history of the disease seeks to identify factors related to the course of a
Epidemiology disease once established in order to determine its duration and the probability of the various
- the study of of the occurrence and distribution of health conditions such as disease, possible outcomes such as recovery, death or specific complications.
death, deformities, or disability on human population.
It also concerned with the study of probable factors that influence the development of Understanding the natural history of disease will help institute measure to prevent pathologic
these health conditions. processes from further evolving.

USES OF EPIDEMIOLOGY Stages of Natural History of Disease

 Study the history population and the rise and fall of diseases and changes in their character 1. Prepathogenesis or susceptibility - in this stage, disease has not developed but factors
that favors its occurrence are present
 Diagnose the health of the community and the condition of people to measure the 2. Pathogenesis- disease has developed and has 3 sub- stages:
distribution and dimension of illness in terms of incidence, prevalence, disability and
mortality, to set health problems in perspective and to define their relative importance and A. Pre- symptomatic disease or early pathogenesis - individual has no symptoms that
to identify groups needing special attention. indicate presence of illness.
 Study the work of health services with a view of improving them. Operational research B. Discernible lesions - changes maybe detectable through sophisticated laboratory test, during
shows how community expectations can result in the actual provisions of service. this period the early signs and symptoms of disease are developing.
 Estimate the risk of disease, accident, defects, and the chances of avoiding them.identify
C. Advanced disease - anatomical and functional changes have produced recognizable signs
syndrome by describing the distribution and association of clinical phenomena in the
and symptoms
population.
 Complete the clinical picture of chronic disease and describe their natural history. These stages have relevance to the concept of levels of disease prevention.
LEVELS OF PREVENTION OF HEALTH PROBLEMS
 Search for causes of health and disease by comparing the experience of groups that are
clearly defined by their composition, inheritance, experiences, behavior and environments. 1. Primary Prevention
It is directed to the healthy population, focusing on prevention of emergence of risk factors and
removal of the risk factors or reduction of their levels (specific protection)
FUNCTION OF THE EPIDEMIOLOGY NURSE
2. Secondary Prevention
1. Implement public health surveillance
Aims to identify and treat existing health problems at the earliest possible time.
2. Monitor local health personnel conducting disease surveillance
3. Conduct and/or assist other health personnel in outbreak investigation
3. Tertiary Prevention
4. Assist in the conduct of rapid surveys, and surveillance during disaster
Limits disability progression. Rehabilitation and maintenance of health.
5. Assist in the conduct of surveys, program evaluations, and other epidemiology studies.
6. Assist in the conduct of training course in epidemiology
7. Assist the epidemiologist in preparing the annual report and financial plan
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DISTRIBUTION-Describes the distribution of health status in terms of gender, race,

geography, time and so on might be considered in an expansion of the discipline of
demography to health and disease.

3.Epidemiological Triangle DETERMINANTS-Involves explanation of the patterns of disease distribution in terms of

causal factors.
Components of Epidemiological Triangle
EPIDEMIOLOGICAL STUDIES
Agent is the intrinsic property of microorganism to survive and multiply in the environment to The purpose of an analytic study in epidemiology is to identify and quantify the relationship
produce disease. between an exposure and a health outcome. The hallmark of such a study is the presence of at
least two groups, one of which serves as a comparison group.
Causative agent is the infectious agent or its toxic component that is transmitted from the
source of infection to the susceptible body CATEGORIES
Host is any organism that harbors and provides nourishment for another organism. EXPERIMENTAL STUDIES In an experimental study, the investigator determines the
exposure for the study subjects;
OBSERVATIONAL STUDIES in an observational study, the subjects are exposed under
Environment
-is the sum total of all external condition and influences that affects the development of an more natural conditions.
organism which can be biological, social and physical. It affects both the agent and the host.  Observational cohort study
-For example, the temperature in a given location might affect an agent’s ability to thrive, as
might the quality of drinking water or the accessibility of adequate medical facilities. subjects are enrolled or grouped on the basis of their exposure, then are followed to document
occurrence of disease. Differences in disease rates between the exposed and unexposed groups
Three components of the Environment lead investigators to conclude that exposure is associated with disease
1. Physical environment is composed of the inanimate surroundings such as the  Observational case-control study,
geophysical conditions of the climate. subjects are enrolled according to whether they have the disease or not, then are questioned or
tested to determine their prior exposure. Differences in exposure prevalence between the case
2. Biological environment makes up the living things around us such as plants and animal and control groups allow investigators to conclude that the exposure is associated with the
life. disease.
3. . Socio-economic environment which maybe in the form of level of economic  Cross-sectional studies
development of the community. measure exposure and disease status at the same time, and are better suited to descriptive
epidemiology than causation.
4. Epidemiological Process and Investigation  Approach to disease and Determinants
The present epidemiology approach is based on the interaction of the causative agent and the
2 MAIN AREAS OF INVESTIGATION environment. Essentially , epidemiology patterns depend upon these factors which influence
 The study of the distribution of diseases the probability of contact between an infectious agent and susceptible host.

 The search for determinants (causes) of disease and it's observed distributions
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 Disease distribution Tuberculosis is endemic in all specific areas of the country.

The method and technique of epidemiology are desired to detect the cause of a disease in
relation to the characteristic of the person who has it or to a factor present in his environment.
Since neither population and environment of different times or places are similar, these
characteristics and factors are called epidemiologic variables.
these variables are studied since they determine the individuals and populations at greatest risks
of acquiring particular disease, and knowledge of these association may have predictive value.
For the purpose of analyzing epidemiology data , it has been found helpful to organize that data
according to the valuables of:
TIME
refers both to the period during which the cases of disease being studied were exposed to the
source of infection and the period during which the illness occurred.
PERSON
refer to the characteristics of the individual who were exposed and who contacted the infection
of the disease in question.
EPIDEMIC OCCURRENCE
-is of unusually large number of cases in a relatively short period of time.
-Bird’s flu, there has been no case in any area of the country, the occurrence of few cases in a
given area in a given time would constitute a bird’s flu epidemic.
PANDEMIC OCCURRENCE
is the simultaneous occurrence of epidemic of the same disease in several countries. It is
another pattern of occurrence from an international persperctive.
Corona Virus has been existed and with diffrent pattern of occurrence in the present as we
call it now COVID-19
Instruction:
 Share and discuss with your classmates the ideas on Philippine Health Status and the
importance of epidemiology in the role of the nurse in protecting the public health.
 Please use the Neo LMS assignment to answer this activity.

PLACE
-refers to the features, factor or conditions which existed in or described the environment in
which the diseases occurred.
-Urban/ Rural Differences: diseases spread more rapid in urban areas than in rural areas
primarily because of the greater population.

Patterns of Occurrences and Distribution

The variables of disease as to person, time and place are reflected in distinct patterns of
occurrence and distribution in given community.

The following are the characteristic of patterns of disease occurrence;

SPORADIC OCCURRENCE
-Intermittent occurrence of a few isolated and unrelated cases in a given locality.
-The cases are few and scattered, not related, occur on and off, intermittently
Rabies occurs sporadically in the Philippines, he cases are scattered throughout the country, so
that the cases are not related at all to the cases in other areas.

ENDEMIC OCCURRENCE
-is the continuous occurrence throughout a period of time, of the usual number of cases in a
given locality.
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