Module 2; Flashcards
epidemiology features
- conducted in noisy environments (cohort)
- define a relationship betwee a cause/disease outcome in a population
british doctors study 7 findings:
temporality; first cause then disease
strength of association; strong association = causal
reversibility; occurrence changes when there is a change in exposure
biological gradient; proportional relationship
biological plausibility of association; make sense biologically?
consistency of association; reputable (lots of diff people have same findings)
specificity of association; WEAKEST; one cause —> one effect
epidemiological triad
host (person in population)
environment; physical, social, political
agent; biological, nutritional, physical, chemical
rothmans causal pie model
recognises multicausality
- dont have to identify every component to prevent some cases of disease
- can intervene any component.
sufficient cause
whole pie
minimum set of conditions wo anyone of which the disease would not occur
multiple factors
several pies can produce same disease
component cause
section of a pie
factor that contributes towards disease but is not what directly causes disease
necessary cause
factor that must! be prsent for a disease to occur
component cause may be necessary cause for some diseases
problems w causal pie model
fails to capture dose-response relationships as a continuum
assumes that all causes are deterministic (one thing leads to another)
probabilic concept of causation
combo increase PROBABILITY, doesn’t directly cause
sufficient cause raises probability to 1
necessary cause raises probability from 0
each component causes in increase in probability
counterfactual definition of causation
presence/absence of cause makes a difference in the outcome
necessary, sufficient, component, probabilistic definitions clarify what kind of difference it makes
consistent w both deterministic, and probabilistic phenomena.
individuals determinants
any characteristic/definable entity that brings about a change for better or worse in health
- income, employment, education, housing/neighbourhoods/societal characteristics
population determinants
similar to individuals, but the nature of determinants is diff.
“population health is more than the sum of its parts”
downstream determinants
proximal causes
near the change in health status (readily associated w immediate cause of diease (e.g. lifestyle behavioural factors related to nutrition/smoking)
upstream determinants
distant in time/place from the change in health status
national/political/legal/cultural factors that indirectly influence health
government policy
social gradient
increase of quintile (deprived) = increase in obesity
