EPIDEMIOLOGY

Melissa Dean, BSN-BC

 COURSE
OBJECTIVE #2
• Epidemiology, social
epidemiology and cultural
influences
• Analyze perspectives of
epidemiology and social
epidemiology in terms of
current issues and cultural
influences
 CHAPTER
OBJECTIVES
• Describe epidemiology and
social epidemiology
• Explain how the processes
involved in epidemiology
and social epidemiology are
important within the context
of providing for the public’s
health
• Analyze the different
perspectives of
epidemiology and social
epidemiology of the context
of public health nursing
 EPIDEMIOLOGY TERMS

- Age-specific rates - Epidemiological triad

- Analytical epidemiology - Agent
- Environment
- Attack rates
- Host
- Chain of infection
- Incidence rates
- Crude rates
- Prevalence rates
- Descriptive epidemiology
- Rate
 SOCIAL EPIDEMIOLOGY TERMS

- Developmental and life-course - Social determinants of health

perspective - Discrimination
- Life course model - Education
- Income
- Multilevel analysis
- Income inequality
- Population perspective - Occupation
- Social context - Socioeconomic position
- Socioeconomic status

• What is it?
• Is the scientific discipline that studies
the distribution and determinants of
the diseases and injuries in human
populations
EPIDEMIOLOGY
• What is the goal?
• To limit disease, injury, and death
via specific interventions designed
to prevent or limit outbreaks or
epidemics
• Epidemiology is concerned with
the health of particular
populations
• Clinical nursing is concerned
with individual health issues
 EPIDEMIOLOGY
• Epidemiology Focus • Nursing focus
• Source of illness or exposure • Obtain HPI
• Who has been exposed • Assessment
• Has exposure spread • Treat
• Prevent reoccurrences
• Medicine
• Obtain HPI
• Assessment
• Diagnose
• Prescribe
• Treat
 EXAMPLE
• 50 students attend a picnic
• Food provided
• 1 student falls sick
• Student seeks health clinic
 CLINICAL
• History of present illness
• Diagnosis
• Treatment
 EPIDEMIOLOGY
• History of present illness
• Number of students
• Who else was sick
• Timing
• What caused illness
• Food
• Heat
• Is this an epidemic
FLORENCE
NIGHTINGALE
• Recognized problems
• Sanitation
• Nutrition
• Contaminated blankets
 EPIDEMIOLOGY

• Hippocrates
• John Graunt
• James Lind
• William Farr
• John Snow
• Joseph Goldberger
REVOLUTION
• Infectious diseases
• Immunizations developed
• Antibiotics discovered
• Advances
• Water purification
• Pasteurization
• Chronic diseases
• Causes
• Tabaco
• Diet and inactivity
• Alcohol
• Prevention
INFECTIOUS
DISEASE
INCIDENCE
• Food production
• Less malnutrition
• Clean water
• Pasteurization of milk
• Living conditions
• Sanitation
• Less crowding
 DECLINE IN
INCIDENCE
• Chronic disease
• Cancer
• Heart disease
• Asthma
• Diabetes
• Violence
APPLICATIONS
• Roles in decision making
• Smoking
• Exercise
• Healthy eating
• Safe sex
• Hand washing

• Policy development
• Recourse utilization and allocation
 IN ACTION
• HIV
• 1980
• Pneumonia
• Pneumocystis carinii
• Kaposi’s sarcoma
• Outbreak in gay men
• Epidemiologists looked for links
• Research
• 1986 AIDs is coined as a term
 APPROACH
• Who
• What
• Environmental
• Social
• personal
• Other cases
• When
• Why
• Case definition – what determines
incidence of disease
NUMBERS AND
RATES

• Measure
• Describe
• Compare
• Looking for trends
• Rates
 CHAIN OF
INFECTION
• Agent
• Host
• Environment
• Transmission
 SOCIAL EPIDEMIOLOGY
• Social conditions • Population – risk is associated with
• Poverty population
• Socioeconomic status • Social – behaviors e.g. smoking
• Discrimination
• Multilevel – income, education
• Social implications
• Developmental – early life
• Social context
• Inequality
 SOCIAL
DETERMINANTS
• Income
• Education
• Occupation
• Medical care
• Healthcare barriers
• Language
• Environmental exposure
• Discrimination
• Status
• Position
 SOCIOECONOMIC
• Status and health
• Education level
• Family income Social determinants of health
• Education level
• Occupation influence health outcomes of
• Income the future.
• Income inequality
• Discrimination
 APPLICATION
• Identify causes
• Study natural disease and prognosis
• Evaluate health care models
• Foundation for regulatory decisions
• Clues to changes over time
• Identify high risk subgroups
• Develop prevention measures
• primary – disease prevention
• Secondary – early detection
 EPIDEMIOLOGISTS
• Epidemiologists – study distribution and
determinants of disease and injury
• Social Epidemiologists – study how
equality or inequality effects health
 REFERENCES
• Truglio-Londrigan, M. Lewenson, S. (2013). Public Health Nursing Practicing
Population-Based Care. (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
• What is Epidemiology? (2017). Retrieved from
https://www.cdc.gov/careerpaths/k12teacherroadmap/epidemiology.html
• Whitehead, D. (2000, July 5-11). Is there a place for epidemiology in nursing?
[Journal]. Nursing Standard, 14(42), 35-39. http://dx.doi.org/
10.7748/ns2000.07.14.42.35.c2871
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