Epidemiology: Measuring & Describing Disease 1 Flashcards

- Exposures and outcomes - Epidemiologic transition and populations - HIV

1
Q

Define endemic

A

Diseases that reside within a population

They are consistently present and cause regular cases

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2
Q

Define epidemic

A

Diseases that befall a population

Causing a sudden outbreak of a new disease or rise in cases

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3
Q

Define epidemiology

A

How often diseases occur in different groups of people and WHY

Study distribution and determinants of health-related states/events and the application of this study to the control of health problems

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4
Q

What is the main thing epidemiology allows us to do?

A

Prevent disease

eg. John snow and cholera water pumps show how using epidemiology to understand the cause of disease can allow us to find prevention strategies

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5
Q

List the 3 types of prevention

A

Primary, secondary and tertiary

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6
Q

Define primary intervention and relate it to an example

A

Primary: the prevention of disease through the control of exposure to risk factors. Eg. reducing salt in you diet reduces the risk of developing hypertension.

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7
Q

Define secondary intervention and relate it to an example

A

Detect early departures from health and to introduce appropriate treatment and interventions.
Eg. controlling hypertension with antihypertensive drugs to progression

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8
Q

Define tertiary intervention and relate it to an example

A

Minimise suffering caused by disease by reducing disability and promoting adjustments.
Eg. Rehabilitation for someone who’s had a stroke so that they can return as close as possible to their pre-morbid activities.

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9
Q

Which type of prevention is for before the onset of disease

A

Primary prevention

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10
Q

Which type of prevention aims to slow progression of disease

A

Secondary Prevention

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11
Q

Which type of prevention enables return to functioning after insult of disease

A

Tertiary prevention

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12
Q

which types of prevention do the NHS currently focus more on? Which type of prevention would be best to focus on

A
  • NHS focuses primarily on secondary and tertiary prevention - Focussing on Primary prevention would be a true health service
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13
Q

Which questions are important to ask during the study of epidemiology

A

What Why When How Where Who

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14
Q

A typical epidemiology research question looks for answers in what 3 areas?

A

Time Person Place

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15
Q

Describe Exposure and outcome in epidemiological terms. Use the example of the study of cancer.

A

An exposure in epidemiological terminology is essentially the variable that we are trying to associate with a change in health status. eg. in a study of cancer outcomes, we might look at Drug X (the exposure) and test its association on mortality at five-years (the outcome).

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16
Q

Describe the demographic transition model

A
  • Looks at birth rate, death rate and total population.
  • in the diagram, at stage 1, we have a high birthrate and a high death rate that broadly keep the total population in check, perhaps with a little bit of gradual increase over time.
  • The death rate lowers and the birth rate maintains its trajectory at stage two, resulting in a large natural increase in the total population.
  • eventually the birthrate begins to catch up with the reduction in death rate and the population begins to stabilise
17
Q

Describe the epidemiological transition through this diagram

A
  • Related to demographic transition
  • Pestilence and famine receding pandemics and degenerative, man-made diseases and delayed degenerative diseases and emerging infections
18
Q

Define the first stage of the epidemiological transition: Pestilence and famine

A

Period of Pre-Industrial Revolution in UK (up to 1800)

  • Urbanisation
  • Constraints on food supply
  • High birth rate and high mortality.
  • Life expectancy is low at birth.
19
Q

What is life expectancy at birth

A

Life expectancy is a period of time at a specific age.

  • the average length of time one can expect to live for based on everyone else in the population i.e average across entire population
20
Q

Describe the second stage of the epidemiological transition: Recedeing pandemics

A

Receding Pandemics

Period of 1800s - 1950 in UK

  • Agricultural development improves nutrition
  • Water, sanitation, hygiene
  • Vaccination emerges
  • High birth rate and reducing mortality
  • Life expectancy increasing
21
Q

Describe the third stage of the epidemiological transition: Degenerative and manmade diseases

A

Degenerative and manmade diseases

Period of 1950 - 2010s in UK

  • Lifestyle factors and non communicable diseases (NCDs) predominate: cancer and CVD
  • Environmental and global determinants drive obesity and other risk factors
  • Technology reduces need for physical labour (physical activity decreased)
  • Addiction, violence and other issues emerge
22
Q

Describe the fourth stage of epidemiological transition: Delayed degenerative and manmade diseases and emerging infections

A

Delayed degenerative and manmade diseases and emerging infections

Period of 2010s onwards

  • Health technology defers morbidity, albeit at increasing financial cost
  • Emerging zoonotic disease presents new threats (eg. COVID-19)
  • Inequalities within and between countries come to the fore
23
Q

Is every country/population at the same stage in the epidemiological transition?

A

No - countries can be at different stages of this progression, depending on the availability of healthcare, water, sanitation and hygiene.

24
Q

Why is it important to understand population pyramids?

A

there are some diseases that affect young people, and other diseases that more commonly affect older people - the shape of your population is going to be an important thing to consider when planning your health system and predicting what needs are likely to arise.

25
Q

Which shape is needed for a rapidly growing population?

A

A - As the infant mortality (in particular) decreases, the population will rapidly grow.

26
Q

Which shape would best characterise the UK? Which factor plays into this

A

B - But Without immigration the UK would be demonstrating the C shape.

27
Q

If you were advising the Italian government on their health system planning, which diseases do you think are going to cause most difficulty for their health system over the coming decade?

A
  • Dementia
  • Cancer
  • Cardiovascular disease
28
Q

What primarily accounts for the dip in life expectancy observed in 1918/19 worldwide

A

Pandemic H1N1 influenza
(Spanish Flu)

29
Q

What is the correlation between life expectancy and income per capita worldwide between 1800-2020

A

As income per person (GDP/capita) increases, life expectancy generally increases

https://www.gapminder.org/tools/#$state$time$value=1800;;&chart-type=bubbles

30
Q

What is the correlation over time between Child Mortality and Income per capita worldwide between 1800-2020

A

negative correlation - as income per capita increased, child mortality generally decreased

https://bit.ly/3u46wsh

31
Q

Define exposure

A

the variable being tried to associate with a change in health status
• Can be a drug/behaviour/demographic characteristic etc.

32
Q

Define outcome

A

The associated change in health status

Example: drug X (exposure) and test its association on mortality five years (the outcome)

33
Q

What was the role of epidemiology in the history of HIV?

A
  • Describing a consistent constellation of signs and symptoms
  • Identifying the causative pathogen
  • Inferring the mechanism(s) of transmission
  • Determining the risk factors associated with disease transmission and prognosis
  • Informing prevention strategies
  • Evaluating the efficacy and effectiveness of therapies (including drugs and other interventions)
34
Q

What is a case series study

A

a document comprising multiple case reports drawn together. The editorial note provides over-riding commentary.

35
Q

What is the “language” of epidemiology?

A

Precisely and scientifically describe relationships between exposures and outcomes