Dr. KHULOOD M.

ALNAJAR
Lecturer of Physical Therapy for
Cardiopulmonary Diseases

Community Medicine
sinaiuniversity.net
Epidemiology

Lecture 10
 Epidemiology

• Epidemiology is the branch of medical science that investigates all the factors that
determine the presence or absence of diseases and disorders.

• Epidemiological research helps to understand how many people have a disease or

disorder, if those numbers are changing, and how the disorder affects society and
economy.

• Many epidemiological estimates try to determine how the number of people

affected by a disorder changes over time.

• The definition of a disorder also tends to change over time, however, making
estimates more difficult. Even scientists working in the same field at the same
time may not agree on the best way to measure or define a particular disorder.
 Epidemiology

Common terms used in epidemiology:

•Incidence: The number of new cases of a disease or disorder in a population over a period of time.
•Prevalence: The number of existing cases of a disease in a population at a given time.
•Cost of illness: (COI) is defined as the value of the resources that are expended or forgone as a
result of a health problem. It includes health sector costs (direct costs), the value of decreased or
lost productivity by the patient (indirect costs), and the cost of pain and suffering (intangible costs).
Many reports use expenditures on medical care (i.e., actual money spent) as the cost of illness.
Ideally, the cost of illness would also take into account factors that are more difficult to measure,
such as work-related costs, educational costs, the cost of support services required by the medical
condition, and the amount individuals would pay to avoid health risks.
 Epidemiology

Common terms used in epidemiology:

• Burden of disease: The total significance of disease for society, beyond the immediate cost
of treatment. It is measured in years of life lost to ill health, or the difference between total
life expectancy and disability-adjusted life expectancy (DALY).

• DALY (Disability-Adjusted Life Year): A summary measure of the health of a population.

One DALY represents one lost year of healthy life and is used to estimate the gap between the
current health of a population and an ideal situation in which everyone in that population
would live into old age in full health.
Epidemiology
 Epidemiology:
CDC Definition

Definition:
The study of the frequency, distribution and determinants of disease and other
health related conditions in specified human populations, & the application of
this study to the promotion of health & to the prevention & control of health
problems.
1. Distribution
2. Determinants
3. Health-related States
4. Specified Population
5. Application
 Epidemiology: CDC Definition

1. Distribution:
Includes frequency and pattern

• Frequency: the number of health events (e.g. number of cases of diabetes in a population), also the
relationship of that number to the size of the population
• Pattern: the occurrence of health-related events by time, place, and personal
a. Time patterns: annual, seasonal, weekly, daily, hourly, weekdays versus weekends
b. Place patterns: geographic variation, urban/rural differences, work sites & schools
c. Personal characteristics: demographic factors (age, gender, marital status, and socioeconomic
status), as well as behaviors and environmental exposures
 Epidemiology: CDC Definition

2. Determinants

• Causes and other factors that influence the occurrence of disease and other health-related
events, including (physical, biological, social, cultural, and behavioral factors).
• Illness does not occur randomly in a population, but happens only when the right
accumulation of risk factors or determinants exists in an individual

Example: Smoking was a risk factor or determinant for the greater number of
cancer deaths among women ages 45-54 in Country X.
 Epidemiology: CDC Definition

3. Health-related States
• Diagnosis of a specific disease or cause of death

• Health-related behavior (e.g., smoking, taking prenatal vitamins)

Example: According to the 2008 study in Country X,1,034 cervical cancer deaths
occurred among women between the ages of 45-54.
 Epidemiology: CDC Definition

4. Specified Population

A measurable group, defined by location, time, demographics, and other characteristics

Example: Women aged 45-54 living in a rural village in Country X from

2001 through 2009.
 Epidemiology: CDC Definition

5. Application

• Analysis, conclusion, distribution, and timely use of epidemiologic information to

protect the health of the population

• Example: As a result of the Country X Study, free cervical cancer screening

programs were implemented. They targeted women living in remote areas in hopes
of finding women with cervical cancer at an earlier stage of cancer in order to
prevent death.
 Epidemiology: CDC Definition

Level of prevention and control (e.g., stroke)

Maintenance of good Avoid progression in Reduce disability,

health stroke prone subject improve outcome

Primary Secondary Tertiary

prevention prevention prevention
 Epidemiology: CDC Definition

Intervention
• Interventions targeting populations can achieve major and rapid health gains in an entire
population.
• These should be complemented with interventions for individuals, which are needed to
reduce disease risk, slow disease progression and treat complications

Example :
• Low-cost drugs that lower blood pressure and cholesterol
• Number of strict legislative measures towards tobacco
• Type of cooking oil
• The Fruit in Schools
 Approaches to
Epidemiology
Descriptive Epidemiology Analytic Epidemiology

Definition • Studies the pattern of health events and • Studies the association between risk factors and
their frequency in populations in terms of disease
5 W’s • Tests hypotheses about:
1. What = health issue of concern 1. Why
2. Who = person 2. How
3. Where = place
4. When = time Comparing groups with different rates of disease
5. Why/how = causes, risk factors, modes occurrence and with differences in demographic
of transmission characteristics, genetic or immunologic make-up,
behaviors, environmental exposures, and other
potential risk factors

Purpose • To identify problems for further study • To determine why & how disease rates are high
• To plan, provide, and evaluate health (or low) in a particular group
services
Thank You