M1 Introduction to Epidemiology
At this point of time, our world is on a state of
health crisis as Covid-19 continue to spread and
mutate. This pandemic situation has caused us
so many problems such and as social and
economic disruptions that caused school
interruptions and millions of people to be in
extreme poverty and not to mention the tragic
way of losing lives. Covid-19 is just an example
of what can be under study in epidemiology.
Epidemiology is a unique science of high
importance that is observational in nature and
aims to understand the risk factors to control
and prevent diseases or conditions that affects
humanity.
A. Definition
Epidemiology is the study of the distribution
(who has the problem) and determinants
(things that influence the problem) of health-
related conditions in human populations and
the application of this method to the control of
health problems. Also defined as the study of
the distribution of health and disease in groups
of people and the study of the factors that
influence this distribution. As a scientific term,
epidemiology was introduced in the 19th
century, derived from three Greek roots: epi,
meaning “upon or among”; demos, “people”
or “population” and logos, “discussion” or
“study.”
Epidemiology deals with much more than the
study of epidemics, in which a disease spreads
quickly or extensively, leading to more cases
than normally seen. Epidemiology provides
methods to study disease, injury, and clinical
practice. It is the study of a scientific method of
problem solving that helps “disease detectives”
understand how people get sick and die, who
gets sick and dies, and how to avoid getting sick.
Epidemiology is a basic medical science with the
goal of improving the health of populations.
B. Uses
 Investigates the causes of
communicable disease which can
lead to identification of preventive
methods
 Describes the health status of the
population
 Evaluation of intervention
 Used to answer a number of
questions related to health
problems in human populations
 Used to describe disease
occurrence and to identify the
cause s of disease and find factors
that increase a person’s risk of
disease
 Used to describe the extent of
disease in a population and the
natural history (the course of
disease if left untreated) and
characteristics of a disease, as well
as to evaluate preventive measures
and guide policy decisions.
 Can be used to tract trends (how
many people have a particular
disease over time)
 Help understand trends in disease
or health-related states
 Establish risk factors that are
nonmodifiable and modifiable.
Identify modifiable risk factors that
can be changed and that will lead to
prevention programs designed to
control the disease.
 We can determine the health of a
community by counting the number
of people with specific diseases or
poor health habits who live in that
area
 To understand the causes of
disease
 To monitor the health status of a
population and search for risk
factors that can be modified to
improve the health status of a
population
C. Historical Milestones
Edward Jenner (1749 – 1823) – developed a
vaccine against smallpox using cow pox 160s
years before the virus was identified.
John Snow (1813 – 1858) – described the
association between dirty water and cholera 44
years before the suspect bacterium, Vibrio
cholerae, was identified.
Ignaz Semmelweis (1818 – 1865) – described
the association between childbed fever, a life-
threatening infection contracted by a woman
during or shortly after childbirth, and
physicians’ unclean hands 32 years before a
causal agent was discovered.
James Lind (1716 – 1794) – conducted an
experiment showing that scurvy, a disease
common among sailors on long voyages with no
access to fresh fruits or vegetables, could be
treated and prevented with limes, lemons and
oranges 175 years before ascorbic acid was
discovered.
Joseph Goldberger (1874 – 1927) – in 1915 he
proved that pellagra, a disease characterized by
diarrhea, dermatitis, dementia and death, was
not infectious but nutritional in origin and could
be prevented by increasing the amount animal
products in the diet and by substituting oatmeal
for corn grits. This finding occurred 10 years
before the cause of pellagra, a deficiency of
Vitamin B3 or niacin, was discovered.
D. Specialties in Epidemiology:
Chronic Disease – studies the occurrence and
risk factors for disease such as cancer, heart
disease and diabetes that are slow to develop
but span many years.
Behavioral – studies lifestyle factors that may
be associated with disease status; examples
include smoking, lack of physical activity, poor
diet.
Environmental – studies the effect of
environment on human health; can
subspecialize in water quality, air pollution,
