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[SOUND] Hello, in this week's lectures, we'll
discuss what epidemiology is, the history of epidemiology, and the

different public health perspectives. >> In order to orient you to the
course, we will provide a course map at the beginning of
each week's lectures. This week is module one and we will be covering an
explanation of what
epidemiology is. And the population perspective of
epidemiology. After you have reviewed all of week one
lectures, you should be able to complete these
learning objectives. They include define epidemiology. List the uses of
epidemiology in public
health. Describe how epidemiology supports
improving the public's health. Characterize two perspectives on health
outcomes in populations, the biomedical perspective, and the
population perspective. Relate the mission of public health, to the population
perspective on health
outcomes in populations. Describe the historic development of
epidemiology. And apply the population perspective to an
understanding of the global burden of health outcomes
and disease. Epidemiology is the study of the distribution of health outcomes or
disease within populations. And the factors that determine the spread
of health outcomes and diseases. These factors that determine whether
someone gets a certain health outcome or disease are
called risk factors. Epidemiologists, focus their attention at
the population level rather than the
individual level. In order to understand an epidemiology, it is first
helpful to review some of the basic history of the
field. People have long viewed epidemics of disease, and plagues as terrifying
occurrences. There has been a continued desire to have a more rational, and
complete way to
explain diseases. And more recently, other health outcomes
rather than believing that diseases were simply
caused by spirits or a God.
Empirical observations of epidemics and other causes of mortality, were the
beginning of the field of epidemiology. Epidemiology's focus was initially on
infectious diseases, until early in the 20th century.
Towards the end of the 20th century, computers, increasing information
technology, and new methodological approaches altered the field of
epidemiology. Epidemiology has become a standard area of
clinical science, and is the most fundamental basic science
of public health. Over time, the definition and focus of
epidemiology has changed. The focus was just on infectious diseases
and epidemics in the mid 1800s. Epidemiology began to focus on infectious
disease overall in the mid 1900s. By the mid 1950's epidemiology's focus
then included not just infectious diseases, but specific
conditions associated with them. In the 1960's epidemiology began to focus
on laws regarding the distribution of disease at a
community level. Then, in the late 1980's, epidemiology
focused on how to control or minimize health problems
and diseases. Next, we will talk about epidemiologic
transitions. An epidemiologic transition describes
changing patterns of population age distributions, mortality, fertility, life
expectancy, and causes of death. The human population has gone through four major
disease transitions since the
agricultural period began. The first transition is related to the
emergence of infectious diseases and diseases
related to nutrition. And to the beginning of the practice of
agriculture and food production. 10,000 years ago, people became less
dependent on hunting and gathering once they were able to produce food and
domesticate
animals. This shift led to zoonotic disease,
nutrient deficiencies, and increased contact with disease vectors
during agricultural activities. The second transition was a time where
human immune systems and disease-causing organisms both
evolved, resulting in a change from major epidemics of disease to endemic disease.
People developed physical and genetic
changes that serve to minimize the effects of diseases. The third transition
resulted when disease
patterns changed from infectious to chronic and
degenerative diseases, in developed parts of the world due to improvements in
nutrition, public health,
and clinical medicine. Cardiovascular diseases and cancer began
to occur more during this transition. They are often associated with the longer
lifespan and a sedentary lifestyle. The fourth transition started at the end
of the 20th century. When both new diseases and the reemergence
of infectious ones occurred as well as the rapid spread of disease due
to globalization. So let's compare the four epidemiologic
transitions. The first transition started when hunter
gatherers began to practice agriculture and began to live in
one place. There was a transition from few epidemics
to major epidemics. The second transition happened because
populations developed immunologic resistance and
disease-causing organisms changed. There was a transition from major epidemics of
disease to endemic
diseases. The third transition came from improved
public health and sanitation. There was a transition from infectious diseases to
non-infectious chronic and
degenerative diseases. The fourth transition was due to increased
globalization. There was a resurgence and rapid spread of
infectious diseases. This concludes the first part of this
lecture on the history of epidemiology. Please continue on to the next part, where
I will discuss some pioneers in the field of
epidemiology.

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[SOUND] Hello, in this week's lectures, we'll

discuss what epidemiology is, the history of epidemiology, and the

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