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EPIDEMIOLOGY
CHAPTER 2
APPLICATIONS OF EPIDEMIOLOGY
Learning Objectives
Discuss uses and applications of epidemiology
Disease Etiology
1. Estimate the individual risks and chances
2. Identify syndromes
3. Complete the clinical picture
4. Search for causes
Demographic Transition
Shift from high birth and death rates found in agrarian societies to lower birth and
death rates found in developed countries.
Epidemiologic Transition
Shift in the pattern of morbidity and mortality from infectious and communicable
diseases to chronic, degenerative diseases.
Epidemiology and the Health
of the Community
Provides
a key to the types of
problems requiring attention
Applications include:
Search for causes
Individual risks
Specific clinical concerns
Causality in Epidemiologic
Research
Epidemiologic research is the
subject of criticism.
Many conflicting studies
Henle-Koch postulates are not
relevant to many contemporary
diseases.
Multivariate causality
Risk Factors Defined
Due to the uncertainty of causal factors the term risk factor is used.
Definition: exposure that is associated with a disease
Example of a risk factor: smoking.
Risk Factors Defined (contd)
Three Criteria for Risk Factors
The frequency of the disease varies by
category or value of the factor, e.g., light
smokers vs. heavy smokers.
The risk factor precedes onset of the
disease.
The observation must not be due to
error.
Modern Concepts of Causality: 1964 Surgeon
Generals Report
Active
Necessitates behavior change on the part of the
subject
Examples: Vaccinations and wearing protective
devices
Passive
Does not require any behavior change
Examples: Fluoridation of public water and vitamin
fortifications of milk and bread products
Secondary Prevention