MGTA01H3 Lecture Notes - National Cancer Institute, Cholera, Built Environment

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13 Sep 2013
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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
4 major cholera outbreaks in mid-19th 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)
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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 determinewhether 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
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