CPHM Flashcards
statistical study of human population
demography
method to orderly processes of data collection, organization, presentation, interpretation
statistics
quantitative data, collected in order to measure something
data
branches of statistics
descriptive and inferential
classification of statistical data (4)
demographic, health status, health resources, health related socio economic environmental factors
classification of SD,POPULATION Size, age, sex, mortality, morbidity, growth rate
demographic
CLASSIFICATION OF SD, causes and distribution of mortality and morbidity as to residence, age, sex
health status
CLASSIFICATION OF SD, number and distribution of health facilities, manpower, health expidentures
health resources
CLASSIFICATION OF SD, water supply, excreta disposal, school enrolment, food establishment, transports, food intake habits
health related socio economic environmental factors
the science of __ lies on statistics
epidemiology
proportion if the quotient of sum of 2 numbers
ratio
ratio involving a time period, count or measurement is observed over a period and then divided
by its base or population of observation.
rate
measures the frequency of occurrence of the phenomenon during a
given period of time. Deals only with NEW cases.
incidence rate
•Measures the proportion of the population which exhibits a
particular disease at a particular time.
•This can only be determined following a survey of the population
concerned.
•Deals with total (OLD and NEW) number of cases
prevalence rate
•Also known as attack rate, case, sickness rate morbidity rate
•It refers to newly discovered cases of a particular disease
•It answers the question “how frequent do cases of a particular
disease occur during a given period of time”
•Used when dealing with acute conditions and accidents
incidenvce
•It refers to the newly discovered and old cases of a particular
disease over a population
•Used when dealing with chronic conditions and disabilities
•It answers the question “what proportion of the group or
population is actually ill with a particular disease at a point in time.
•Usually determined by means of survey
prevalence
This is a measure of fertility of the population
CBR
This is a measure of the risk of dying from all causes in a population.
CDR
statistical values that can be utilized to measure the growth or
decline of a population.
CBR AND CDR
•Measure the risk of dying due to the process of pregnancy,
childbirth and puerperium.
•It also measures the adequacy of maternal health services
MMR
Measures the risk of dying due to infancy (under 1 year of age)
IMR
Measures the risk of dying in the first four weeks of life of the infant
(newborn)
•The number of children dying under 28 days of age divided by the
number of live births that year
NEONATAL MORTALITY RATE
Measures the risk of dying before birth
FETAL DEATH RATE
The word means around the period of birth ( a month or more
before births and one month after birth)
•Measures the loss of life in later pregnancy and early infancy.
`PERI-NATAL MORTALITY RATE
•Study the occurrence and distribution of diseases
as well as distribution of determinants of health
state or events in specified population and the
application of this study to control health
problems
•Field of science dealing with the relationship of
the various factors which determine the
frequencies and distribution of an infectious
process. A disease or a physiological state in
human community.
epidemiolgy
an increase in the frequency (incidence) of a
disease above the usual and expected rate, which
is called the endemic rate., thus epidemiology
count cases of a disease, and when they detect the
sign of epidemic, they ask who, when and where
questions.
epidemic
surveillance made by the government before many people start dying.
notifiable disease
the ultimate goal of epidemiology
control and prevent the spread of disease
father of modern epidemiology
- Study about cholera.
john snow
2 main areas of investigation
distribution and patterns of disease distribution
uses of epidemiology
. Study the history of the health population and the rise and fall of diseases and changes in their character
2. Diagnose the health of the community and the condition of the people.
3. Study the work of health services with a view of improving them
4. Estimate the risk of diseases, accidents, detects and the changes avoiding them
5. Complete the clinical feature of chronic disease and describe their natural history
s any element, substance or force whether
living or non-living thing; the presence or absence
can initiate or perpetuate a disease process.
