Application of Epidemiology in

Public Health
 Lecture outlines
• What is applied epidemiology?
• Activities of applied epidemiology
• Epidemiological approach to public health
actions.
• Scope and jurisdiction
• Where have we come from, where do we
need to go?
• Functions utilizing epidemiological expertise.
• Significant contributions of epidemiology to
public health.

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Applied Epidemiology: Poplhlth 304
Epidemiology can take you places...

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 What epidemiology isn't

Statistics

Health promotion

Easy, requires effort

Static, rather constantly evolving
 Definition of applied epidemiology
Applied epidemiology tracks diseases and
disease indicators in populations. It is the
scientific foundation of public health research
that seeks to reduce risk factors and improve
health. The discipline also contributes to public
health practice and policy, and research in
other related fields such as medicine and
pharmacy.

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 Definition of applied epidemiology
• The study of the frequency and distribution of
disease in human populations as applied to
public health practices.
• Approach to preparing epidemiologists for the
emerging challenges of public health in which
epidemiological research and practice are
applied toward improving public health and
health care.
• In short, Applied Epidemiology is
‘Epidemiology in Action’
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 EPIDEMILOGY PROVIDES
INTELLIGENCE
FOR HEALTH ACTION
INTELLIGENCE MEANS
INFORMATION REGARDING
THE DETERMINANTS OF HEALTH &
DISEASE AND THEIR OCCURRENCE &
MAGNITUDE IN POPULATIONS
FOR TAKING HEALTH ACTION
J. N. MORRIS
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 Uses of Epidemiologic Methods
Applied Epidemiology finds answers of questions:
What are the actual and potential health problems in
the community? Where are they? Who is at risk?
Which problems are declining or increasing over
time?
How do these relate to the level and distribution of
services available?.

The descriptive and analytic epidemiology provide

ways to answer all these questions. With answers
provided through the application of epidemiology, the
policy makers can make informed decisions that will
lead to improved health for the population.
 Use of ..
Individual decisions.
When people decide to stop smoking, take the stairs
instead of the elevator, order a salad instead of a
cheeseburger, or choose one method of contraception
instead of another, they may be influenced, consciously
or unconsciously, by epidemiologists’ assessment of
risk.

In the 1950’s, epidemiologists documented the increased

risk of lung cancer among smokers; in the mid-1980’s,
epidemiologists identified the increased risk of human
immunodeficiency virus (HIV) infection associated with
certain sexual and drug-related behaviors. These type
of epidemiologic findings are directly relevant to the
choices that people make every day and that affect their
health over a lifetime.
 Significant contributions of
epidemiology to public health
• USA: Average life expectancy 47.3 yrs at
the beginning of 20th century to 77.2 yrs at
the end of the century.
• USA as well as in developing world:
Epidemiological transition-major causes of
death switched over from communicable to
chronic & noncommunicable diseaes

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 Outstanding examples of the
contributions of epidemiology
• Smallpox
• The health hazards of smoking
• Injuries
• Environmentally induced diseases
• Methodological advances

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 Activities performed in Applied Epidemiology
Use the Epidemiological methods in practical like:
•Design and evaluate surveillance systems to assess
health problems.
•Play a functional role in emergency preparedness and
response.
•Be able to interpret surveillance data.
•Design an epidemiologic study to address a health
problem.
•Understand the basic types of study design and the
advantages and limitations of each type.
•Design a questionnaire or other data collection tool to
address a health problem.
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Activities performed in Applied Epidemiology
• Collect health data from appropriate sources
(e.g., case interviews, medical records, vital
statistics records, laboratory reports, or
pathology reports).
• Interpret findings from epidemiologic studies,
including recognition of the limitations of the
data and potential sources of bias and/or
confounding.
• Recommend control measures, prevention
programs, or other public health interventions
based on epidemiologic findings.
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 EPIDEMIOLOGICAL PURPOSE &
SEQUENCE
1. IDENTIFYING DISEASE/ HEALTH PROBLEM
2. LINKING WITH THE CAUSE / RISK
FACTORS
3. ESTABLISHING CAUSAL RELATION- SHIP
4. DESIGNING AN INTERVENTION FOR
CONTROLLING PROBLEM
5. TO EVALUATE THE EFFECTIVENESS OF
INTERVENTION

