The Road to Applied Epidemiology

1. The Road to Applied Epidemiology John R. MacArthur, MD, MPH Director Thailand MOPH – US CDC Collaboration

2. Family and Community Medicine • COPC • Faculty influence • Epidemic Intelligence Service

3. Family and Community Medicine • Carrillo Community Clinic – Santa Barbara, California, USA • Primary health care for low income patients • Social determinants of health • Georgetown University School of Medicine, Washington, DC, USA • Catholic University – Jesuits • Refugee health care • University of California at San Francisco • Primary health care for low income migrants • Refugee & migrant health • Social determinants of health

4. Community Oriented Primary Care • Community-oriented primary care (COPC) is a systematic approach to health care based upon principles derived from epidemiology, primary care, preventive medicine, and health promotion (Longlett et al. 2001)

5. Faculty Influences • Internal medicine, surgery, pediatrics, obstetrics & gynecology, family practice, radiology, dermatology… • Teaching but also mentoring, orientation, guidance… •  What about going beyond the traditional models of patient – physician care? • Community as your patient • Magnitude of impact • Opening new horizons

6. Hey, have you ever thought about EIS?

7. What is the Epidemic Intelligence Service (EIS)? CDC’s 2-year training program in the practice of applied epidemiology Training through service on the front lines of Public Health

8. EIS Officers • Are physicians, veterinarians, scientists, and other health professionals • Complete a 2-year, on-the-job training, and service fellowship • Serve our country while learning to apply epidemiology • Gain practical skills to become future leaders

9. Historical Background • July 1946 — CDC established with mandate to help state control communicable diseases • October 1947 — CDC assigned responsibility for epidemic aid to states • July 1951 — Epidemic Intelligence Service (EIS) established with 23 recruits

10. 60+ Years of Training, Service, and Response http://www.cdc.gov/eis/downloads/eis-timeline-booklet.pdf

11. EIS Officer Assignments State or Local Health Department (Field) • Broad, front-line public health experience • Surveillance, investigation, and intervention Headquarters • Specialized, disease- or problem-specific experience (e.g., vaccine preventable disease, STD, injury, ectopic pregnancy) • Surveillance, investigation, and policy development

12. EIS Mission: Training The 158 officers in the 2015 and 2016 EIS classes are assigned to CDC headquarters and field positions

13. Field Investigations topics -- 2014 and 2015 EIS classes 0 10 20 30 40 50 60 70 0 10 20 30 40 50 60 70

14. Field Investigations Indonesia Kenya Liberia Malawi Mali Mongolia Mozambique Nigeria Saudi Arabia Sierra Leone South Africa Tanzania Uganda Ukraine Botswana Cambodia China Colombia Cote de Ivoire DRC Dominican Republic Ethiopia Gambia Georgia Ghana Guinea Haiti India

15. 79 EIS Officers (Class of 2016) Were Selected from 564 Applicants

16. EIS Officers Gain Skills and Experience Needed to Strengthen the Public Health Workforce Setting of First Job After EIS (n = 618), 2004-2013 EIS Classes

17. EIS Mission: Training What is an EIS Graduate? • An applied epidemiologist who can: • Respond to public health emergencies • Complete an epidemiologic study from design to results • Evaluate and improve surveillance systems • Publish short reports and peer-reviewed journal articles • Present findings coherently to lay and scientific audiences • Collaborate with domestic and international partners • A future subject matter expert or public health leader!