agent`
types of agent
- This could be living or non-living things, physical or
mechanical in nature such as extremes of
temperature, light electricity. - They could be chemicals- endogenous (within the
body) or exogenous (poison)
characteristics of agent of disease
inherent characteristics, characteristics in relation to environment, characteristics directly related to man
characteristic directly related to man
infectivity, pathogenicity, virulence
characteristic directly related to man, ability to gain access and adapt to the human host to the extent of finding of finding lodgement and multiplication
infectivity
characteristic directly related to man, measures the ability of agent when lodged in the body set up a specific reaction
pathogenicity
characteristic directly related to man, refers to the severity of the reaction produce and is usually measured in terms of fatality.
virulence
characteristic directly related to man, ability to stimulate the host to producte antibody
antigenicity
modes of transmission
direct, indirect, airborne
MOT, immediate transfer of infectious agent a receptive
portal of entry
direct transmission
4 INDIRECT TRANSMISSIONS
vehicle borne, vector borne, mechanical vector, biological vector
INDIRECT TRANSMISSION, from contaminated objects
vehicle borne
INDIRECT TRANSMISSION, from living things
vector borne
dissemination of microbial aerosols to a suitable portal of
entry usually the respiratory tract
airborne
2 types of airborne transmission
droplet nuclei, dust
AIRBORNE TRANSMISSION, usually small residues which result from evaporation of
fluid from droplets emitted by an infected host
droplet nuclei
THE HOST FACTOR OF DISEASE
- Age
- Sex
- Race
- Habits, Customs and religions
- Exposure to agent
- Defense mechanism of the host
these are cells in our body like plasma cells and lymphocytes
that produce antibodies to neutralize harmful effects of the infectious agents
and body fluids in our body that possess substance that have antimicrobial
properties
humoral defense
there are cells in our body like macrophages and neutrophils
involve in the process of phagocytocis
cellular defense
sum total of an organism’s external
surrounding conditions and influences that affect
its life and development
environment
environmental factors of disease
physical environment, climate, geography and location, biologic environment
Time between exposure to infectious agent up to the time of appearance of the earliest signs and symptoms
incubation period
2 types of incubation period
biological and clinical
INCUBATION PERIOD, the time between exposure to a pathogenic organism and the onset of symptoms of a disease.
Clinical IP
INCUBATION PERIOD, The time taken by the parasite to complete its development in the definite host (from the time of entry of the infective larvae to the presence of microfilariae) is called the Intrinsic incubation period (Biological incubation).
biological
As applied to patient, separation for the period of
communicability, of infected persons or animals
from others in such places and under such
conditions as to prevent or limit the effect of the
direct or indirect transmission of the infectious
agent from those infected to those who are
susceptible or who may spread the disease agent.
isolation
he science and art of
a. preventing disease,
b. prolonging life and
c. promoting physical health and efficient through:
1. organized community efforts and informed choices of society,
2. private and public communities, communities and individuals for
the sanitation of the environment,
3. control of community infections,
4. the education of the individual in principles of personal hygiene,
5. the organization of medical and nursing services for the early
diagnosis and preventive treatment of disease, and
6. the development of social machinery
public health
It is concerned with threats to the overall health of a community based on population
health analysis.
Ecological in perspective, multi-sectoral in scope and collaborative in strategy
It aims to improve the health of community through an organized community effort
public health
divisions of public health (7)
Epidemiology
Biostatistics
Health Services/Health Policy and Management/Health
Administration
Environmental Health
Occupational health
Social and Behavioral Health
Nutrition
characteristics of public health
It deals with the PREVENTIVE ASCPECTS of health rather than
curative aspects.
It deals with POPULATION LEVEL, rather than indivdual health
issues.
3 core functions of public health
assessment pollicy development assurance
a. Monitor health status to identify community health problems.
b. Diagnose and investigate health problems and health hazards in the
community.
assessment
a. Inform, educate and empower people about health issues.
b. Mobilize community partnerships to identify and solve health problems.
c. Develop policies and plans that support individual and community health
efforts.
policy development
a. Enforce laws and regulations that protect health and ensure safety.
b. Link people to needed personal health services and assure the provision of
health care when otherwise unavailable.
c. Assure a competent public health and personal healthcare workforce.
d. Evaluate effectiveness, accessibility, and quality of personal and population-
based health services.
assurance
levels of prevention
primary secondary tertiary
lvl of prevention, prevents an illness or an injury from occurring at all, by preventing exposure to risk factors.
primary prevention
lvl of prevention, seeks to minimize the severity of the illness or the damage due to an injury-causing event once the event has occurred.
secondary
lvl of prevention, seeks to minimize disability by providing medical care and rehabilitation services.
tertiary prevention
person’s physical and psychological capacity to establish
and maintain balance.
