DESCRIPTIVE EPIDEMIOLOGY for Public Health Professionals Part 1 Ian R.H. Rockett, PhD, MPH Department of Community Medicine West Virginia University School of Medicine Prepared under the.
Download ReportTranscript DESCRIPTIVE EPIDEMIOLOGY for Public Health Professionals Part 1 Ian R.H. Rockett, PhD, MPH Department of Community Medicine West Virginia University School of Medicine Prepared under the.
DESCRIPTIVE EPIDEMIOLOGY for Public Health Professionals Part 1
Ian R.H. Rockett, PhD, MPH Department of Community Medicine West Virginia University School of Medicine Prepared under the auspices of the Southeast Public Health Training Center, University of North Carolina, Chapel Hill, 2005.
Learning Objectives
1.
To introduce some key historical contributors to the evolution of epidemiology 2.
To present basic models of disease and injury 3.
To address data sources, classification, and measurement 4.
To build a bridge between descriptive and analytic epidemiology
Performance Objectives
1.
To be sensitive to the history of epidemiology against the background of broad population change 2.
To identify mortality and morbidity data sources 3.
To calculate basic measures 4.
To generate hypotheses from descriptive data
POPULATION TRANSITIONS and HISTORY
The Big Population Picture Source: Joseph A. McFalls, Jr. Population: A Lively Introduction. Third edition. Population Bulletin 53(3); 1998: 38.
The Demographic Transition The demographic transition framework illustrates population growth in terms of discrepancies and changes in two crude vital rates – mortality and fertility (ignores the third component of growth, migration)
Source: Joseph A. McFalls, Jr. Population: A Lively Introduction. Third edition. Population Bulletin 53(3); 1998: 39.
Top 10 Causes of Death in the U.S. , 1900 Rank Cause of Death Deaths per 100,000 Percent of all Deaths 1 2 3 4 5 6 7 8 9 10 Pneumonia Tuberculosis Diarrhea and enteritis Heart disease Chronic nephritis (Bright’s disease) Unintentional injury (accidents) Stroke Diseases of early infancy Cancer Diptheria 202 194 140 137 81 76 73 72 64 40 12 11 8 8 5 4 4 4 4 2
Top 10 Causes of Death in the U.S. , 2000 Rank 1 2 3 4 5 6 7 8 9 10 Cause of Death Heart Disease Cancer Stroke Lung Diseases Unintentional injury (accidents) Diabetes Pneumonia and influenza Alzheimer’s Disease Nephritis, Kidney disease Septicemia Deaths per 100,000 Percent of all Deaths 258 200 60 45 34 30 23 7 5 4 25 24 18 14 12 3 3 2 2 1
Source: Ian R.H. Rockett. Population and Health: An Introduction to Epidemiology. Second edition. Population Bulletin 54(4); 1999: 9.
EPIDEMIOLOGY epi – upon demos – people logos – study The scientific study of the distribution and determinants of health-related states or events in specified populations, and the application of resulting knowledge to the prevention and control of health problems
Epidemiology as a Liberal Art An accessible low-technology science, which incorporates the “scientific method, analogic thinking, deductive reasoning, problem solving within constraints, and concern for aesthetic values” David Fraser,
New England Journal of Medicine
, 316(6); 1987:309-314.
Some Epidemiologic History
Hippocrates
On Airs, Waters, and Places (5 th century BCE)
Hippocrates spearheaded a move away from looking to blame demons for disease and injury
FAST FORWARD
Enter
John Graunt (1629-1674)
vocation – haberdasher (seller of men’s accessories)
avocation – father/founder of demography and epidemiology
Graunt counted rather than considered ( Major Greenwood ) Among his observations, he noted:
regularity of biological phenomena in the mass
that more males are born than females and more males die than females ( annually )
Partial Translation
Ague = Malaria
Purples & Spotted Feaver = Meningococcal Meningitis
King’s Evil = Tuberculosis of the lymph glands of the neck
Age Population Survivorship: Two Populations 17 th century London, England 2002 United States 0 6 16 26 36 16 46 10 56 66 6 3 100 64 40 25 76 1 100 99 99 98 97 95 91 81 63
Miasmatists
Vs
Contagionists
miasm – pathogenic emanation dispersed in the atmosphere (malaria – bad ‘air’) contagion – vehicle of person-to person disease transmission (forerunner of germ theory )
Enter John Snow (1813-1858)
Spot Map of Fatal Cholera Cases in London, 1854 Source: Ian R.H. Rockett. Population and Health: An Introduction to Epidemiology. Second edition. Population Bulletin 54(4); 1999: 6.
Filippo Pacini, 1812-1883