You are in browse mode. You must login to use MEMORY

Confused? » Read about learn, practice and the various modes

» To start learning, click login

1 / 25

[Front]

A state of being well and free from disease (oxford students dictionary, 1991) Professional’s point of view: a. A measure of the state of the physical bodily organs, and the ability of the body as a whole to function. b. It refers to freedom from medically defined diseases. a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (WHO)

[Back]

Health

Practice Known Questions

Stay up to date with your due questions

Complete 5 questions to enable practice

Exams

Exam: Test your skills

Test your skills in exam mode

Learn New Questions

Dynamic Modes

SmartIntelligent mix of all modes

CustomUse settings to weight dynamic modes

Manual Mode [BETA]

Select your own question and answer types

Specific modes

Learn with flashcards

Complete the sentence

Listening & SpellingSpelling: Type what you hear

multiple choiceMultiple choice mode

SpeakingAnswer with voice

Speaking & ListeningPractice pronunciation

TypingTyping only mode

PHARMCARE 4 (PUBLIC HEALTH) - Leaderboard

1 user has completed this course

No users have played this course yet, be the first

PHARMCARE 4 (PUBLIC HEALTH) - Details

Levels:

1) Chapter 1 View
2) EPIDEMIOLOGY View
3) PHARMACO-EPIDEMIOLOGY View
4) IMPROVING PUBLIC HEALTH THROUGH PHARMACY View
5) VACCINATION View

Questions:

244 questions

🇬🇧		🇬🇧

Health

If we can improve quality of life by helping people out of poverty, providing basic sanitation, improving their access to education, healthy food, and medical care, we can greatly improve a population’s chances for a healthy life.

Socioeconomic Factors

Health of all people is fundamental to the attainment of 1 __ and is dependent on the fullest 2 __

1 peace and security, 2 co-operation of individuals and States.

1 The extension of the benefits of __ to all people is essential for the fullest attainment of health 2 __ on the part of the public are of the utmost importance in the improvement of the health of the people. 3 •Governments have a responsibility for the health of their people which can be fulfilled only by the __

1 medical, psychological and related knowledge 2 Informed opinion and Active cooperation 3 provision of adequate health and social measures

DIMENSIONS OF HEALTH

1 Social 2 Spiritual 3 Emotional 4 Environmental 5 Mental 6 Physical SSEE MP

“The science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals.” -CEA Winslow, 1920 ● The sanitation of the environment ● Control of communicable infections ● Education of the individual in personal hygiene ● Organization of medical services for early diagnosis and preventive treatment of disease ● Development of the social machinery to ensure everyone a standard of living adequate for the maintenance of health

Public Health

Was rampant during the early 1800s in London, causing death to tens of thousands of people in the area. __ was commonly thought to be caused by bad air from rotting organic matter.

Cholera

Is best known for his work TRACING THE SOURCE OF THE CHOLERA OUTBREAK and is considered the FATHER OF MODERN EPIDEMIOLOGY.

John Snow, Physician

How did John Snow did it? (fix cholera problem)

1 INTERVENTION EVALUATION - - Stop exposure to the contaminated water supply on a larger scale, and - Stop exposure to the entire supply of contaminated water in the area. 2 IMPLEMENTATION -John Snow’s research convinced the British government that the source of cholera was water contaminated with sewage

CORE FUNCTIONS AND ESSENTIAL SERVICES OF PUBLIC HEALTH 1 Three Core Functions of Public Health

1 Assessment 2 Policy 3 Assurance

1 Systematically collect, analyze, and make available information on healthy communities 2 Promote the use of a scientific knowledge base in (this) and decision making 3 Ensure provision of services to those in need

1 Assessment 2 Policy 3 Assurance

Ten Essential Public Health Services/Care Functions They are grouped under the three core functions. they are intended to SERVE AS A DESCRIPTIVE TOOL to capture the field of public health and to communicate what public health provides.

1. Monitor Health 2. Diagnose and Investigate 3. Inform, Educate, Empower 4. Mobilize Community Partnership 5. Develop Policies 6. Enforce Laws 7. Link to/Provide Care 8. Assure a Competent Workforce 9. Evaluate 10. Research MDI MDE LAER

Play a key role in public health, especially at the COMMUNITY LEVEL. serve many DIFFERENT PURPOSES from ADVOCACY or EDUCATION to EMERGENCY RELIEF and ECONOMIC DEVELOPMENT.

