EPIDEMIOLOGY
2.06 COMMUNITY DIAGNOSIS
Dr. Zulueta | March 1,2017
I.
OUTLINE
Introduction to Community Diagnosis
A. Definition of Community Diagnosis
B. Aims of Community Diagnosis
C. Sources of Data
II. Epidemiologic Methods for Community
Diagnosis
A. Steps of Epidemiologic Methods
B. Definition of the Problem
C. Appraisal of Existing Facts
D. Hypothesis Formulation
E. Practical Application
III. Mini Quiz
IV. Table
OBJECTIVES:
At the end of the lecture, the student should be able to:
1. Discuss the specific steps in conducting community
diagnosis.
Legend:
Remember Previous
Lecturer Book Trans Com
(Exams) Trans
I. INTRODUCTION TO COMMUNITY DIAGNOSIS
A. Definition of Community Diagnosis
1. For this topic, community refers to the rural community
or the urban poor
2. Pattern of diseases in a community, described in terms
of the factors influencing this pattern (Gupta and
Mahajan, 2003)
3. Means of examining aggregate health and social
statistics, liberally spiced with knowledge of the local
situation, to determine health needs of a community
(North Carolina State Center for Health and
Environmental Statistics)
4. Method of assessing a communitys needs and
characteristics that takes into account its social
dynamics and other factors affecting internal problem-
solving capacity
5. Also called community assessment, or CHA
(community health assessment) or CHNA (community
health needs assessment)
6. Basically means identifying needs of a community and
addressing those needs by finding a solution
7. Systematic process involving the community to identify
and analyze community health needs and assets in
order to prioritize these needs, and to plan and act
upon unmet community health needs (CDC, 2015)
B. Aims of Community Diagnosis
1. Identify and quantify health problems in community on
basis of morbidity and mortality rates and ratios
2. Identify individuals or groups in community who are at
risk in developing the disease or who needs
healthcare
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Note: Ultimate goal: develop strategies to address the
communitys health needs and identified issues (CDC,
2015)
C. Sources of Data
Primary data - obtained by the investigator personally
to aid in answering different objectives or purposes
he/she has set for his/her study
o Collected first-hand through surveys,
listening sessions, interviews and
observations (CDC, 2015)
Secondary data - quantified health data can be
obtained from other sources or previously existing
data
o Collected by another entity or for another
purpose (CDC, 2015)
Note: If (1) money, (2) manpower, (3) time and (4)
equipment permit, always use primary data.
II. EPIDEMIOLOGIC METHODS FOR COMMUNITY
DIAGNOSIS
A. Steps of Epidemiologic Methods
1. Definition of problem
2. Appraisal of existing facts
3. Hypothesis formulation
4. Practical application
B. Definition of a Problem
1. What is the present status (nature and extent) of the
problem?
2. Is it a major or minor problem?
a. Prioritization of problems due to limited
resources
b. Leading causes of morbidity and mortality =
major
3. How much is the economic cost of the problem?
a. Total Economic Costs (TEC): TEC = CoT +
CoD + CoED + CoP
b. Cost of Treatment (CoT): CoT = (number of
cases) (amount of drugs + hospitalization +
other medical expenses)
c. Cost of Disability (CoD): CoD = (number of
cases) (average number of days lost due to
illness) (daily wage cost)
i. Daily wage cost = PhP 466.00 +
daily COLA (cost-of-living
adjustment)
ii. Daily wage cost for 2017:
Php 491.00 (see Appendix, Table 1)
d. Cost of Early Death (CoED): CoED =
(number of deaths due to a specific cause)
(years lost due to early death) (expected
annual wage)
e. Cost of Prevention (CoP): CoP = (total
health budget allotted for a specific disease)
/ disorder
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 2.06 COMMUNITY DIAGNOSIS
f. Disability Adjusted Life Years (DALY):
DALY = YLL + YLD
i. Years of Life Lost due to
premature death or mortality
(YLL): YLL = N x L
1. N: number of deaths
2. L: standard life expectancy
at age of death in years
ii. Years Lost due to Disability
(YLD): YLD = I x DW x L
1. I: number of incident cases
2. DW: disability weight
3. L: standard life expectancy
at age of death in years
C. Appraisal of Existing Facts
Know host, agent and environment
What information do you need in order to identify
factors that may have contributed to occurrence of the
problem? Why do you need these data?
What is the present level of knowledge (i.e., literature
review) with regards to etiology of an identified
problem?
What are the disease patterns according to:
(descriptive epidemiology)
Person: age group, culture, civil status,
educational attainment, social class, state of
nutrition, occupation
Place: regional, geographic differences
E.g. Filariasis is more common in
places with abaca
Time of occurrence: secular trend
What are the characteristics of the host/individual that
influence the pattern of the disease?
Age distribution
What are the characteristics of the disease agent that
influence the pattern of disease?
Nature or virulence factors of the disease
agent
Mode of transmission
Note: What is easier to control: agent or host?
It depends. If the agent is strong and host is
vulnerable, then the host will be infected. On
the other hand, the host will not be infected if
the agent is weak and the host has good
immune status.
Why do these disease patterns occur?
Geographic distribution
Related to differences in
socioeconomic development and
cultural differences
Related to environmental conditions
and access to health services
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EPIDEMIOLOGY 2020C
Seasonal variation
Fluctuation of disease occurrence
within a calendar year, reflecting
climatic changes
Dry months / season
Wet months / season
E.g. It is most appropriate to give
the influenza vaccine just before the
rainy season at around May
D. Hypothesis Formulation
What are the possible explanations for the existence
and level of the identified disease or health problem?
Cite specific reasons or factors which directly or
indirectly affect the status of the disease or health
problem in the community.
Are the reasons or explanations given really existent
or applicable to the community only or the whole
country?
How do you consolidate the knowledge gained in the
preceding part (appraisal of existing facts) to
formulate a hypothesis of causation?
E. Practical Application
Propose solutions to identified problems
Prevent, diagnose and treat early
In general, what may be done to improve, if not
altogether solve, the identified disease or health
problem in the community and in the country?
Are there existing activities or programs (Department
of Health) being done presently to address the
problem?
For identified prevalent diseases, what specific
measures may be applied on:
Host or population
Disease agent or sources of problem
Means of transmission
Note: Prevalent diseases = cross-sectional studies
What resources in the community may be utilized to
address the identified problem?
Roles of community agencies: LGUs (local
government units) and NGOs (non-
government organizations)
Roles of medical practitioners and allied
health professionals
What preventive measures (primary, secondary,
tertiary) can be done to control disease and remedy
health problem at level of:
Individual
Family members
Community
Note: PDR for preventive measures: prevent,
diagnose and treat early, and rehabilitate
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2. Centers for Disease Control and Prevention. (2015).

