Introduction to Epidemiology

St. James Institute of Nursing

and Health Sciences

Sineer Micah
RN, Dip-Card, Post RN BScN, MScN
 What is epidemiology?
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Epidemiology is the study of how disease is distributed in

population.

Why does disease is developed in some people and not in

others?
 Definition
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A branch of medical science that deals with the incidence,

distribution, and control of disease in a population.
(www.merriam-webster.com)

The study of the distribution and determinants of health-

related status or events in specified population and the
application of this study to control of health problems.
(Leon Gordis, 2009)
 The Objectives of Epidemiology
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To identify the etiology or cause of the disease and the

relevant risk factors (factors that increases the person’s
risk for a disease).

To determine the extent of the disease found in the

community.

To study the natural history and prognosis of disease.

 The Objectives of Epidemiology
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To evaluate both existing and newly developed preventive

and therapeutic measures and modes of health care
delivery.

To provide the foundation for developing public policy

relating to environmental problems, genetic issues, and
other considerations regarding disease prevention and
health promotion.
 Changing Pattern of Community Health Problems
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Major role of epidemiology is to provide a clue to change

that take place over time in the health problems
presenting in the community.
In 1900 the leading cause of
In 2007 the leading cause of
death was the communicable
death are the chronic dieses.
disease.
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 Epidemiology and Prevention
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By using the epidemiological studies we can identify the

sub-groups in the community, who are at high risk for the
disease.

Then we can direct the preventive efforts such as,

screening programs for early disease detection.

Secondly, if we can identify such groups, we may be able

to identify the specific factor or characteristics that put
them at high risk and then try to modify those factors.
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 Types of Prevention
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• In person who is well and does not have the disease.

Primary • Primary prevention is our ultimate goal.

• A disease is already begun but patient had not

develop a clinical S/S of the illness (preclinical
Secondary phases of the disease)
• Prevention is done to identify the disease earlier in its
occurrence.

• For people who are in the clinical phase of the disease.

Tertiary • Prevention achieved through prompt and appropriate
treatment of the illness.
 Epidemiology and Clinical Practice
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A practice of medicine is dependent on population data.

Example, a patient ask his doctor, “ How long I have to

live, doctor?” and the doctor replied, Six months to one
year.”
Observation of patients with same;
• Disease
• Condition
• Age
• Stage of disease
• Treatment
 Edward Jenner and Smallpox
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In late 18th century 400,000 people died from smallpox

each year.
Every third survivors became blind as a result of corneal
infection.
“Variolation”
Some variolated people died because of smallpox.

The term vaccination is drived from vacca, the Latin

word for cow.
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 Jenner’s experiment was purely based on the observational data

that provide the bases of the disease prevention.
John Snow and Cholera
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 Epidemiology Study Types
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Descriptive
Observational

Analytical
Epidemiology
study

Experimental
 EXPERIMENTAL STUDY
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The investigators can control certain factors within the study

from the beginning. An example of this type is a vaccine
efficacy trial that might be conducted by the National
Institutes of Health. In such a trial, the investigators randomly
control who receives the test vaccine and who does not among
a limited group of participants; they then observe the outcome
to determine if it should to be used more widely.
 Observational Study
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The epidemiologist does not control the circumstances. These

studies can be further subdivided into descriptive and analytic.

Descriptive epidemiology is the more basic of these

categories and is fundamental to what epidemiologists do. In
a descriptive study, the epidemiologist collects information
that characterizes and summarizes the health event or
problem.
In the analytic study, the epidemiologist relies on
comparisons between different groups to determine the role
of different causative conditions or risk factors.
 Scope of Epidemiology
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Classical Epidemiology: This is population- oriented

epidemiology and addresses the community origin of
health problems e.g. nutrition, behavior, psychosocial
state of the population.

Clinical Epidemiology: This is patient-orientated

epidemiology and aimed at improving diagnosis,
treatment and prognosis of patients who already suffer a
medical condition.
 Key Aspects
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Key Aspects of this Definition:

Determinants
Distribution
Population
Health phenomena
Morbidity and mortality
 Determinants
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Factors or events that are capable of bringing about a

change in health.
Examples of Determinants:
o Biologic agents—bacteria
o Chemical agents--carcinogens
o Less specific factors--stress, drinking, sedentary lifestyle,
or high-fat diet
 Distribution
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Frequency of disease occurrence may vary from one

population group to another.
Disease distribution example:
– Hypertension is more common among young black
men than among young white men.
 Population
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Epidemiology examines disease occurrence among

population groups.
The epidemiologic description indicates variation by age
groups, time period, geographic location etc.
 Who is an epidemiologist ?
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Epidemiologists are public health professionals who

investigate patterns and causes of disease and injury in
humans. They seek to reduce the risk and occurrence of
negative health outcomes through research, community
education, and health policy
Who is an epidemiologist ?
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 Health Phenomena
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Epidemiology investigates many different kinds of health

outcomes:
– Infectious diseases
– Chronic diseases
– Disability, injury, limitation of activity
– Mortality
– Life expectancy
– Mental illness, suicide, drug addiction
 Summary
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Epidemiology is a fundamental science of public health.

Epidemiology has made major contributions to improving
population health.
Epidemiology is essential to the process of identifying
emerging diseases.
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