Fundamentals of Epidemiology

Introduction to Epidemiology History of Epidemiology Epidemiology developed alongside medical science and is related to each other. The purpose of studying the history of epidemiology is to know the development of epidemiologic thinking at various times and how epidemiologic leaders derive a theory of epidemiologic study. The First Epidemiologist 1. Hippocrates (460-377 BC)  Hippocrates was the first epidemiologist.  He explained how rational basic diseases occur  Books he wrote: Epidemic I, Epidemic II, On Airs, Waters, and Places.  Hippocrates also introduced the terms epidemic and endemic. 2. Graunt (1662)  Graunt recorded births and deaths in the city of London for 30 years since 1632.  He also made a life course table based on the results of records obtained from the number and percentage or probability of death at each age goal during his lifetime.  Graunt is known as the father of statistics. 3. William Farr (1839),  William Farr successfully proved the existence of a statistical relationship between life events and the state of public health.  He used statistical and epidemiological methods to analyze mortality data related to cholera epidemics in several London boroughs in 1832 and 1849.  William Farr's activities: a. He observed deaths in various institutions (prisons, mining industry) and compared them with deaths that occurred in the community. b. He used statistical methods in the analysis of cholera epidemiology data in London to demonstrate the relationship between the incidence and distribution of cholera and the pollution of drinking water sourced from the river Thames. 4. John Snow (1894)  John Snow studied cholera outbreaks in the city of London and succeeded in proving the relationship between the onset of cholera outbreaks and the source of drinking water of the population.  The study was conducted only on existing or naturally occurring data, so it is called the natural experiment stage (observational). John Snow is known as the father of field epidemiology. 5. Doll and Hill (1950) Austin Bradford Hill and Richard Doll conducted a study of smoking in relation to lung cancer and a study of cardiovascular disease in residents of Framingham, Massachusetts. Introduction to Epidemiology Epidemiology is known as the basic science of public health or often known as The Mother of Public Health. Epidemiology comes from the Greek language:  Epi = upon, or at.  Demos=people: population, people, population, community, society, people.  Logia = knowledge: science, knowledge. Definition of Epidemiology Epidemiology means the study of the distribution (spread) and determinants (determining factors) of a health problem in a particular population in the context of efforts to prevent and overcome health problems. Meanwhile, epidemiologists are people who use epidemiological methods and principles to overcome health problems. Epidemiology Distribution Epidemiologic distribution patterns refer to the incidence of health-related events according to time, place and person characteristics. Characterizing the distribution of health-related circumstances or events is one broad aspect of epidemiology called "descriptive epidemiology". Descriptive epidemiology presents: What, Who, How and Where of health-related events. Determinants of Epidemiology Epidemiology is also used to examine or look for causes and other factors th influence health events related to events. Another aspect called "analytical epidemiology" seeks to present or explain the "why" and "how" of an event according to group comparisons with differences in rates of disease occurrence and with differences in demographic characteristics, genetic or immunological status, behavior, environmental exposure and other so-called potential risk factors. Health Related Conditions or Events A. Origin of epidemiology concerned with infectious diseases B. Later expanded to 1. Endemic diseases 2. Non-communicable diseases 3. Chronic diseases 4. Injuries 5. Maternal and child health 6. Occupational health 7. Environmental health 8. Behaviors related to health and well-being (exercise, seat belt use, etc.) are known to be valid subjects of application of epidemiological methods. Specific Population 1. Clinicians are concerned with the health of an individual 2. Epidemiologists are concerned with the health of a group of individuals in a community or other area 3. Control and prevent disease in the community Scope of Epidemiology Known as the 6Es: 1. Etiology, identifying the cause of disease and other health problems. Example: Tuberculosis disease 2. Efficacy, relates to the optimal effect or power that can be obtained from a health intervention. Example: the efficacy of malaria vaccine is 40%. 3. Effectiveness, the magnitude of the results that can be obtained from an actio (treatment or intervention) and the magnitude of the difference from one action to another 4. Efficiency, an economic concept that looks at the effect that can be obtained based on the magnitude of the costs given 5. Evaluation, an overall assessment of the success of a treatment or public hea program. 6. Education, an intervention to increase knowledge about public health as part o disease prevention efforts.