Epidemiology Lecture 1

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epidemiology

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study of the distribution and determinants of disease frequency in human populations; derives from the Greek word meaning "upon the people"; study of factors controlling the presence or absence of a bug; addresses health at a population level

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Hippocrates (400BC)

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man you hypothesized that disease might be associated with the physical environment, including seasonal variation in illness

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John Graunt (1662)

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man who was first to employ quantitative methods in describing population vital statistics

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John Snow (1813-1858)

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an English physician and modern day father of epidemiology; used scientific method to identify cause of cholera epidemic in London; identified the water pump on Broad Street responsible for the disease

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Lambeth

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water supplier in London that pulled water upstream from sewage; people drinking it had a lower cholera death rate

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Southwark and Vauxhall

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water supplier in London that pulled water downstream from sewage; people drinking it had a higher death rate from cholera

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Doll and Hill (1950)

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scientists who used a case-control design to describe and test the association between smoking and lung cancer

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Frances et al. (1950)

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scientist who performed a huge formal field trial of the poliomyelitis vaccine in school children

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Dawber et al. (1955)

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scientist who used the cohort design to study risk factors fro cardiovascular disease in the Farmingham Heart Study

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study

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surveillance, observation, hypothesis testing or analytic research, experiment

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distribution

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analysis by time, place, and class of persons affected

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determinants

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all the physical, biological, social, cultural, and behavioural factors that influence health

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health-related states and events

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diseases, causes of death, behaviour, and provision and use of health services

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specified populations

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populations with identified characteristics such as precisely defined numbers

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applications to control

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to promote, protect, and restore health

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clinical practical uses of population data

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diagnosis, prognosis, and selection of therapy determined from large groups of patients

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agent

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a necessary ingredient in the production of disease; may be infectious or noninfectious (chemical, radiation); may be single or complex

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host

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biological and behavioural qualities of an individual; factors can influence the exposure to disease-causing agents and the occurrence of disease after exposure

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environment

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external factors that affect the likelihood of disease occurrence, e.g. population density

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analytic study

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discovery of key determinants and definition of natural history of diseases

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intervention/experimental study

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assessment of efficacy and efficiency of methods to prevent, cure and alleviate disease

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descriptive study

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description of the distribution of health-related states and determinants in the population

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health services research

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evaluation of the process and outcome of services provided