Epidemiology: basic science of public
health
Because:
the science that describes the
relationship of health and/or disease
with other health-related factors in
human populations, such as human
pathogens
used to generate much of the
information required by public health
professionals to develop, implement,
and evaluate effective intervention
programs for the prevention of disease
and promotion of health
Maxcys definition:
Epidemiology is that field of medical
science which is concerned with the
relationship of various factors and
conditions which determine the
frequencies and distributions of an
infectious process, a disease, or a
physiologic state in a human
community. (Lilienfeld 1978, p. 88)
John Lasts definition:
The study of the distribution and
determinants of health-related states
or events in specified populations, and
the application of this study to the
control of health problems. (Dictionary
of Epidemiology)
Causal inference process of providing an
accumulation of increasingly convincing
indirect evidence of a relationship between
health or disease and other factors
Predisease stage early intervention may
avert exposure to the agent of disease (e.g.
microbes, trans-fatty acids, lead) PRIMARY
INTERVENTION
Latent stage screening for disease and
providing appropriate treatment may prevent
progression to symptomatic disease
SECONDARY PREVENTION
Symptomatic stage intervention may
slow, arrest, or reverse the progression of
disease TERTIARY PREVENTION
Applying the epidemiological method to
resolve a health question successfully can be
compared to constructing a memorable
Chinese banquet. It is not enough to have
the best ingredients and to know the various
Chinese cooking methods. The truly great
chefs must be able to select the appropriate
ingredients and cooking methods to bring
out the flavors of each dish, and further,
must know how to construct the correct
sequence of dishes to excite the palate
without overwhelming it. Thy create a
memorable banquet by adding their creative
genius to the raw ingredients and the
established cooking methods.
B. Mechanism and Causes of Disease
EXAMPLE: Osteomalacia bone dse that may
have both social and biologic causes; social:
Muslin custom of purdah; biologic deficiency
of vitamin D (prevention of irradiation of
ergosterol in the skin, may develop
osteomalacia as a result of insufficient
calcium absorption. Osteomalacia can
adversely affect future preganancye by
causing the pelvis to become distorted (more
pear shaped), making the pelvic opening too
small for the fetus to pass through that may
lead to infant mortality.
C. Host, Agent Environment, and Vector
Example: Measles: host (human), agent
(rubeola virus), the environment (population
of unvaccinated individuals)
Host factors responsible for the degree to
which the individual is able to adapt to the
stressor produced by the agent
Host resistance is influenced by: genotype,
nutritional status and BMI, immune system,
and social behavior
Agents of disease divided into several
categories (biologic, chemical, physical
agents)
Environment influences the probability and
circumstances of contact between the host
and the agent; also includes social, political,
and economic factors
Vectors include insects, arachnids, and
mammals; can be applied more widely to
include human groups (vendors of heroin,
cocaine, and meth), and inanimate objects
(fomites)
Time-place-person
Describe disease or disease factors occurring
in the population to elucidate the causative
agent:
Time (e.g. trends, outbreaks, etc.)
Place (the geographic area in which the
disease is occurring)
Person (the characteristics of the affected
individuals; e.g. age, gender, etc.)