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The Impact of Epidemiology in Public Health

The Impact of Epidemiology in Public Health. Robert Hirokawa Epidemiologist, Science and Research Group HHI / TSP, Hawaii Department of Health. 3 Core Functions of Public Health. The Institutes  of Medicine (IOM) defines the three core functions of governmental public health as: Assessment

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The Impact of Epidemiology in Public Health

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  1. The Impact of Epidemiology in Public Health Robert Hirokawa Epidemiologist, Science and Research Group HHI / TSP, Hawaii Department of Health

  2. 3 Core Functions of Public Health • The Institutes  of Medicine (IOM) defines the three core functions of governmental public health as: • Assessment • Policy development • Assurance

  3. 10 Essential Public Health Services • Monitor health status to identify community problems. • Diagnose and investigate health problems and health hazards in the community. • Inform, educate, and empower people about health issues. • Mobilize community partnerships and action to identify and solve health problems. • Develop policies and plans that support individual and community health efforts. • Enforce laws and regulations that protect health and ensure safety. • Link people to needed personal health services and assure the provision of  health care when otherwise unavailable. • Assure a competent public health and personal health care workforce. • Evaluate effectiveness, accessibility, and quality of personal and population- based health services. • Research for new insights and innovative solutions to health problems.

  4. Epidemiology Defined • The study of distribution and determinants of health and disease in human populations

  5. 3 Essential Components of Epidemiology • Disease distribution • Disease determinants • Disease frequency • Expected levels • Endemic • Sporadic • Epidemic • Pandemic

  6. Types of Epidemiologic Studies • Descriptive • Analytic

  7. Descriptive Studies • Frequency of occurrence of a particular condition • Patterns of occurrence • Person • Place • Time

  8. Hawaii Obesity and Diabetes Trends 1. Percentage of Hawaii adults that are obese, BRFSS 1990 - 2006 2. Percentage of Hawaii adults who have been diagnosed with diabetes, BRFSS 1995 - 2006

  9. Hawaii crude adult obesity (BMI > 30) prevalence (%), BRFSS, 2005

  10. Hawaii crude adult obesity (BMI > 30) prevalence (%) by race/ethnicity, BRFSS, 2005

  11. Hawaii crude adult diabetes prevalence (%), BRFSS, 2005

  12. Hawaii crude adult diabetes prevalence (%) by race/ethnicity,BRFSS, 2005

  13. Analytic Studies • Observational Studies (exposure not controlled) • Case-control • Cohort • Experimental (exposure controlled)

  14. Case-Control Study (Observational Study) Exposure Disease ??? Group 1 has disease (Cases) ??? Group 2 disease free (Controls)

  15. Cohort Study (Observational Study) Exposure Disease Group 1 has exposure ??? Group 2 not exposed ???

  16. Experimental Study • Intervention Studies • Clinical Trial

  17. Basic Presentation of Results Lung Cancer? Smoke? Relative Risk = Probability of disease among those exposed divided by the probability of disease among those not exposed

  18. Basic Presentation of Results Lung Cancer? Smoke? RR = 40/100 divided by 10/100 = .4/.1 = 4

  19. Measurement Errors • Bias • Information • Selection • Confounding • Statistical Errors

  20. Cause – Effect Relationship • Strength of association • Consistency • Temporality • Biological plausibility • Gradient (dose – response)

  21. Measures of Disease Frequency • Prevalence Rate = # of existing cases / total population • Incidence Rate = # of new cases / total population at risk

  22. Commonly Used Rates • Crude • Category-specific • Age-adjusted

  23. Impact of Epidemiology in Public Health • Improved understanding of the distribution and determinants of health and disease in human populations • Used to drive program planning, resource allocation, interventions, and evaluation

  24. Thank you!

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