Epidemiology Principles - slide 4

Monday, February 27, 2023 7:50 PM

Objectives:

• Calculate incidence and prevalence of selected diseases

• Identify relations between incidence and prevalence of selected diseases

Measurements and Calculations

• In epidemiology, the occurrence of a disease or condition can be measured using rates and proportions. We use these measures
to express the extent of these outcomes in a community or other population.

• Rates tell us how fast the disease is occurring in a population.

• Proportions tell us what fraction of the population is affected.

Morbidity

• Morbidity rate
○ Refers to the number of individuals who have contracted a disease during a given time period (the incidence rate)
or the number who currently have that disease (the prevalence rate), scaled to the size of the population.

• Mortality rate
○ A measure of the number of deaths (in general, or due to a specific cause) in some population, scaled to the size of that
population, per unit time. Mortality rate is typically expressed in units of deaths per 1000 individuals per year; thus, a
mortality rate of 9.5 in a population of 100,000 would mean 950 deaths per year in that entire population

Risk vs Rate

• Risk and rate are often used interchangeably by epidemiologists but there are differences

• Risk is a probability statement assuming an individual is not removed for any other reason during a given period of time

○ As such, risk ranges from 0 to 1 (no chance to 100% probability of occurrence)

○ Risk requires a reference period and reflects the cumulative incidence of a disease over that period

• Rates can be used to estimate risk if the time period is short (annual) and the incidence of disease over the interval is
relatively constant
○ If however, individuals are in a population for different periods of time for any reason, then you should estimate risk by
incidence density

Incidence Density

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Natality

• The ratio of live births in an area to the population of that area; expressed per 1000 population per year.
• Often discussed in the context of (birth rate, fertility rate)
• Natality measures are used primarily by demographers for population projection

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Concerns about Crude Birth rates

• Definitions of a live birth may vary

• U.S. = “any product of conception that shows any sign of life after complete birth (pulse, heartbeat, respiration, crying,
pulsation of umbilical cord or movement of the voluntary muscles)”

• Total fertility rate: Same as above, but use women 10-49 years and adjust for age cohorts
• Gross reproductive rate: Same as TFR, but use only live births of females in numerator
• Net reproductive rate: Same as GRR, but count only births of females who survive to reproductive age in the numerator

Net Reproductive Rate (NRR)

• If NRR = 1,000, each generation will just replace itself

• If NRR < 1,000, indicates a potentially declining population
• If NRR > 1,000, indicates a potential population increase

Mortality Measures Related to Natality

• Fetal Death Rate or Ratio: Used primarily by public health officials to estimate the health of populations

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