Successful defense of the host against forces that disturb body
equilibrium.
health
aspects of health
physical, mental, social
failure of the body’s defense mechanism to cope with
forces tending to disturb body equilibrium.
disease
stages of disease
pre disease, latent stage. symptomatic
other term for asymptomatic
latent stage
risck factors of disease
- Biologic and Behavioral Factors
- Environmental Factors
- Immunologic Factors
- Nutritional Factors
- Genetic Factors
- Services, Social Factors and Spiritual Factors
History of public health
- Pre-American Occupation ( up to 1898 )
- American Military Government ( 1898-1907)
- Philippine assembly (1907-1916)
- The Jones law (1916-1936)
- The Commonwealth (1936-1941)
- Japanese occupation ( 1941-1945)
- Post World war II (1945-1972)
- Post EDSA revolution (1986 to present)
CHANGES IN HEALTH SCENARIO
- rapid decline of mortality and morbidity
- steady progress towards control of infectious diseases
- the current status of service delivery infrastructure that preventive and promotive health programs had not sufficiently covered population
- 1980 PHC strategy focused on maternal and child care services, control of prevalent diseases, nutrition, and family planning
MAJOR FACTORS THAT INFLUENCED THE PUBLIC HEALTH DEVELOPMENT
- international org.
- advances in biomedical and bioengineering research
- psycho socially based
- scientific approach to program management
FUTURE CHALLENGES IN PUBLIC HEALTH (4)
urbanization
industrialization
environmental concern
revenge of germs
it has been forecast that by the year2020, the urban population comprise 65 to 75% of the totalpopulation
The chaotic growth of cities will result in a multitude ofeconomic and social problems.
The rise of slums, criminality, disease and unemployment
Overcrowding, inadequate housing facilities, poorenvironmental sanitation
urbanization
more women joining the work force.This may or may not have adverse effect on the family. Care ofchildren will be entrusted to caretakers
Occupational hazards become a major concern
Air, soil and water pollutions
industialization
environmental degradation caused by deforestation, deterioration ofseas and rivers due to industrial waste, indiscriminatedisposal of waste. All these lead to ecologicalimbalance and pave the way for the emergence of thenew types of microorganisms
environmental concern
the discriminate consumption and overuse of antibiotics have resulted in drug-resistant bacteria, viruses and parasites.Switching from inexpensive penicillin to other drugsincreased treatment costs which are beyond the reachof the poor.
revenge of germs
BRANCHES OF STATISTICS
descriptive statistics and inferential
BRANCH OF STATISTICS, Statistical techniques for summarizing and presenting data in a form that will make them easier to analyze and interpret
ex.Counts, proportions, tables, graphs,
summary measures
descriptive statistics
BRANCH OF STATISTIC, Concerned in making estimates, predictions, generalizations, and conclusions about a target population based on information from a
sample
INFERENTIAL STATISTICS
2 TYPES OF INFERENTIAL STATISTIC
Estimation and hypothesis testing
the term ___ refers to both the numbers that describe the health of populations and the science that helps to interpret those numbers.
statistics
Used to described the variety and frequency of past outcomes under similar conditions as a way of predicting what should happen in the future.
probability
p value
use to express the degree of probability or improbability
of a certain result in an experiment.
•This is a range of values within which the true result probably falls.
•The narrower the confidence interval, the lower the likelihood of random error.