Nongovernmental organizations (often referred to as “NGOs”)

Nongovernmental Organization Examples 1 Organization Types

1 Professional membership organizations 2 Associations related to a specific health concern 3 Organizations of citizens focused on health concerns. 4 Foundations that support health projects and influence public policy development PA OF (pa off)

Nongovernmental Organization Examples GIVE EXAMPLE OF THESE Organization Types 1 Professional membership organizations 2 Associations related to a specific health concern 3 Organizations of citizens focused on health concerns. 4 Foundations that support health projects and influence public policy development

. 1 Philippine Public Health Association 2 Philippine Cancer Society 3 Organization for Nonsmokers Rights 4 Bill and Melinda Gates Foundation

1 Plays a vital role in protecting and promoting the public’s HEALTH along with public health organizations. 2 Public health focuses on __, while clinical care focuses on the __ 3 __are complementary. When they work collaboratively, all people benefit.

1 Health care 2) 1 populations, 2 individual patient. 3 Health care and public health

Public Health VS Health Care

PUBLIC HEALTH ------- 1 Population focus 2 Public health ethic 3 Prevention or public health emphasis 4 Joint laboratory and field involvement 5 Clinical sciences 6 Peripheral to professional training 7 Public sector basis HEALTH CARE ------ 1 Individual patient focus 2 Personal service ethic 3 Diagnosis and treatment emphasis 4 Joint laboratory and patient involvement 5 Clinical sciences 6 Essential professional Training 7 Private sector basis

Other Partners in Public Health

1 Media 2 Employers and Businesses 3 Government Agencies 4 Academia

Health Determinants list

1 Genes and biology (sex, age, genetic makeup.) 2 Health behaviors (smoking, eating habits, physical activity) 3 Social/societal characteristics, including the total ecology (discrimination) 4 Health services/Medical care (quality health care, insurance coverage)

Health Impact Pyramid

(LOWEST IMPACT) 1 Counseling and Education 2 Medical Care 3 Preventive Medicine 4 Making Healthy Decisions the Default 5 Socioeconomic Factors (BIGGEST IMPACT) CMP MS

Is regarded by some as the ESSENCE OF PUBLIC HEALTH ACTION, but unfortunately, it is not as effective as we would like. That being said, at times, __ are the only forms of intervention available and, when applied consistently and repeatedly, can have an impact. Examples: warning labels on cigarette packs and campaigns to promote tobacco cessation

HEALTH IMPACT PYRAMID Counseling and education

In the case of cardiovascular disease, these interventions can have a considerable effect. However, we are limited by a lack of access to certain patients who need care and lack of adherence to medical instructions in the real world.

HEALTH IMPACT PYRAMID Clinical Interventions

Vaccines for example, prevent 2.5 million deaths among children around the world every year. In this case, a single dose or instance of an intervention can have a life-long effect

HEALTH IMPACT PYRAMID Preventive Medicine

We make __ by changing the context in which behaviors occur, making it difficult to avoid the intervention. For example, changing the laws to require seat belt use in cars and banning smoking in certain public places have had substantial impact

HEALTH IMPACT PYRAMID Making Healthy Decisions by Default

If we can IMPROVE QUALITY OF LIFE by helping people out of poverty, providing basic sanitation, improving their access to education, healthy food, and medical care, we can greatly improve a population’s chances for a healthy life.

HEALTH IMPACT PYRAMID Socioeconomic Factors

THE HISTORY OF PUBLIC HEALTH (Sanitation and Environmental Health) 1) 500 BCE 2) 1840s 3) 1970

. 1) Greeks and Romans practice community sanitation measures. 2) The Public Health Act of 1848 was established in the United Kingdom 3) The Environmental Protection Agency (EPA) was founded.

THE HISTORY OF PUBLIC HEALTH (Pandemics) 1) 500 million infected worldwide in 1918. 2) Vaccine introduced in 1) __; eradication initiative launched in __. 3) 34 million with __ worldwide; 20% decline in new infections since 2001.

. 1 Influenza 2 Polio 1) introduced:1955 2) eradication initiative: 1988 3) HIV

THE HISTORY OF PUBLIC HEALTH (Preparedness for Disaster Response) 1 plague used as a weapon of war during the Siege of Kaffa. 2 - On this date, PUBLIC HEALTH SURVEILLANCE are conducted after the 9/11 attacks 3 - Emergency services, public health surveillance, and disease treatment provided

. 1 Biologic Warfare 2 September 2001 3 Hurricane Katrina

THE HISTORY OF PUBLIC HEALTH (Prevention Through Policy) 1 - The world’s first written health code. 2 - Laws banning smoking in public places. 3 Food labeling and promotion of physical activity.