MINI QUIZ Data and Benchmarks. Retrieved from
https://www.cdc.gov/stltpublichealth/cha/data.html
1. Primary data must be used when which of the 3. Zulueta, J. (2017). Community Diagnosis. Lecture,
following is/are permitted? JMC Auditiorium 1, UERMMMCI, Quezon City,
a. Money Philippines.
b. Manpower
c. Time
d. Equipment
e. All of the above
f. None of the above
2. For prevalent diseases, which type/s of study should
be used?
a. Case-control study
b. Cohort study
c. Cross-sectional study
d. Ecologic study
e. All of the above
f. None of the above
3. The epidemiologic method consists of the following,
except:
a. Hypothesis formulation
b. Appraisal of existing facts
c. Practical application
d. Definition of problem
e. All of the above
f. None of the above
4. The TEC (total economic costs) is the summation of
the following, except:
a. CoT
b. DALY
c. CoP
d. CoED
e. CoD
f. None of the above
5. Why is it important to identify whether a health
problem is major or minor (i.e., prioritization of certain
problems)?
a. Because major problems require more time
to be solved
b. Because minor problems demand less time
to be solved
c. Because there is limited resources
d. Because there is abundant resources
e. a and c only
f. None of the above

ANSWERS: ECFBC

REFERENCES:
1. Centers for Disease Control and Prevention. (2015).
Community Health Assessments & Health
Improvement Plans. Retrieved from
https://www.cdc.gov/stltpublichealth/cha/plan.html

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 2.06 COMMUNITY DIAGNOSIS EPIDEMIOLOGY 2020C

New
COLA New
Basic New Minimum
Sector/Industry Integrati Basic
Wage COLA Wage
on Wage
Rate

Non-agriculture (including private hospitals

Php 466.00 Php 15.00 Php 481.00 Php 10.00 Php 491.00
with bed capacity of 100 or less)

Agriculture (plantation and non-plantation)

Retail/service establishments employing 15

workers or less Php 429.00 Php 15.00 Php 444.00 Php 10.00 Php 454.00

Manufacturing establishments regularly

employing less than 10 workers

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