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DESCRIPTIVE EPIDEMIOLOGY for Public Health Professionals Part 1

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.

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DESCRIPTIVE EPIDEMIOLOGY for Public Health Professionals Part 1

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  1. DESCRIPTIVE EPIDEMIOLOGYfor 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. irockett@hsc.wvu.edu

  2. Learning Objectives To introduce some key historical contributors to the evolution of epidemiology To present basic models of disease and injury To address data sources, classification, and measurement To build a bridge between descriptive and analytic epidemiology

  3. Performance Objectives To be sensitive to the history of epidemiology against the background of broad population change To identify mortality and morbidity data sources To calculate basic measures To generate hypotheses from descriptive data

  4. POPULATION TRANSITIONS and HISTORY

  5. The Big Population Picture Source: Joseph A. McFalls, Jr. Population: A Lively Introduction. Third edition. Population Bulletin 53(3); 1998: 38.

  6. 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)

  7. Source: Joseph A. McFalls, Jr. Population: A Lively Introduction. Third edition. Population Bulletin 53(3); 1998: 39.

  8. Top 10 Causes of Death in the U.S. , 1900

  9. Top 10 Causes of Death in the U.S. , 2000

  10. Source: Ian R.H. Rockett. Population and Health: An Introduction to Epidemiology. Second edition. Population Bulletin 54(4); 1999: 9.

  11. 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

  12. 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.

  13. Some Epidemiologic History

  14. Hippocrates On Airs, Waters, and Places (5th century BCE)

  15. Hippocrates spearheaded a move away from lookingtoblame demons for disease and injury

  16. FAST FORWARD

  17. Enter John Graunt (1629-1674) • vocation – haberdasher (seller of men’s accessories) • avocation – father/founder of demography and epidemiology

  18. Graunt counted rather than considered (Major Greenwood)Among his observations, he noted: • regularity of biological phenomena in the mass • thatmore males are born than females and more males die than females (annually)

  19. Partial Translation • Ague = Malaria • Purples & Spotted Feaver = Meningococcal Meningitis • King’s Evil = Tuberculosis of the lymph glands of the neck

  20. Population Survivorship: Two Populations th 17 century 2002 Age United States London, England 0 100 100 6 64 99 16 40 99 26 25 98 36 16 97 46 10 95 56 6 91 66 3 81 76 1 63

  21. 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)

  22. EnterJohnSnow (1813-1858)

  23. 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.

  24. Filippo Pacini, 1812-1883

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