Scribd
Upload
104 views21 pages

An Introduction: Epidemiology Matters: A New Introduction To Methodological Foundations

This chapter introduces epidemiology and describes the approach taken in this book. It defines epidemiology as understanding the causes and distribution of population health to intervene and promote health. It outlines seven steps for conducting epidemiologic studies: defining the population, measuring exposures and outcomes, sampling, estimating associations, evaluating causality, assessing interactions, and external validity. The book aims to provide a systematic foundation in epidemiology concepts and their application to public health. It uses the hypothetical place of Farrlandia for examples and builds on past methodological development.

Uploaded by

Ben-Hur Albergaria
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
104 views21 pages

An Introduction: Epidemiology Matters: A New Introduction To Methodological Foundations

This chapter introduces epidemiology and describes the approach taken in this book. It defines epidemiology as understanding the causes and distribution of population health to intervene and promote health. It outlines seven steps for conducting epidemiologic studies: defining the population, measuring exposures and outcomes, sampling, estimating associations, evaluating causality, assessing interactions, and external validity. The book aims to provide a systematic foundation in epidemiology concepts and their application to public health. It uses the hypothetical place of Farrlandia for examples and builds on past methodological development.

Uploaded by

Ben-Hur Albergaria
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 21

An introduction

Epidemiology matters: a new introduction to methodological foundations


Chapter 1
Epidemiology is the science of understanding the
causes and distribution of population health so that we
may intervene to prevent disease and promote health.

Epidemiology Matters – Chapter 1 2


Examples of questions epidemiologists ask

 What is the incidence of myocardial infarctions between


2010-2020 among women born in 1950 in the United
States?
 What are the causes of myocardial infarctions in this
population?
 If we were to change population dietary habits, what
improvement in myocardial infarction incidence could we
affect?
Epidemiology Matters – Chapter 1 3
1. Evolution of epidemiology

2. Our approach to teaching epidemiology

3. Seven steps to conduct an epidemiologic study

4. Farrlandia

5. Summary

Epidemiology Matters – Chapter 1 4


1. Evolution of epidemiology

2. Our approach to teaching epidemiology

3. Seven steps to conduct an epidemiologic study

4. Farrlandia

5. Summary

Epidemiology Matters – Chapter 1 5


Evolution of epidemiology
 Epidemiology is a relatively new as a formal scientific
discipline
 Practice of conducting epidemiologic studies is not new;
‘counting’ health and disease goes back centuries
 Many of design and analytic techniques that we use
today arose in response to health concerns during 19 th
and 20th century

Epidemiology Matters – Chapter 1 6


Epidemiology, a beginning
 John Graunt – 17th century - pioneered approaches to tabulating
population health and mortality in rates, ratios, and proportions
 William Farr – 18th and 19th century - developed more
sophisticated life table approaches to understanding the force
and burden of mortality
 John Snow – 19th century - used epidemiologic approaches to
understand London cholera epidemic; developed and applied
basic measures of disease frequency and occurrence

Epidemiology Matters – Chapter 1 7


Epidemiology history, continued
 19th century – focus on infectious disease

 20th century – high-income countries shifted toward


non-communicable diseases
 Mid 20th century – methods formalized (1970s)

 Late 20th century – Miettinen, Rothman, and


Greenland - modern epidemiology (1980s)
formalized central disciplinary principles
Epidemiology Matters – Chapter 1 8
Current conceptual movements
1. Ecosocial perspective on population health – suggests policies,
institutions, and characteristics of context contribute to the
shaping of health
2. Life course perspective – determinants of health are distributed
across the life course and even before conception  

Therefore, epidemiology understands causes of population health


across levels of influence - from cells to society - and across life
course.

Epidemiology Matters – Chapter 1 9


An ecosocial framework
Social and Economic Policies

Institutions

Neighborhoods and Communities

Living Conditions

Social Relationships

Individual Risk Factors

``
Genetic/Constitutional Factors
``
Pathophysiologic pathways

Individual/Population
Health

Kaplan, G. What’s wrong with social epidemiology, and how can we make it better? Epid Rev 2004; 26: 124-135
A lifecourse approach to health production

Uauy, R. et al. Diet, nutrition, and the life-course approach to cancer prevention. J Nutr 2005; 135: 2934S-2945S
1. Evolution of epidemiology
2. Our approach to teaching epidemiology

3. Seven steps to conduct an epidemiologic


study

4. Farrlandia

5. Summary
Epidemiology Matters – Chapter 1 12
Our approach to teaching epidemiology

 We are interested in an epidemiology of consequence, an epidemiology


that can guide the improvement of the health of population
 Therefore, we focus here on teaching underlying concepts that start
from understanding populations, and lead the learner through the key
steps to designing an epidemiologic study
 We will mention and adopt the labels that are used in many other
epidemiology textbooks (e.g., confounding) but only after we have
introduced the reader to the underlying concepts

Epidemiology Matters – Chapter 1 13


1. Evolution of epidemiology
2. Our approach to teaching epidemiology

3. Seven steps to conduct an epidemiologic study

4. Farrlandia

5. Summary

Epidemiology Matters – Chapter 1 14


Epidemiology of consequence, seven steps
1. Define the population of interest
2. Conceptualize and create measures of exposures and health
indicators
3. Take a sample of the population
4. Estimate measures of association between exposures and health
indicators of interest
5. Rigorously evaluate whether the association observed suggests a
causal association
6. Assess the evidence for causes working together
7. Assess the extent to which the result matters, is externally valid, to
other populations

Epidemiology Matters – Chapter 1 15


Epidemiology of consequence, seven steps

Descriptive epidemiology
 Step 1. Define the population of interest
 Step 2. Conceptualize and create measures of exposures and health indicators
 Step 3. Take a sample of the population
 Step 4. Estimate measures of association between exposures and health indicators of interest

Assessing for causal effect


 Step 5. Rigorously evaluate whether the association observed suggests a causal association

Conceptualizing and testing for interactions


 Step 6. Assess the evidence for causes working together
 Step 7. Assess the extent to which the result matters (is externally valid) to other populations

Epidemiology Matters – Chapter 1 16


1. Evolution of epidemiology
2. Our approach to teaching epidemiology

3. Seven steps to conduct an epidemiologic study

4. Farrlandia

5. Summary

Epidemiology Matters – Chapter 1 17


Farrlandia

 Examples often based on hypothetical geographic area,


Farrlandia
 Inspired by William Farr, pioneering epidemiologist and
statistician
 Through use of Farrlandia examples, students will focus
on applying foundational concepts to populations

Epidemiology Matters – Chapter 1 18


1. Evolution of epidemiology
2. Our approach to teaching epidemiology

3. Seven steps to conduct an epidemiologic study

4. Farrlandia

5. Summary

Epidemiology Matters – Chapter 1 19


Summary
 This book aims to provide learners with a systematic
grounding in the theoretical underpinnings of epidemiology
with an awareness of the practical considerations that are
essential for public health professionals
 This text establishes a foundation by building on
methodological innovation and teaching of the previous
century, while adopting a novel approach to teaching
epidemiologic foundations

Epidemiology Matters – Chapter 1 20


epidemiologymatters.org

Epidemiology Matters – Chapter 1 21

You might also like