EPIDEMIOLOGY

Definition of Epidemiology
The word epidemiology comes from epidemic, which, translated from Greek, means "upon the
people."
Epidemiology is the study of the distribution and the determinants of health-related states or
events in specified populations, and the application of this study to control of health problems
(John M Last (1988).
• Study: observation, hypothesis testing, analytic research, and experiments. surveillance,
• Distribution: thru surveillance and descriptive studies (Person, Place, & Time).
• Determinants: “BEINGS” factors that influence health; thru analytical studies.
• Health-related states or events: diseases, causes of death, behavior, reactions to
preventive regimens, and provision and use of health services.
• Specified populations: include those with identifiable characteristics, such as
occupational groups.
• Application to prevention and control: the aims of public health—to promote, protect,
and restore health.
The definition of epidemiology includes three important elements:
1. All diseases included. The term is no longer restricted to the study of infections but it
includes cancer, malnutrition, road accidents, mental illness and other non-communicable
diseases. Epidemiological techniques are also being applied to the study of the operation
of health services.
2. Populations. Whereas clinical medicine is concerned with the features of disease in the
individual, epidemiology deals with the distribution of disease in populations,
communities or groups.
3. Ecological approach (Epidemiological Approach):The frequency and distribution of
disease are examined against the background of various circumstances in man's total
environment - physical, biological and social (the occurrence of disease is examined in
terms of the interrelationship between human beings and their total environment).
Epidemiological Approach to problems of health and disease is based on two major
foundations:
 asking questions related to health problems and health actions and
 making comparisons thru the different types of studies

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Scope of epidemiology
The scope of epidemiology is demonstrated in figure1.

Epidemiology has three principal traits:

1. Epidemiology always deals with the aggregate (with groups of people), not with
individuals.
2. Epidemiology always compares one group with another group.
3. Epidemiology is concerned with those within the same group who have a characteristic
or who are subject to some phenomenon, and with those who do not have the
characteristic or who are not subject to the phenomenon under study.
In other words, in any epidemiologic interpretation or investigation, the epidemiologist
always asks two questions: (a) why do those who have a condition have it. In addition (b),
why are those who do not have the condition spared?

Objectives (aims) of Epidemiology

1. describe the spectrum of diseases and their determinants in the community
2. to study the natural history and prognosis of disease, injury, disability & death
3. to identify causal factors of diseases and the relevant risk factors
4. to evaluate both existing and newly developed preventive, control and therapeutic
measures and modes of health care delivery
5. to apply this knowledge for health promotion, disease prevention and public health
practice
6. To aid in planning & development of health services

Uses of Epidemiology
The most important use of epidemiology is to improve our understanding of health and
disease. Epidemiologist Jeremy Morris defined five uses of epidemiology:
1 Historical study: determining whether community health is getting better or worse
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2 Community assessment: defining actual and potential health problems
3 Working with health services: improving efficacy, effectiveness, and efficiency of health
services.
4 Individual risk and chances: determining actuary risk and health hazards appraisals for
individuals and populations (e.g., what is the risk that an individual will die before his
next birthday?)
5 Completing the clinical picture: offering different presentations of a disease

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