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PUBH 4040 > 2: Practical Applications of Epidemiology > Flashcards

2: Practical Applications of Epidemiology Flashcards

1
Q

Seven Uses of Epidemiology

A
  1. to study the HISTORY of the health of populations
  2. to DIAGNOSE the health of the community
  3. to study the working of health services-OPERATIONS RESEARCH
  4. to estimate the INDIVIDUAL RISKS of disease and other conditions, and the chances of avoiding them
  5. to IDENTIFY SYNDROMES
  6. to complete the CLINICAL PICTURE of chronic diseases
  7. to SEARCH FOR CAUSES of health and disease
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2
Q

Historical Use of Epidemiology

A

refers to the study of past and future trends in health and illness. EX. secular trends

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3
Q

Secular Trends

A

changes in disease frequency over time

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4
Q

factors affecting reliability of observed changes over time

A
  1. lack of comparability over time due to altered diagnostic criteria
  2. aging of the general population
  3. changes in the fatal course of the condition
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5
Q

trends that reduce reliability of morbidity and mortality

A
  1. New Epidemic Disorders
  2. Persisting Disorders
  3. Residual Disorders
  4. Disappearing Disorders
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6
Q
  1. New Epidemic Disorders
A

Disease that are increasing in frequency.

-HIV, Type 2 Diabetes, Asthma, Obesity

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7
Q
  1. Persisting Disorders
A

Diseases for which there is no effective method of prevention or no known cure.
-cancer, mental disorders

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8
Q
  1. Residual Disorders
A

Conditions for which the key contributing factors are largely known. Methods of control not implemented effectively.
-STDs, alcohol abuse, tobacco use

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9
Q
  1. Disappearing Disorders
A

Conditions that were one common but are no longer present in epidemic form. Immunizations, sanitary conditions, antibiotics, etc. led to eradication of these diseases.
-smallpox, polio, measles

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10
Q

Syphilis

A
  • Bacterial STD, only human->human
  • treated with antibiotics
  • 80% asymptomatic
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11
Q

Tuberculosis

A

-Bacterial, airborne and respiratory transmission

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12
Q

Polio

A
  • Virus

- food, water, fecal & oral transmission

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13
Q

three factors that affect size of populations

A
  1. births
  2. deaths
  3. migration
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14
Q

population equilibrium

A

when births, deaths, or migration don’t contribute to net increases or decreases

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15
Q

Fixed Population

A

adds no new members and, as a result, decreases in size due to deaths only

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16
Q

Dynamic Population

A

adds new members through migration and births or loses members through emigration and deaths

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17
Q

Demographic Transition

A

shift from high birth and death rates found in agrarian societies to lower birth and death rates found in developed countries

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18
Q

Epidemiologic Transition

A

shift in the pattern of morbidity and mortality from infectious and communicable diseases to chronic, degenerative diseases.

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19
Q

Steady Population

A

close to equilibrium

20
Q

Variables Related to Community Infrastructure

A
  1. availability of social and health services
  2. quality of housing stock (apartments vs. homes)
  3. social stability (residential mobility, employment opportunities)
21
Q

Health-Related Outcome Variables

A
  1. Homicide and Suicide rates
  2. Infant Mortality rate
  3. Selected Mortality rates
  4. Drug and Alcohol Abuse rates
  5. Teen Pregnancy rates
  6. Birth rate
22
Q

Health People 2020

A
  1. Achieve health equity, eliminate disparities, and improve health of all groups
  2. Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death
  3. Create social and physical environments that promote good health for all
  4. Promote quality of life, health development, and healthy behaviors across all stages of life
23
Q

Gini Index

A

income inequality. Ranges from 0 (equal) - 1 (high inequality)

24
Q

Disparities

A

differences

25
Q

Operations Research

A

the study of the placement and optimum utilization of health services in a community

26
Q

Program Evaluation

A

uses epidemiologic tools to determine how well a health program meets certain stated goals

27
Q

Causality in epidemiologic research

A
  1. research is subject of criticism
  2. many conflicting studies
  3. Henle-Koch postulates not relevant to many contemporary diseases
  4. multivariate causality
28
Q

How are Henle-Koch postulates not relevant to many contemporary diseases?

A
  1. “Agent present in every disease” vs. chronic diseases
  2. “One agent-one disease” vs. CVD
  3. “Exposure of healthy subjects to suspected agents” vs. smoker never gets lung cancer
29
Q

Rick Factors definition

A

exposure that is associated with a disease

30
Q

Three Criteria for Risk Factors

A
  1. Frequency of disease varies by category or value of factor
  2. Risk factor precedes onset of disease
  3. Observation must not be due to error
31
Q

Modern concepts of causality

A
  1. Strength of association
  2. Consistency upon repetition
  3. Specificity (miners vs. black lung)
  4. Time sequence
  5. Biologic gradient (dose-response relationship)
  6. Plausibility
  7. Coherence of explanation
  8. Experiment (natural experiments)
  9. Analogy (similar associations)
32
Q

Case-Control Study design

A
  • compares persons with disease (cases) with those who are free of the disease (controls)
  • explores whether differences between groups result from exposures to risk factors
33
Q

Case-Control Study examples

A
  • cell phone use and brain cancer

- high HPV load and potential for cervical cancer

34
Q

Cohort Study design

A

group (cohort) of people free from a disease is assembled according to a variety of exposures and is followed over a period of time for development of disease, health risks, or behaviors.

35
Q

considerations that determine a study’s influence

A
  1. criteria of causality
  2. relevance to each patient (size of risk)
  3. public health implications (individual vs. population)
36
Q

Prevention of Disease

A

epidemiological research is applied to identify where ina disease’s natural history effective intervention might be implemented

37
Q

Natural History of Disease

A

refers to the course of disease from its beginning to its final clinical end points

38
Q

Prepathogenesis

A

before agent reacts with host

39
Q

Pathogenesis

A

after agent reacts with host

40
Q

Clinical End Points

A

recovery, disability, or death

41
Q

Primary Prevention

A
  • occurs during prepathogenesis
  • includes health promotion, education and specific protection against diseases
  • active vs. passive
42
Q

Active Primary Prevention

A

necessitates behavior change on the part of the subject. EX. vaccinations and wearing protective devices

43
Q

Passive Primary Prevention

A

does not require any behavior change. EX. fluoridation of public water and vitamin fortifications of milk and bread products

44
Q

Secondary Preventioin

A

-occurs during pathogenesis
-designed to reduce the progress of disease
EX. cancer and diabetes screening programs, Plan B for pregnant teens

45
Q

Tertiary Prevention

A
  • designed to limit disability from disease

- also directed at rehabilitation

PUBH 4040 (12 decks)

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