. 1 Book of Leviticus 2 Tobacco Laws 3 Obesity

A PUBLIC HEALTH APPROACH

1 Surveillance (what is the problem) 2 Risk Factor Identification (what is the cause) 3 Intervention Evaluation (what works?) 4 Implementation (How do you do it?) SIRI

PUBLIC HEALTH CORE SCIENCES

1 Prevention Effectiveness 2 Epidemiology 3 Laboratory 4 Informatics 5 Surveillance PELIS

(Partners in the Public Health System) 1 The field of public health is __. Beyond government, it requires __ with skills in intervention programs, policies, research, evaluation, and education. 2 What other sectors and fields can you think of that have a stake in public health?

1) 1 broad and interdisciplinary 2 stakeholders 2 Transportation, housing, schools, city planning, or law enforcement. Other partners: governments, community groups, clinical care, employers and businesses, the media, and academia

Serves as VEHICLE for the PUBLIC’S DISCOURSE on public health concerns, and historically, public health agencies and other partners have educated the public and promoted healthy behaviors through the news and entertainment media.

Media

Contribute to the public’s health by providing health insurance. Workplaces also have wellness initiatives, such as gym subsidies that promote the health of their employees

Employers and Businesses

Can work as partners in public health by including health considerations in their policy development. ➔ city planning ➔ Education ➔ Health in all policies

Government Agencies

- EDUCATES & TRAINS THE PUBLIC HEALTH WORKFORCE, such as scientists, epidemiologists, and informaticians. Additionally, research conducted is put to use in the larger communities around the US and the world. ➔ education ➔ Training ➔ Research ➔ Public services.

Academia

This resolution decided that the main social targets of governments and the WHO should be the ATTAINMENT BY ALL THE PEOPLE OF THE WORLD by the Year 2000 a LEVEL OF HEALTH that will permit them to lead a socially and economically productive life.

Resolution WHO 30:43 by the The 30th World Health Assembly May 1977

International Conference in Primary Health Care that was held at Alma Ata, Kazakhstan, USSR. indicate the date: __ indicate the name: __ Indicate the sponsors: __

September 12, 1978 ALMA ATA DECLARATION - represents a global idea about how to achieve world health Sponsored by: - World Health Organization - UNICEF

OBJECTIVES OF ALMA ATA

➔ To promote the concept of primary health care ➔ To evaluate the present health care situation ➔ To define the principles of primary health care ➔ To define the roles of governmental, national and international organizations ➔ To formulate recommendations for the development

1 IN 1979, The World Health Organization (WHO) launched the __ 2 PHC was adapted in the Philippines through 1) __, signed by Pres. Ferdinand E. Marcos, on 2) __

1 Global Strategy for Health for All 2) 1 Letter of Instruction 949, 2) October 19, 1979

•“an essential health care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-determination.”- WHO “Health for all Filipinos by the year 2000 and Health in the Hands of the People by the year 2020”

Primary Health Care

Primary Health Care Framework: People’s __ is the Key strategy to achieve the GOAL,

1 Empowerment and Partnership

Mission of PHC PHC aims to strengthen the health care system by increasing 1__ and 2 __ wherein people will 3 __

1 opportunities, 2 supporting conditions, 3 manage their own health care.

The FIRST INTERNATIONAL CONFERENCE on HEALTH PROMOTION, meeting in OTTAWA (indicate the date__), hereby presents this CHARTER for action to achieve Health for All by the year 2000 and beyond. - This conference was primarily a RESPONSE to GROWING expectations for a NEW PUBLIC HEALTH MOVEMENT around the world. - Discussions focused on the needs in industrialized countries, but took into account similar concerns in all other regions.

Ottawa Charter for Health Promotion 1986 Date: Ottawa, November 21, 1986

PROCESS OF ENABLING PEOPLE TO INCREASE CONTROL OVER, AND TO IMPROVE, THEIR HEALTH. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being.

Health Promotion

FIVE PRIORITY ACTION AREAS as outlined in the Ottawa Charter for health promotion:

1. Health Public Policy 2. Create Supportive Environment 3. Strengthen Community Action: Community Participation 4. Develop Personal Skills 5. Reorient Health Services HCS DR 6. Public Health Policy

1 In 1981, the role of the pharmacist in public health is defined by the __. This association outlined that the role of the pharmacist is now escalating beyond the dispensation and distribution of medicines, and health supplies 2 A pharmacist can provide many services to public health that may include __

1 American Public Health Association (APHA) 2 pharmacotherapy, provide care, and prevention measures

Activities where pharmacists can play an important role to promote public health:

1. Population-based Care 2. Prevention of Disease and Medication Safety 3. Health Education 4. Research and Training PPHR

1) __ characterized public health pharmacy services as occurring on MICRO and MACRO LEVELS.

