Importance and Uses of Epidemiology

Is it a science? Or is it a method?
Is Epidemiology a Science?
 Science is a creative endeavor
It relies on questioning, imagination, exploration
It seeks out empirical evidence
It tests ideas
Study questions
Hypotheses
Important Issues that Epidemiology can Address
Disease It’s not just disease!

Mortality(death)
Hospitalization
Disability
Quality of Life
Health Status
Epidemiology
 Epidemiology weighs and balances

 Epidemiology contrasts and compares
 Epidemiologists use RATES
events/population at risk
Epidemiology
 Numerator
the number of people to whom something
happened (i.e. they got sick, died, etc.)
 Denominator
the population at risk -- all the people at risk for
the event
Uses of Epidemiology
1. Explaining causation:
 To study the cause (or etiology) of disease(s), or conditions,
disorders, disabilities, etc.
 determine the primary agent responsible or ascertain causative
factors
 determine the characteristics of the agent or causative factors
 define the mode of transmission
 determine contributing factors
 identify and determine geographic patterns
2. Historical Study/ Disease History:

 Study disease pattern over period of time and fluctuation
occurring. Knowing where is the health problem is receding or
growing.
3. Describes the health status of papulation and helps in
community Diagnosis.
 Describe what portion of papulation is healthy, how health status
change, time, factor influence this change
 Occurrence of disease in different geographical area in different
period of time .
 Identification and quantification of the health problem in
community.
4. Evaluation of the working of Health Services:

 Measure the efficacy, efficiency and effectiveness of health
services. E.g. Health promotion activities.
5. Evolution of an individuals Risk and chance:
 Calculating
the strength of the risk factors influencing human
health. Quantify the hazards of occupational and environmental
risks.
6. Syndrome identification :
 Lumping and splitting of syndrome. Eg. Many types of hepatitis,
Childe leukemia etc
Example: Use of Epidemiology
 In the United States, the National Center for Health Statistics

is a data source for information on health and disease
 http://www.cdc.gov/nchs
 Globally,the World Health Organization is a data source for
information on health and disease
 http://www.who.int
Leading Causes of Death, USA, 2000
(number of deaths)
1. Heart Disease
2. Neoplasms
3. Cerebrovascular Disease
4. Chronic Pulmonary Disease
5. Accidents/Injuries
6. Diabetes mellitus
7. Influenza and pneumonia
8. Alzheimer’s Disease(brain diseases)
9. Nephritis, nephrotic syndrome
10. Septicemia
Leading Causes of Death Worldwide, 2000
(Based on number of global deaths)

1. Ischemic Heart Disease
2.Cerebrovascular Disease
3. Lower Respiratory Infections
4. HIV/AIDS
5. COPD
6. Perinatal Conditions
7. Diarrhoeal Diseases
8. Tuberculosis
9. Road Traffic Injuries
10. Lung Cancers
Pakistan: Leading Causes of
Premature Death, 1990
1. Diarrhea
2. Lower Respiratory Infections - child
3. Tuberculosis
4. Rheumatic heart disease
5. Chronic liver disease
6. Congenital malformations
7. Birth Diseases
8. Ischemic heart disease
9. Child Septicemia
10. Injuries
Purpose of Epidemiology
To provide a basis for developing disease

control and prevention measures for groups at
risk. This translates into developing measures
to prevent or control disease.
Two Broad Types of Epidemiology
Descriptive Epidemiology
 Examining the distribution, frequency of disease in a population,
and observing the basic features of its distribution. Descriptive
epidemiology enquires as to what the problem is, its magnitude
( The no of causes and events reported ) where and when the
problem occur. No clinical work done in descriptive epidemiology.
 describe on the basses of
 Who ( Person) e.g Age, Sex, Social Class, Educational Level,
Occupation
 Where ( Place ) eg. Temperature, urban /Rural, Health Facility
 When (Time) eg. Per days, Per week, Long Term etc
Analytic Epidemiology
Testing a hypothesis about the cause of disease by studying
how exposures relate to the disease. Analyzing the causes or
determinants or etiology of disease .
Analytical epidemiology making comparisons between control
and cases
control : people do not have the disease
Cases :people who have been exposed to the disease agent or
have disease.
Descriptive & Analytical Epidemiology
 Descriptive Epidemiology is the Originator to

Analytical Epidemiology
 Analytic epidemiology studies require
information to ….
know where to look
know what to control for
develop viable hypotheses
Example
 You have been asked to investigate an event

in which 2,220 people were exposed and
1,640 which died.
 Your role as an epidemiologist is to ask
questions about person, place and time.
with questions you learn that ...
 Person: Men, women and children were all exposed and

at risk. The majority of people who died were wealthy
and young men between 18-50 years (when compared to
survivors).
 Place:
All those exposed were within 1 block of one
another, the climate was cold.
 Time: Mid April, people died within hours of the
precipitating exposure.
 You have been asked to investigate an
event in September 2022 in which
2,220 people were exposed in
Islamabad and 1,640 which are
hospitalized which platelets are below
than normal and 120 of them died.
 Your role as an epidemiologist is to
investigate disease , determinants and
control of disease.
Epidemiologic Homeostasis
Host
Agent Environment
The Epidemiologic Triangle
Host
Host Factors
Personal traits
behaviors
genetic predisposition
Agent Environment immunologic factors
• Influence the chance

for disease or its severity
Host
Agents
Biological
Physical
Chemical
Agent Environment
• Necessary for
disease to occur
Host
Environment
External conditions
Physical or biologic
or social
Agent Environment
• Contribute to the
disease process
Epidemics arise when host, agent, and
environmental factors are not in balance
 Due to new agent
 Due to change in existing agent (infectivity, pathogenicity,
virulence)
 Due to change in number of susceptibles in the population
 Dueto environmental changes that affect transmission of
the agent or growth of the agent

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Importance and Uses of Epidemiology

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Is it a science? Or is it a method?

Disease It’s not just disease!

 Epidemiology weighs and balances

2. Historical Study/ Disease History:

4. Evaluation of the working of Health Services:

 In the United States, the National Center for Health Statistics

(Based on number of global deaths)

To provide a basis for developing disease

 Descriptive Epidemiology is the Originator to

 You have been asked to investigate an event

 Person: Men, women and children were all exposed and

• Influence the chance

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