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epidemiology
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scientific study of the disease pattern in a pop.
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what is epidemiology the study of?
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the study of the distribution and determinants of health related states or events in specified pop. and application of the study to control of health problems
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what are the study targets of epidemiological studies?
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population in geographical area, age, sex, ethnicity, race, etc.
most common is the pop. in given area at given time
all findings must relate to defined pop.
most common is the pop. in given area at given time
all findings must relate to defined pop.
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what do you need to consider for epidemiological studies?
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positive and negative cases
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what does epidemiology include?
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humans
zoonotic diseases
similar clues to pathogenesis (chimpanzees)
pets
zoonotic diseases
similar clues to pathogenesis (chimpanzees)
pets
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zoonotic diseases
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from people to animals vice versa
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what are the aims of epidemiology?
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1. describe/analyze disease occurrence and distribution in human pops.
2. identify etiological factors in pathogenesis of diseases
3. provide data essential to planning, implementation, and evaluation of services for prevention, control and treatment of diseases and to setting up go priorities among those services
2. identify etiological factors in pathogenesis of diseases
3. provide data essential to planning, implementation, and evaluation of services for prevention, control and treatment of diseases and to setting up go priorities among those services
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what do the aims of epidemiology answer?
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when, where, who affected
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why answer the questions of the aims of epidemiology?
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1. eliminate/reduce health problem in question (or its consequences)
2. promote health/wellbeing of society as a whole
2. promote health/wellbeing of society as a whole
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incidence
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proportion or rate of subjects who develop a condition during a particular time period
yesterday= has to be a complete date
yesterday= has to be a complete date
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prevalence
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proportion of subjects who have a condition at or during a particular time period
depends on incidence and duration
since the start=confirmed cases today (all cases)
depends on incidence and duration
since the start=confirmed cases today (all cases)
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proportion
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comparison of a part to the whole
amount of disease that can be attributed to a particular exposure
vaccinated pop.
amount of disease that can be attributed to a particular exposure
vaccinated pop.
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rate
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measure of frequency with which an events occurs in a defined pop. over a specific period of time
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attack rate
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proportion of population that develops illness during an outbreak
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prevalence rate
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proportion of pop. that has a health condition at a point in time
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cases fatality rate
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proportion of persons with the disease who die from it
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morbidity
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referencing illness/disease/impairment
physical or psychological state considered outside normal wellbeing
often used in relation to chronic/age related diseases
can worsen over time
impact quality of life
physical or psychological state considered outside normal wellbeing
often used in relation to chronic/age related diseases
can worsen over time
impact quality of life
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what are the most common morbidities?
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heart disease, cancer, stroke, Alzheimer's, influenza and suicide
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mortality
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referencing death - # of deaths due to a specific condition
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mortality rate
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# deaths due to an illness / total pop. at specific point in time
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excess mortality
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comparison of # of expected deaths vs number of actual deaths
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mortality vs morbidity of chicken pox
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high morbidity, low mortality
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mortality vs morbidity of flu
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high morbidity, low mortality
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mortality vs morbidity of rabies
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low morbidity, high mortality
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structural violence
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avoidable/unnatural
fundamental human needs are lost
high cause of unnecessary death
affects diff. people in diff. social structures
bottom rungs of society
subtle, people are marginalized
gradual
systematized
normally accepted
responsibility is. blurred
determines who is heard, valued/devalued/gets resources
fundamental human needs are lost
high cause of unnecessary death
affects diff. people in diff. social structures
bottom rungs of society
subtle, people are marginalized
gradual
systematized
normally accepted
responsibility is. blurred
determines who is heard, valued/devalued/gets resources
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what are some examples of structural violence?
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poverty, unemployment, discrimination, corrupt political system, poor accountability fo misuse of power, poor health care/schools/housing, racial profiling
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mortality complex
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the role of stress: stress is implicated in diseases. too much stress releases too much hormones which degrades your body to respond to certain things
mental illness related to mortality (schizophrenia, depression/anxiety)
mental illness related to mortality (schizophrenia, depression/anxiety)
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disease
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needs to be cured
pathological process
ex: infection, injury, toxic exposure
etiology: bacteria, fungus, virus, parasites
absence of this does not indicate good health
pathological process
ex: infection, injury, toxic exposure
etiology: bacteria, fungus, virus, parasites
absence of this does not indicate good health
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illness
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needs to be managed
ex: pain, weakness, fatigue
experience of/feeling of unhealth
etiology: stress and anxiety
has a societal component
to some degree a subjective measure
ex: pain, weakness, fatigue
experience of/feeling of unhealth
etiology: stress and anxiety
has a societal component
to some degree a subjective measure
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disease and illness
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not mutually exclusive
often co-occur
disease often causes illnesses
often co-occur
disease often causes illnesses
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health disparities
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a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage
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disparity
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health outcome different between populations
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what causes a difference in health outcome?
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environment, access to/ utilization of/ quality of care, health status, particular health outcome needing review
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what are some health inequalities - social determinants of health?
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economics, food, education, health care, social, environment
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social determinants of health
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circumstances in which people ae born/grow up/live/work/age
the system put in place to deal with illness
shaped by economics, social policies,
social circumstances create societal stratification and are responsible for health inequities
WHO
between and within countries
the system put in place to deal with illness
shaped by economics, social policies,
social circumstances create societal stratification and are responsible for health inequities
WHO
between and within countries
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SDOH/health inequities complex
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the intangible aspect of lower class stress
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what is the stress?
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stressors
coping mechanisms (overweight, smoking, drinking)
coping mechanisms (overweight, smoking, drinking)
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or is it resources? (Phelan argument)
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fundamental social cause of health inequalities
influences multiple disease processes
access to resources can help avoid risks (SES and having flexible resources)
basic premise: people with high SES have superior, flexible resources and avoid disease in multiple circumstances
greater resources leads to better health
inequality in health will exist as long as financial inequalities does because of basic premise
influences multiple disease processes
access to resources can help avoid risks (SES and having flexible resources)
basic premise: people with high SES have superior, flexible resources and avoid disease in multiple circumstances
greater resources leads to better health
inequality in health will exist as long as financial inequalities does because of basic premise
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who makes the changes that work?
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human service organizations, grant funding. doctors can't make the change (structural change)
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how are we addressing the issue? (healthy people 2020)
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attain high quality, longer lives free of preventable disease, disability, injury, premature death
achieve healthy equity, eliminate disparities, and improve health of all groups
create social and physical environments that promote good health for all
promote quality of life, healthy development, healthy behaviors across all life stages
achieve healthy equity, eliminate disparities, and improve health of all groups
create social and physical environments that promote good health for all
promote quality of life, healthy development, healthy behaviors across all life stages