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Descriptive epidemiology
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-characterizes health events by who, what, where, and how many?
-this is about the amount and distribution of health and disease in a population
-once we figure out patterns of diseases, we can look at current health services and then look for solutions/ improvements
-this is about the amount and distribution of health and disease in a population
-once we figure out patterns of diseases, we can look at current health services and then look for solutions/ improvements
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The three approaches to descriptive epidemiology
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case reports (counts), case series, and cross sectional studies
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Case reports (counts)
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this is a detailed report of a single patient's experience with a health outcome (case)
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Case series
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a collection of case reports that have similar diagnoses or treatments
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Cross sectional studies
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-surveys of a population to estimate the prevalence of a disease
-looks at both exposure and outcome at the same time
-looks at both exposure and outcome at the same time
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Analytic epidemiology
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-this asks why and how?
-this is about the causes and determinants of health outcomes
-this is about the causes and determinants of health outcomes
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What are the characteristics of people that can affect their health outcomes?
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age, sex, marital status, nativity and migration, religion, socioeconomic status, and race/ ethnicity
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How age can affect health outcomes
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-age can be a huge factor to consider when looking at chronic diseases, because it often takes a long time for many illnesses to develop in a person
-additionally diagnostic tools and treatment may have changed over time
-also lifestyle choices often change over the course of a lifetime
-additionally diagnostic tools and treatment may have changed over time
-also lifestyle choices often change over the course of a lifetime
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How sex can affect health outcomes (the female paradox)
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-males generally have higher mortality rates than women
-but women often have higher morbidity rates for those same diseases
-may have to do with hormone levels, the presence of certain organs, lifestyle choices (due to social norms), sex practices, and job related exposures
-but women often have higher morbidity rates for those same diseases
-may have to do with hormone levels, the presence of certain organs, lifestyle choices (due to social norms), sex practices, and job related exposures
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How marital status can affect health outcomes
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-there has been a correlation between presence of less mental health issues and being married
-protective hypothesis: marriage gives an environment that promotes one's health
-selective hypothesis: people who marry are just healthier than people who never get married
-protective hypothesis: marriage gives an environment that promotes one's health
-selective hypothesis: people who marry are just healthier than people who never get married
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How nativity and migration can affect health outcomes
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-when people migrate they move to a country with different endemic diseases (so they will have diff immunological memories and vaccines)
-the healthy migrant effect: most people who migrate are often young and healthy
-the healthy migrant effect: most people who migrate are often young and healthy
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How religion can affect health outcomes
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-sometimes the prescribed lifestyle recommended by one's religion can protect them from certain health outcomes
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How socioeconomic status can affect health outcomes
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-one's wealth, job, and education can influence their risk for getting certain illnesses
-those of lower status are linked to having worse health (may be due to more chronic stress, more occupational exposure, etc)
-those of lower status are linked to having worse health (may be due to more chronic stress, more occupational exposure, etc)
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Social causation explanation for mental health and social class
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that conditions associated with being of a lower social class produce mental illnesses
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Downward drift hypothesis for mental health and social class
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that people with severe mental disorders move to impoverished areas (to get a certain community)
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How race and ethnicity can affect health outcomes
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can be due to differences in socioeconomic status, health practices, stress and lack of resources, environmental exposures, discrimination, health care services
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Acculturation hypothesis
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as immigrants become acculturated to a host country, their health tends to get more similar to that of the native population
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What are the characteristics of place that affect health comparisons?
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-international places
-different variations within a country (can be due to climate, wealth, resources environmental conditions, etc)
-urban and rural communities (due to resources, environmental exposures, or behavioral differences)
-and there are also sometimes just localized occurrences of disease
-different variations within a country (can be due to climate, wealth, resources environmental conditions, etc)
-urban and rural communities (due to resources, environmental exposures, or behavioral differences)
-and there are also sometimes just localized occurrences of disease
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What are the characteristics of time that affect health outcomes/ comparisons?
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-cyclic fluctuations
-common source epidemics
-secular time trends
-clustering
-common source epidemics
-secular time trends
-clustering
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Cyclic fluctuations
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-periodic changes in the frequency of health outcomes
-seasonal patterns of health outcomes
-may be due to changes in host lifestyle, seasonal climate changes, and virulence of an infectious disease
-seasonal patterns of health outcomes
-may be due to changes in host lifestyle, seasonal climate changes, and virulence of an infectious disease
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Common source epidemic
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an outbreak due to the exposure of people to a common source/ agent (can be point or continuous)
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Point epidemic
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an outbreak where common source is known, and it lasts just one incubation period (ex: food borne illnesses)
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Continuous common source epidemic
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an outbreak where cause/ source is known, but it lasts slightly longer than one incubation period
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Propagated epidemic
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an outbreak where the source is unknown, the disease is passed person to person, a lot of people get it, and the outbreak lasts WAY longer than a single incubation period
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Secular time trends
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-the gradual change in disease frequency over time
-can be due to health services, lifestyle changes, better treatment/ education, etc
-can be due to health services, lifestyle changes, better treatment/ education, etc
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Case clustering and the two types
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-Case clustering is just a bunch of cases aggregating around a certain time (temporal clustering), or around a certain geographic area (spatial clustering)
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