Epidemiology Exam 1

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Epidemiology

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The study of patterns, causes, and effects on health on a disease in a defined population.

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Health

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- The homeostatic parameters of a person

- Based on population statistics

- Quantitative

-Absence of disease

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Wellness

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Qualitative state of a persons personal health

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Fitness

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The mental & physical ability to get through the day

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Disease

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- Any disturbance of structure/function which impairs normal activity

- Any condition that causes pain, dysfunction, distress, social problems, or death.

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Death

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The cessation of all cellular activity

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4 Stages of Death

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1. Cellular Death

2. Tissue Death

3. Organ Death

4. Somatic Death (full body death)

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Pathology

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The study of disease state, not upon a defined population

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Pathophysiology

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The study of the nature of disease (step by step process to function of body)

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Etiology

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Study of the cause vs. the origin (ex. the cause of Ebola was the Ebola virus, the origin was fruit bats)

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Pathogenesis

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The mechanism & development of the disease

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Pathogen

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- Develops disease, 5 types:

1. Prion (smallest)

2. Virus

3. Bacteria

4. Parasite

5. Fungi/yeast (largest)

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Symptom

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Outward appearance of the disease

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2 Disease States

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1. Symptomatic- outward appearance, has disease

2. Asymptomatic- no appearance, has diease

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Manifestation

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Development of symptoms

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#1 cause of death in the world

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Heart Disease

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#2 cause of death in the world

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Stroke (CVA)

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#3 cause of death in the world

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Infectious disease; respiratory, diarrhea, AIDS & HIV, tuberculosis, malaria, measles

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#4 cause of death in the world

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Cancer

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#5 cause of death in the world

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Respiratory (non-infectious)

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Causes of Death (6)

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1. Disease

2. Cell senescence

3. Predation

4. Physical injury

5. Paranatal

6. Malnutrition

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Mortality

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Incidence of death in a population

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Disease classifications (6)

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1. Infectious/contagious

2. Inflammatory diseases

3. Congenital/Hereditary diseases

4. Neoplastic diseases

5. Degenerative diseases

6. Metabolic diseases

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Infectious

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Body invaded by a pathogen

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Contagious

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Passed on to other people

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Innate Immune System

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Immediate response; inflammation and cellular

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Adaptive/acquired Immune System

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Presence of antigens (signature on the cell) in the body; humoral and cellular response

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Inflammatory diseases

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Activate the inflammatory process by physical, infectious (biological), or chemical agents.

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Normal response to inflammation (4)

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1. Redness

2. Heat

3. Pain

4. Swelling

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Congenital diseases

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Occur from time of birth to within 1 month of life; caused by uterine environment, infections, the birth process, morphological development, or idiopathic (no known cause)

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Neoplastic diseases (aka cancers)

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Uncontrolled cell growth by irregularity within the cell cycle; cell bypasses all check phases and goes straight to abnormal division, produces cancer antigens (nonself)

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Degenerative diseases

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Breakdown in the structure of function; caused by age, potential infections, overuse/impact, injury, arthritis

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Metabolic diseases

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Deal with the metabolism by altering ATP production, typically due to ischemia or hypoxia

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Ischemia

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Lack of blood flow

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Hypoxia

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Lack of oxygen

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Public Health

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The science of protecting, maintaining, and improving health in a population/community.

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4 purposes of public health

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1. prevention of disease

2. surveillance/monitoring of diseases

3. controlling diseases

4. tracking the spread of disease

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Prevention of disease

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includes primary prevention, secondary prevention, and tertiary prevention

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Primary prevention

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Prevention prior to disease (ex. education about risk factors, etc.)

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Secondary prevention (pre-clinical)

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Disease state but no symptoms, the latency/incubation period that includes blood tests and/or isolation.

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Tertiary prevention (clinical)

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Persons with the disease and symptoms, the goals are to try and prevent pain/further damage, slow the pathogenesis, prevent complications, provide better care, or to cure the disease.

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8 diseases currently monitored by the WHO

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1. Cholera

2. Plaque

3. Yellow fever

4. Relapsing fever

5. Typhus

6. Small pox

7. Polio

8. SARS

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Cholera

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Vibriocholeal; severe dehydration, found in water

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Plague

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Yersina Pestis; bubonic plague, involves the lympathic system (blood) and respiratory, affects skin & lymph

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Yellow fever

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viral RNA virus; liver destruction

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Relapsing fever

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Rickessia; in 3rd world countries, recurring fever every 2-9 days, hard to get rid of

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Typhus

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Caused by ticks, fleas, etc., increase in body temp to about 105-106 degrees, meningeal sulfilitis