1 Bush and Johnson

EMPHASIZING THE WELLBEING of the PATIENT occur frequently; examples are -tobacco cessation efforts, -immunizations, -health screening and referral, -health education, -patient counseling & monitoring -responding to adverse drug events in an institution

Micro-level activities

Involve ASSESSMENT, IDENTIFICATION, and PRIORITIZATION of the PUBLIC HEALTH NEEDS in a community or population.

Macro-level

INFLUENCES POPULATION HEALTH OUTCOMES by WORSENING, UNDERMINING, or IMPEDING A NUMBER OF PROCESSES, including social relationships, resource availability, stress, and psychological and behavioral responses, exacerbating poor health. a well documented GLOBAL BARRIER to health seeking behavior [1], engagement in care [2], and adherence to treatment [3] across a range of health conditions [4, 5]. ENABLES VARIETIES OF DISCRIMINATION that ultimately deny the individual/group full social acceptance, reduce the individuals’ opportunities and fuel social inequalities

Stigma

➔ PRE-REQUISITE FOR SUCCESSFUL HEALTH PROMOTION ➔ characterized by a concern for health and equity and an accountability for health impact ➔ According to the Adelaide Conference (1988), “The main aim of __ is to create a supportive environment to enable the people to lead healthy lives. Healthy choices are thereby made possible and easier for citizens”.

Five priority action areas as outlined in the Ottawa Charter for health promotion: Health Public Policy

➔ A health-system pharmacist must get adequate education and training to carry out his responsibility in public health. ➔ Health-system pharmacists should be expertise in pharmacoepidemiology, research methodology, and biostatistics with their applications in decision related to public health

Research and Training

➔ is essential for health. ➔ It covers the physical, social, economic, and political environment. ➔ Everyone has a role in creating __ for health.

Five priority action areas as outlined in the Ottawa Charter for health promotion: Create Supportive Environment

Research and Training

➔ According to the Ottawa Charter, “health promotion works through concrete and effective __ in setting priorities, making decisions, planning strategies and implementing them to achieve better health”. occurs when communities participate in equal partnership with health professionals as stakeholders in setting the health agenda. A Definition (Rifkin et al. 1988)

Five priority action areas as outlined in the Ottawa Charter for health promotion: Strengthen Community Action: Community Participation

➔ __ which can promote an individual’s health include those pertaining to identifying, selecting and applying healthy options in daily life. ➔ Health education is life-long, so that people can develop the relevant __ to meet the health challenges of all stages of life, and to be able to cope with chronic illness and disabilities. ➔ “Health education should be conducted in all settings.”

Five priority action areas as outlined in the Ottawa Charter for health promotion: Develop Personal Skills

➔ Shift of emphasis from provision of curative services. ➔ Health care system must be equitable and client-centered

Five priority action areas as outlined in the Ottawa Charter for health promotion: Reorient Health Services

➔ The Center for Advancement in Pharmaceutical Education (CAPE) Educational Outcomes suggested that pharmacists should involve in both __

1 Population-based Care 2 Patient-based Care

➔ They can help in the establishment of some screening programs to check out the status of immunization, and identification of some undiagnosed medical conditions.

Activities where pharmacists can play an important role to promote public health: Prevention of Disease and Medication Safety

➔ Health-system pharmacists can educate their health care colleagues about the safe and effective use of medication that further improves use of medications. ➔ The pharmacists can also educate community leaders like public office holders, legislators, school officials, regulators, and religious leaders who involve in public health customs.

Activities where pharmacists can play an important role to promote public health: Health Education

Activities where pharmacists can play an important role to promote public health: Research and Training

1 Health is a state of being well and free from __ (oxford students dictionary, 1991) 2 Health is a state of complete __ and not merely the absence of disease or __

1 disease 2 physical, mental, and social wellbeing, infirmity

Health From professional’s point of view: a. A measure of the state of the __, and the ability of the body as a whole to __ b. It refers to freedom from __

A. physical bodily organs, function b. medically defined diseases

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

1 Public Health is “The science and art of __, __ and __ through the organized efforts and informed choices of society, organizations, public and private communities, and individuals.” 2 who said this?