•Are often expressed as margins of error, as in political polling, when a politician’s support might be estimated at 50 percent. The confidence interval would be 47% to 53%
confidence interval
USES OF BIOSTATISTICS
•Problems of estimates
•Problems of comparison
•Health need identification
•Analysis of problem and trends
•Epidemiologic evaluation
•Program planning
•Budget preparation and justification
•Administrative decision making
•Health education
LEVELS OF MEASUREMENTS
nominal ordinal interval ratio
It refers to the arrangement of any data in an orderly sequence, so that they can be presented concisely and compactly and so that they can be understood easily.
tabulation
Types of data for tabulation
frquency distribution, correlation data, time series data
used to compare two or more frequencies
correlation data
some variable changes over a period of time is the one being presented
time series data
Data are grouped according to some scale of classification, where the sum of the entries is equal to
the total. The figures may either be in equal numbers, in percent or in both. The scales used may be qualitative, quantitative or both.
frequency distribution
•The purpose is to convey a simpler idea of what the statistical table contains .
•Statistical graph either a series of lines joined together, or bars or enclosed areas, drawn to represent certain statistical information under consideration.
•Intended for comparison, to show correlation, or simply for the purpose of data presentation
•Primary tools for presentation and analysis.
graphing
PART OF GRAPH, indicate clearly and briefly what the figures in the body of the graph stand for, how the data were classified, and where and when obtained. This is placed at the bottom of the graph, preceded by number for easy reference.
title
PART OF GRAPH,
the vertical and the horizontal:
•Each represents separate scales of classification corresponding to the row and column headings of the table being graphically presented.
•One of the axes is always quantitative scale while the other is either qualitative or quantitative scales.
AXIS
PART OF GRAPH, this is needed when one is drawing more than one graph in a graphing space. This clarifies to what particular item each of the graph refers. It is placed either at the bottom of the graph or as close as possible to the figures being identified.
LEGEND
these are the lines, bars or figures drawn within the graphing space.
BODY OF GRAPH
- Used to graph time series data depict trends or changes with time with respect to some other variables
line graph
used to graph continuous variables. A graphical representation, similar to a bar chart in
structure, that organizes a group of data points into user-specified ranges. The histogram condenses a data series into an easily interpreted visual by taking many data points and grouping them into logical ranges or bins
histogram
Used to graph continuous variables
polygon
used to graph qualitative variables and discontinuous variables of the quantitative
variety
bar and stick graph
usually in the form of rectangles, square or circles (pies), used to depict the distribution of a whole with different segments representing different frequencies
pictorial diagram
sed to show relationship of simultaneous measurement
scatter poit
Registration systems such that collected by
the
civil registrars office
Vital events
births, deaths, marriage, divorces and
the like.
study of the character, number, and distribution of
living organisms residing in or migrating through particular places.
population
is the study of the
attributes of and changes in the aggregate number of people
residing in particular communities around the world and their
causes.
HUMAN DEMOGRAPHY
mathematical estimates
arithmetic increase and geometric increse
assumed that the population increases at a constant amount
per year
– difference between the last two censuses is taken and then
divided by the number of year between them to get the
average amount of population increase per year
arithmetic
mathematical– assume that population increases at a constant rate per year
– determination of annual rate of population change
GEOMETRIC
the annual number of live births per
1,000 women of childbearing age (often taken to be from 15 to 49
years old, but sometimes from 15 to 44)
general fertility rate
the annual number of live births per
1,000 women in particular age groups (usually age 15-19, 20-24
etc.)
age specific fertility rate
the annual number of deaths per 1,000
people.
crude death rate
the annual number of deaths of children
less than 1 year old per 1,000 live births.
infant mortality rate
the number of years which an
individual at a given age could expect to live at present
mortality levels.
expectation of life
the number of live births per woman
completing her reproductive life, if her childbearing at each age
reflected current age-specific fertility rates.
total fertility rate
the average number of children
a woman must have in order to replace herself with a daughter
in the next generation.
replavement lefel fertility
the number of daughters who would be born to a woman completing her reproductive life at current age-specific fertility rates.
gross reproduction rate
the expected number of
daughters, per newborn prospective mother, who may or may
not survive to and through the ages of childbearing.