(MAXCY) 16
 SEARCH FOR CAUSES
SEVERAL CAUSES SINGLE DISEASE

SINGLE CAUSE  SEVERAL DISEASES

SEARCH FOR CAUSE IN INTERRELATED

DISEASES MAY YIELD CLUES FOR NEW
CAUSES / RISK FACTORS
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 SCOPE AND JURISDICTION
STRICTLY SPEAKING, THERE IS NO LIFE SCIENCE, WHERE
EPIDEMIOLOGICAL APPROACH AND PRINCIPLES CANNOT
BE APPLIED

FROM WOMB TO TOMB EPIDEMIOLOGY IS APPLICABLE

PREVENTIVE PAEDIATRICS
PREVENTIVE GERIATRICS
PREVENTIVE CARDIOLOGY
CLINICAL EPIDEMIOLOGY

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 1. Epidemiology studies populations
Epidemiology is the study of health and
disease in populations for the purposes of
(i) understanding disease dynamics,
(ii) controlling disease, and (iii) promoting
health.
Comparison across and within populations
is the key strategy of epidemiologic inquiry.

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 2. Populations are diverse
Populations (meaningful collections of
people) are diverse, heterogeneous,
dynamic, and interconnected.
Epidemiology depends on these qualities in
order to make useful comparisons.
Comparisons must not be confounded by
uncontrolled diversity.

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 Measures for studying populations
1) Counts of people – rates, proportions,
and ratios, e.g., birth rate, death rate,
incidence, prevalence, abortion ratio;
2) Distributions of characteristics of people,
e.g., mean age, mean education, mean
cholesterol level;
3) Characteristics of groups or
environment, e.g., sexual networks

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Where have we come from, where
do we need to go?

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 Epidemiology in the 19th century –
focus on acute infectious disease
• Virulent, highly contagious
microorganisms – measles, yellow fever,
smallpox, typhoid, cholera,…
• Prototypical for public health
• widespread impact
• Inherently social (external threat)

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 Expanding beyond the original
rationale
• Non-contagious diseases
• Indirect societal involvement
• Mass disease
• Opportunity for prevention

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 Epidemiology in the 20th century
• Infectious diseases – tuberculosis
• Deficiency diseases – pellagra (niacin
deficiency)
• Chronic diseases – CVD, cancer
• Psychiatric disorder – schizophrenia,
depression

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 Epidemiology in the 20 century
th

• Injury – motor vehicle crashes, suicide,

homicide
• Pharmaceuticals – efficacy and adverse
effects
• Personal behavior – noncompliance with
medical treatment regimens, smoking,
alcohol, exercise

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 Behavior and public health
1. Behavior is a fundamental determinant of
public health.
2. Behavior arises from awareness.
3. Awareness is influenced by biology,
behavior, and the environment.
4. Epidemiology can help to improve
awareness, behavior, and health.
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 Epidemiology of behavior:
a new frontier for epidemiology
• Epidemiology and public health have
primarily studied personal behavior, e.g.:
- Health care-related (treatment seeking,
compliance)
- Lifestyle behavior (smoking, use of
alcohol, sloth, etc.)

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 The right to health
“The enjoyment of the highest
attainable standard of health is one of
the fundamental rights of every human
being without distinction of race,
religion, political belief, economic or
social condition.” 1946 Constitution of the World
Health Organization, AJPH Dec 2001:1923

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 The role of epidemiology

“Epidemiology is fundamentally
engaged in the broader quest for
social justice and equality.”

John Cassel, a founder of the UNC Department

of Epidemiology and a revered figure among
epidemiologists

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 Study questions
• What do you mean by applied epidemiology?
• Explain Significant contributions of
epidemiology to public health and outstanding
examples.
• An outbreak of cholera occurred in a village of
your area . How can you apply epidemiology in
combating this outbreak?
• Enumerate 10 public health issues and write
down the epidemiological approaches to
address each of the issues.

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 References
• The Development of Modern
Epidemiology,Walter W. Holland,Jorn Olsen,&
Charles Du V.Florey; Oxford University
Press,2007.1st edition
• Paddasree Dr.Rekha Dutta,India(Internet)
• Epidemiology -its perspectives &
applications, Dr. A.K.Avasarala MBBS,MD

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THANK YOU

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