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HLTB21-Sept. 12- Lecture 2.docx

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Management (MGT)
Course Code
Chris Bovaird

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September 12, 2013 - Lecture 2  Calgary flooding vs. third world country Epidemiology The Study of (Human) Disease, Illness and Injury • causes, manifestations, distribution and consequences... and the application of this study to the control of health problems (public health) • interactions of host, agent and environment  Epidemiology: a discipline that is relatively new  study of disease, illness and injury  Public health: functions to observe and collect data, but mainly to prevent and control disease  Close relationship between humans and environment - if you suffer from disease, you probably have an imbalance in the relationship of human and environment - malnourishment (immunity) -> disease - Environment: overcrowding -> Incubation time: pathogen spreads faster if incubation is short THUS: it examines the biology and behaviour of humans (animals) (host) and disease-causing pathogens (agents), as well as non-living and living environmental factors (natural and cultural) influencing the development and manifestations of disease • And applies this knowledge to deal with/the control of health issues Descriptive(morbidity/mortality), theoretical (models), analytical (quantitative) and applied (public health control / prevention) ‘Miasma’ and Cholera • London, England th • 4 major cholera outbreaks in mid-19 C. • Cholera: acute intestinal infection caused by bacterium Vibrio cholerae • 600+ deaths in 1854 • John Snow Morbidity: sickness ; and mortality: death Epidemiological Questions • who is prone to a particular disease? • when is the disease most likely to occur 
(including trends over time) • where is the risk of disease highest/lowest? • what exposure (factor) do its victims have in common? • how much is the risk increased through exposure? • how many cases of the disease could be avoided by eliminating the exposure? Who gets what, where, and when Methodology Analysis of vital statistics on morbidity and mortality Large-scale population surveys and surveillance (CDC, WHO) To determine
whether there is a statistical association between particular characteristics and the development of a disease (risk, prevalence) Sources of Data • Censuses (population numbers and composition): which provide the denominator, or the population at risk, for computing epidemiologic rates/proportions) • Vital Statistics: births/deaths(#andcauses) • Disease Registries, e.g., National Cancer Institute • Health Surveys: national, governmental • Health Care Utilization Records: doctors’ records • Supplemental Sources: media, insurance companies, work sites, police, schools, social workers • Anthropological Ethnographies Disease Ecology Puts more emphasis on the environment part of the triad Disease Ecology Framework • Interdisciplinary field that merges microbiology, ecology, genetics, geography, medicine, mathematics and epidemiology to explore the relationships between infectious disease agents, their animal and human hosts, and their environment (to ultimately understand variations in disease patterns / geographic distribution of diseases) • Recognizes that disease is due to 1) genetics, 2) environment, and 3) behaviour What are “vulnerable” spaces / places? Environment: Natural and Built  Built environment : structures that we live in (roads, highways, sanitation or lack of it, etc.)  Bottom environment: social environment -> interaction between people and communities, inequalities Medical Ecology  emphasizes the study of health and disease in environmental context Medical Geography  Field of medicine that incorporates concepts and techniques of geography into the study of health and the spread of disease: 1) examines the relationships between people and their environments in holistic terms; 2) spatial analysis (where disease occurs, and at what rate, is important....for clues to causation) – thus distributional maps showing patterns of health- related phenomena  Also: impact of climate and location on a person’s health  Distribution of health services Environmental burden of disease globally  unsafe water, poor sanitation and hygiene  Indoor smoke  Malaria  Urban air pollution  Unintentional acute poisoning (chemicals, pesticides, etc.)  Climate change Anthropology and Infectious Disease  Explores health of living communities today  Offering a more cultural perspective Health and Belief Model  Knowledge= behavior  Giving as much info as possible to the general public, so that once they’re informed, they can prevent it  Behavioural change -> ex. when you sneeze, you cover with your sleeves  The health belief model is problematic because we can’t just assume that just because people have knowledge, they’ll use it safely Anthropological Model of Infectious Disease Ec
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