1 preventing disease, prolonging life, promoting health 2 -CEA Winslow, 1920

The Mission of Public Health 1 “Fulfilling society’s interest in assuring conditions in which people can be healthy.” 2 “Public health aims to provide maximum benefit for the largest number of people.”

1 —Institute of Medicine 2 —World Health Organization

Primary Health Care is: “an 1 __ health care made 2 __ to individuals and families in the community by means 3 __ to them through their full 4 __ and at a 5 __ that the community and country can 6 __ to maintain at every stage of their development in the spirit of self-determination.”- WHO

1 essential, 2 universally accessible, 3 acceptable, 4 participation 5 cost, 6 afford

Full community participation occurs when __ as stakeholders in setting the health agenda. A Definition (Rifkin et al. 1988)

Communities participate in equal partnership with health professionals

Health education is __, so that people can develop the relevant skills to meet the health challenges of all stages of life, and to be able to cope with chronic illness and disabilities.

Life-long

Study of distribution and determinants of health-related conditions or events in populations “the study of distribution and determine of health-related states or events in specific populations, and the application of this study to control of health problems”

EPIDEMIOLOGY

EPIDEMIOLOGY comes from the greek word 1 ◆ epi, meaning __ 2 ◆ demos,meaning __ 3 ◆ logos, meaning __

1 “on or upon” 2 “people” 3 “the study of”

Three important components included in EPIDEMIOLOGY are:

1 Frequency 2 Distribution 3 Determinants

1 The first component to be considered is measurement of disease __, which involves quantification of the occurrence of disease. 2 The second component is __ of disease in terms of TIME, PLACE, & PERSON- who is getting the disease, where and when the disease is occurring. 3 derives from the first two, necessary to test an epidemiological hypothesis.

1 Frequency 2 Distribution 3 Determinants

Disease Frequency examples

● Rate - incidence rate, prevalence rate etc. ● Ratio - sex ratio, doctor-population rate

1 Distribution of disease (process) 2 Determinants of Disease (process) 3 Help in developing sound scientific program

1) 1 Disease in community → 2 find causative factor 3 Generate hypothesis 4 Descriptive epidemiology 2) 1 To test hypothesis 2 Analytic epidemiology 3 Analytic epidemiology

(HISTORY) 1 (circa 400 B.C.) attempted to explain disease occurrence from a rational instead of a supernatural viewpoint 2 a London haberdasher, published his landmark analysis of mortality data in 1662. He was the first to quantify patterns of birth, death, and disease occurrence, noting male-female disparities, high infant mortality, and seasonal variations

1 Hippocrates 2 John Graunt

(HISTORY) 1 began to systematically collect and analyze Britain’s mortality statistics. 2 an anesthesiologist, conducted a series of investigations in London that later earned him the title “the father of epidemiology.”

1 William Farr 2 John Snow Discipline did not flourish until the end of the Second World War.

AIMS OF EPIDEMIOLOGY

1 To describe the distribution and size of disease problems in human populations. (Descriptive epidemiology) 2 To identify the etiological factors in the pathogenesis of disease (Analytical epidemiology) 3 To provide the data essential in planning, implementation and evaluation of services for the prevention, control and treatment of disease and setting up priorities among those services. (Experimental epidemiology)

The ULTIMATE AIM of epidemiology is

◆ To eliminate or reduce the health problem or its consequences ◆ To improve medical care and provide administrative guidance for community health services ◆ To promote the health and well being of society as a whole.

PURPOSES OF EPIDEMIOLOGY

1. To investigate nature / extent of health-related phenomena in the community / identify priorities 2. To study natural history and prognosis of health-related problems 3. To identify causes and risk factors 4. To recommend / assist in application of / evaluate best interventions (preventive and therapeutic measures) 5. To provide foundation for public policy

SCOPE OF EPIDEMIOLOGY

1 Disease definition 2 Disease occurrence 3 Disease causation 4 Disease outcome 5 Disease management 6 Disease prevention DOC POM

1 characteristics or combination of character that best discriminate disease from non diseased 2 the rate of development of new case in population. The proportion of current disease within population 3 the risk factors for disease development and their relative strength with respect to an individual and population.