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Small pox

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Variola virus; inhaled, goes into blood, affects skin, scarring

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Polio (myelitis)

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Polio virus; viral infection of the muscle, feces in the water

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SARS

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Crono virus; severe acute respiratory syndrome, accumulation in lungs causing drowning

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Controlling disease

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involves:

1. identifying the source (etiological agent)

2. identifying the origin

3. understand chain of infection

4. regulation of the prevalence (health care practices & vaccines, herd immunity)

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Herd immunity

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A group of people can build up an immunity, based on the size and strength of the herd

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Endemic disease

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Natural existence/occurrence of the disease in a population, the stable point

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Epidemic disease

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An increase above the normal occurrence within one defined population (separated by geographical barriers)

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Pandemic disease

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Epidemic that has crossed the geographical barriers (mountains, river, etc.) and traveled into new populations

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Descriptive epidemiology

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Accumulate data about time, location, characteristics, prevalence, incidence, etc.

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Analytical epidemiology

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Test associations between the risk factors and the disease state.

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Individual perspectives of epi

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How or what affects the individual person?

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Population perspective of epi

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Mass affect of a disease on a population, the impact on a population and the individual is measure by AR

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Attributable risk (AR)

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Exposed state- Unexposed state= AR

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Absolute (AR)

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Facts that show how much of the total risk is attributable to a factor

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Absolute AR frames

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Crude measures- prevalence in a population (total # of cases)

Crude incidence- total # of new cases

Crude mortality- total # of deaths

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Relative measures of AR

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How much of the risk is/can be attributed to a factor, associations; includes proportion, rates, & ratios

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Proportions

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# of people experiencing something, numerator is in the demoninator

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Rate formula

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# of cases/time

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Ratios

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x= exposed with the disease/y= unexposed with the disease

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Population

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Summation of all organisms of the same group that inhabit a specific geographical area, interact and interbreed

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Population chart

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Persons/individuals with similar characteristics

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3 primary assumptions of any population

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1. Diversity

2. Dynamic

3. Heterogenous

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Diversity in a population

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Large # of genetic characteristics within a population

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Dynamic population

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Always changing and has potential to do so; people come/leave, born/die, sickness/cured

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Heterogeneous population

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No distinct uniformity, more than one factor can cause a disease

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Population classifications

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1. Demographics

2. Health status

3. Development

4. Socioeconomic

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Strata

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Levels within a given parameter (population)

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Demographics (classification)

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Gender, age, race, ethnicity, religion

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Health status (classification)

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"burden of disease," a population with a high burden has low health status; death v health, family v community, males v females, morbidity v mortality

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Development (classification)

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"human developmental index," compares countries based on their level of development; developed v undeveloped, rural v urban, poverty, environment

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Socioeconomic (classification)

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Education, income, social class, employment; general ability to get health care

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4 major concerns of countries

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1. Mortality

2. Life expectancy

3. Birth & Fertility rate

4. Health status

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Mortality (concern of country)

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average # of deaths

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Life expectancy (concern of country)

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average # of years remaining from a given point in life; the longer you live, higher immunity, better chances of living tomorrow; however, age works against this

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Birth & Fertility rate (concern of country)

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High birth rate means high death rate; unstable population

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Health status (concern of country)

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1. average life span

2. prevalence of preventable diseases

3. incidence of disease

4. availability of health services

5. cost- drives health care needs

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Population pyramid

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Graphical representation that shows distribution by age and gender (x axis= gender, y axis= age)

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4 types of pop. pyramids

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1. Early expanding

2. Late expanding

3. Stationary

4. Constrictive

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Burden of disease

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The impact that disease has on a population, the difference between health state & status

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Burden of disease is determined by

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1. prevalence of preventable diseases

2. life span & life expectancy

3. incidence of disease (mortality rate)

4. cost to survive

5. availability of health care

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Health outcome indicator

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A measure of "health" to evaluate a population

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4 important health outcome indicators

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1. life lost due to death in any given age group (babies have low value of life, elderly have even lower value)

2. time lost due to premature death OR living in a state of less than perfect health

3. value of a year based on age

4. discount future health if NOT in perfect health

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Ideal human developmental index

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1.0 (the highest is about 0.9 to date)

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Total fertility rate

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For economic stability, there needs to be an increase in TFR

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HALY

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Health adjusted life years (based on perfect health)

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DALY

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Disabled adjusted life years- measure of the overall burden expressed by # of years lost to ill health; used to compare nations & communities

1 DALY= 1 year of health life lost

DALY= YLL + YLD (years life lost + years with disability)

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QALY

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Quality adjusted life years- measure of disease burden; assessing the quality & quantity of years lived, measures cost (years added by intervention)