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Chapter 6: Epidemiology: The Science of Prevention

Chapter Highlights

Defining epidemiology

Development of epidemiology as a science

Epidemiologic conceptual frameworks

Applying epidemiologic principles in practice

Assessment of health needs and assets

Using assessment data for planning and implementing interventions

Promoting healthy lifestyles

Preventing and controlling outbreaks

Contributing to a safe and healthy environment

Evaluating the effectiveness of health services

Question #1

Is the following statement true or false?

Epidemic—an outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population

Answer to Question #1

True

Rationale: Epidemic—an outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population.

Defining Epidemiology #1

Study of the distribution and determinants of states of health and illness in human populations; used both as a research methodology for studying states of health and illness, and as a body of knowledge that results from the study of a specific state of health or illness

Defining Epidemiology #2

Epidemic—an outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population

Rates—the primary measurement used to describe either the occurrence or the existence of a specific state of health or illness

Question #2

Who is perhaps the best known epidemiologist of the 19th century?

John Graunt

William Farr

John Snow

Florence Nightingale

Answer to Question #2

C. John Snow

Rationale: Perhaps the best known epidemiologist of the 19th century was John Snow, a contemporary of William Farr. One of the first people to study patterns of disease in populations was a London haberdasher, John Graunt. Farr set up a system for consistent collection of the numbers and the causes of deaths. Florence Nightingale, the daughter of a wealthy Englishman, was also a contemporary of William Farr and John Snow. She devoted her life to the prevention of needless illness and death.

Development of Epidemiology as a Science

John Graunt and the Bills of Mortality

William Farr, Registrar General

John Snow and the Broad Street Pump

Florence Nightingale, Nurse and Epidemiologist

Question #3

Is the following statement true or false?

Wheel of causation is the classic model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment, not by any single factor.

Answer to Question #3

False

Rationale: Epidemiologic triad is the classic model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment, not by any single factor. Wheel of causation de-emphasizes the agent as the sole cause of disease while emphasizing the interplay of physical, biologic, and social environments.

Epidemiologic Models

Epidemiologic triad

The wheel of causation

The web of causation

Natural history of disease

Question #4

Is the following sentence true or false?

Community assessments, using epidemiologic principles, form the database that provides the evidence and rationale for interventions.

Answer to Question #4

False

Rationale: Individual and community assessments, using epidemiologic principles, form the database that provides the evidence and rationale for interventions.

Applying Epidemiologic Principles in Practice #1

Assessment of health needs and assets

Individual assessment

Community assessment

Using assessment data for planning and implementing interventions

Promoting healthy lifestyles

Applying Epidemiologic Principles in Practice #2

Preventing and controlling outbreaks

Contributing to a safe and healthy environment

Evaluating the effectiveness of health services