1 Disease definition 2 Disease occurrence 3 Disease causation (SCOPE OF EPIDEMIOLOGY)

1 the outcome following disease onset and of the risk factors. 2 the relative effectiveness of proposed therapeutic interventions 3 the relative effectiveness of proposed preventive strategies including screening

1 Disease outcome 2 Disease management 3 Disease prevention (SCOPE OF EPIDEMIOLOGY)

FUNCTIONS/USES OF EPIDEMIOLOGY

1.To find causation of the disease 2.To describe natural history 3.Description of health status of populations 4.Evaluation of intervention 5.Community diagnosis 6.Planning and evaluation 7.Investigate epidemics of unknown etiology 8.Elucidate mechanism of disease transmission FDD ECPIE (FooDD EGGPIE MMM (Mechanism))

EPIDEMIOLOGIC INFORMATION

1. Case definition 2) Person 3) Place 4) Time Si PPT (C PPT)

1 Standard set of criteria Clinical and lab Allows for comparison example: Smallpox Clinical Description: An illness with acute onset of fever >101 °F followed by a rash characterized by vesicles or firm pustules in the same stage of development without other apparent cause. Laboratory Criteria for Confirmation: Isolation of smallpox (variola) virus from a clinical specimen, or

1) Case Definition (EPIDEMIOLOGIC INFORMATION)

1 Age , Sex, Race/Ethnicity, Socio-Economic Status, Behaviors 2 Geographic Distribution, Natural, Clustering vs. uniform, Home, Work, School, Hospital room 3 Geographic Distribution:

1 Person 2 Place 3 (under Place) ◆ Natural ◆ Clustering vs Uniform (EPIDEMIOLOGIC INFORMATION)

1 ➔ Onset of symptoms ➔ incubation period ➔ Infectious Period ➔ Seasonality ➔ Baseline vs Epidemic ➔ Interval 2 Interval

1 Time 2 (Under Time) ◆ Long - term trends ◆ Shorter for environmental exposure (EPIDEMIOLOGIC INFORMATION)

TYPES OF EPIDEMIOLOGY

1. Descriptive Epidemiology 2. Analytical Epidemiology

- Describes the occurrence of disease (cross-sectional) - examining the distribution of disease in a population, and observing the basic features of its distribution. antecedent to analytical epidemiology organize and summarize data according to TIME, PLACE, & PERSON.

Descriptive Epidemiology

- investigating a hypothesis about the cause of disease by studying how exposures relate to disease ➔ Observational (cohort, case control, cross-sectional, ecologic study) - researcher observes association between exposure and disease, estimates and tests it ➔ Experimental (RCT, quasi experiment) - researcher assigns intervention (treatment), and estimates and tests its effect on health outcome. -Used to search for causes and effects, or the WHY & the HOW.

Analytic Epidemiology

Analytic Epidemiology two study types

1 Observational 2 Experimental

1 (cohort, case control, cross-sectional, ecologic study) - researcher observes association between exposure and disease, estimates and tests it 2 (RCT, quasi experiment) - researcher assigns intervention (treatment), and estimates and tests its effect on health outcome.

1 Observational 2 Experimental

1 disease rates change over time – the seasonal increase in influenza with the onset of cold weather. 2 describe a health event by place to gain insight into the geographical extent of the problem. ● Residence ● Birthplace ● Place of employment ● School district ● Hospital unit, etc. ● presence of agents or vectors I climate I geology I population density I economic development I nutritional practices I medical practices

1 Time 2 Place (DESCRIPTIVE EPIDEMIOLOGY)

1 inherent characteristics of people. ● Age● Race● Sex 2 ➔ Acquired Characteristics of this: 3➔ Activities 4 ➔ Conditions under which people live

1 Person 2 ◆ Immunity ◆ Marital status 3 ◆ Occupation ◆ Leisure activities ◆ Use of medications/tobacco/drugs 4 ◆ socioeconomic status ◆ Access to medical care (DESCRIPTIVE EPIDEMIOLOGY)

➔ form the first step in any process of investigation. ➔ These studies are concerned with observing the distribution of disease in populations

DESCRIPTIVE STUDIES

STEPS in conducting a DESCRIPTIVE STUDY

1. Defining the population. 2. Defining disease under study. 3. Describing the disease. 4. Measurement of disease - Mortality/ Morbidity 5. Compare - Between different population, subgroups 6. Formulate hypothesis - On basis of all data epidemiologist form hypothesis mnemonics: 3D Measure, Compare and Formulate

1 may be the whole population or a representative sample. - Can also be specially selected group such as age and sex groups, occupational groups, hospital patients, school children, small community, etc. 2 Describing the disease is examined by the epidemiologist by asking three questions:__

1 Defining the population 2 ● When is the disease occurring –time distribution? ● Where is it occurring – place distribution? ● Who is getting the disease – person distribution?