chemical exposures, radiation and others.
Forensic – studies the joint integration of law
enforcement functions and public health in
criminal contexts (ex: bioterrorism)
Genetic - studies the role of genetics in disease
development, can include infectious or chronic
diseases.
Infectious Disease – studies diseases that are
acute and contagious, can include long lasting
diseases that are transmissible
Injury – studies the distribution and risk factors
for injuries, either accidental or intentional.
Perinatal – studies health problems of
newborns.
Reproductive Health – studies normal
reproductive processes and problems that can
occur, including infertility, birth defects and low
birth weight.
Social Epidemiology – studies the effect of
community socioeconomic factors on health.
Violence – studies the effect of violence on
health
M1 Lesson 1 Epidemiology - Part 3
E. Measuring Disease and Exposure Occurrence
Simply means counting, wherein we should
know what to count and how to use the
numbers counted. Counting is the means of
measuring disease or exposure occurrence. In
counting it is paramount to define clearly the
terms or concepts that is important for the
study. Under case concepts, the following
terms are significant in any epidemiological
studies.
Case - a case is a person in the population or
study group identified as having the particular
disease, health disorder or condition under
investigation
Case definition - is the characteristics or
condition of an individual who will be
considered a case for the purposes of
surveillance or research. This needs to be
established before data collection and rigidly
followed.
Suspect case - a subject who meets all the
characteristics and symptoms of a case but does
not have formal diagnosis.
Case severity - a measure of adverse events
resulting from the disease that can be identified
by measuring results such as length of hospital
stay, number of follow-up visits, recovery time,
disability or death.
Under the disease stages, it is crucial to
recognize diseases if they are acute or chronic.
As long as the investigator knows the correct
signs and symptoms and laboratory results for a
disease, it is relatively easy to count clinical
disease occurrence. In exposure occurrence,
counting is equally dependent on a clear and
good definitions of the characteristics that will
be classified as exposure and criteria for
measurement.
Counting of the exposures and occurrence
of disease is referred to as the numerator
data and more important is the denominator or
population size, which is the group of subjects
or populations from where the numerator
comes, or the number of subjects in the study.
As a rule, the denominator should be the
population or group from where the cases (or
numerator) came from.
One way of evaluating the health of a
population is by measuring
the morbidity information in which diseases are
classified as existing or new. In epidemiology,
we refer to existing cases of disease
as prevalence and to new cases of disease
as incidence.
A prevalence proportion is the number of
existing cases of disease at a given time divided
by the observed population in the same time
period.
. Number of existing cases
(all cases - new & old) . X 100
Total observed
population at a particular time period
An incidence rate is the number of new
cases of disease in a given time (usually one
year) divided by the population "at risk" to
develop the disease over that same time.
 . Number of new cases of
disease in time period . X 100

Population at risk of the

same disease in same period

These measurements are important

because it can help in the investigation of
patterns of occurrence of diseases. It can help
determine the health of the population for
allocation of resources and health care services,
and to find out the impact of disease on the
economy and the population.

Assignment: Read Chapter 8 of Biostatistics

and Epidemiology by Heather M. Bush,
Caroline A. Macera, Richard Shaffer and Peggy
Shaffer

M1 Lesson 2 Ethic in Epidemiology

Please read the lesson in the role of ethics in

epidemiology by clicking the link below

https://www.healthknowledge.org.uk/public-
health-textbook/research-methods/1a-
epidemiology/ethics-etiquette-epidemiology-
research#:~:text=One%20of%20the%20most
%20basic,part%20gain%20no%20personal
%20benefit (Links to an external site.).
https://www.acepidemiology.org/ethics-
guidelines (Links to an external site.)

By: Dr. Joann Joven

Additional Reading:

https://www.wma.net/policies-post/wma-
declaration-of-helsinki-ethical-principles-for-
medical-research-involving-human-subjects/ (Li
nks to an external site.)

https://edition.cnn.com/2019/10/30/health/
swedish-cavity-experiment-wellness/index.html