net reproduction ratio
one that has had constant crude birth and
death rates for such long time that the percentage of people in
every age class remains constant, or equivalently, the population
pyramid has an unchanging structure.
stable population
one that is both stable and unchanging
in size (the difference between crude birth rate and crude death
rate is zero).
can expand or shrink
stationary population
involves the number of children that women have and
is to be contrasted with fecundity (a woman’s
childbearing potential).
fertility
study of the causes, consequences, and measurement
of processes affecting death to members of the
population.
mortality
– refers to the movement of persons from an origin place to a destination place across some pre-defined, political boundary
migration
simply the difference between the number of births and the number of death occurring in a population in a specified period of time
natural increase
the difference between the CBR and the CDR occurring in a population in a specified period of time
rate of natural increase
Measures the number of people that are added to the population per year
absolute increase per year
Is the actual difference between the two census counts expressed in percent relative to the population size made during an earlier census.
relative increase
is described in terms of age and sex
population composition
represents the number of males for every 1, 000 females in the population.
sex ratio
two ways to describe the age composition of the population.
median age and dependency ratio
The age and sex composition of the population can be described
at the same time using a
population pyramid
any element, substance or force whether
living or non-living thing; the presence or absence
can initiate or perpetuate a disease process.
agent
these are cells in our body like plasma cells and lymphocytes
that produce antibodies to neutralize harmful effects of the infectious agents
and body fluids in our body that possess substance that have antimicrobial
properties
humoral defense
there are cells in our body like macrophages and neutrophils
involve in the process of phagocytocis
cellular defense
sum total of an organism’s external
surrounding conditions and influences that affect
its life and development
environment
environmental factors of disease
•Physical Environment
•climate- certain disease have seasonal distribution
•Geography and location
•Biologic Environment- living environment of man
consist of plants, animals and fellow human
beings.
Time between exposure to infectious agent up to the time of appearance of the earliest signs and symptoms
incubation period
2 types of incubation period
clinical and biological
the time between exposure to a pathogenic organism and the onset of symptoms of a disease.
clinical incubation period
The time taken by the parasite to complete its development in the definite host (from the time of entry of the infective larvae to the presence of microfilariae) is called the Intrinsic incubation period (Biological incubation)
biological incubation period
As applied to patient, separation for the period of
communicability, of infected persons or animals
from others in such places and under such
conditions as to prevent or limit the effect of the
direct or indirect transmission of the infectious
agent from those infected to those who are
susceptible or who may spread the disease agent
isolation
CATEGORIES OF ISOLATION
STRICT, contact, respiratory, tuberculosis
ISOLATION
this category is designed to prevent transmission of
highly contagious or virulent infectious that may spread by direct
contact or droplet.
strict isolation
ISOLATION
for less highly transmissible or serious infections,
for disease or conditions which are spread primarily by close or direct
contact.
contact isolation
ISOLATION
o prevent transmission of infectious diseases
over short distance through the air
respiratory isolation
ISOLATION
(AFB isolation)- for patient with pulmonary
tuberculosis who have a positive sputum smear or chest x-rays which
strongly suggest active tuberculosi
TUBERCULOSIS ISOLATION
CATEGORIES OF PRECAUTIONS
enteric, drainage, blood/body fluid
restriction of the activities of a well
persons or animals who have been exposed to a
case of communicable diseases during its period of
communicability to prevent disease transmission
during incubation of infection should occur.
quarantine
Limitation of movement of those exposed to a
communicable disease for a period of time not
longer than the longest usual incubation period
of that disease.
absolute/complete quarantine
Selective, partial limitation of freedom of
movements of contacts
modified quarantine
pHASES
Pre pathogenesis, pathogenesis
6 requirements for successful invasion
- Condition in the environment must be favorable to the agent or the agent must be able to adapt in the environment
- Suitable reservoirs must be present
- A susceptible host must be present
- Satisfactory portal of entry into the host
- Accessible portal of exit from the host
- Appropriate means of dissemination and transmission to a new host
