Simple
Chapter 1
Epidemiology Past & Present
re: The text
• EKS = Epidemiology Kept Simple
• 20 chapters
• Multiple sections (§) per chapter
• Chapter outlines on first page of each
chapter
§1.1 Epidemiology, Health,
and Public Health
• What is epidemiology?
• What is public health?
• What is health?
Epidemiology Defined
• Greek roots
• epi = upon
• demos = the people
• ology = study of
• Literally - “study of epidemics”
• Modern definitions include references to
• distributions of health determinant (statistical concept)
• determinants of disease (pathophysiologic concept)
• application in control of health problems (biological
and social concepts)
Comparison of epi &
medicine
• Main unit of concern
• Epi population
• Medicine individual
• But …
• Epi becoming increasingly individualized
• Medicine becoming group-based
Public Health
• Definitions of public health include reference to:
• organized effort (“activity”)
• reduction of morbidity / mortality
• improvements in health
• Public health comprises many disciplines
• Epi is just one such discipline
• Compare epi and public health
• Epi a “study of”
• Pub health an activity
Health
• No single definition
• Medical definition absence of disease
• WHO definition (1948) reference to
“physical, mental, and social well-being”
• Should definitions of health reference quality
of life?
• Pros
• Cons
Additional Terms
• Morbidity = related to disease or disability
• Mortality = related to death
• Occurrence of disease = prevalence or
incidence of disease & health-related
conditions
• Endemic = normal occurrence of a condition
• Epidemic = greater than normal occurrence of
a condition
• Pandemic = epidemic on multiple continents
§1.2 Uses of Epi (Morris, 1957)
(pp. 3 – 4 in text)
1. Historical study
2. Community diagnosis
3. Working of health services
4. Individual chances
5. Complete clinical picture
6. Identify new syndromes
7. Determine cause (ultimate importance)
§1.3 Epidemiologic Transition
(pp. 4 – 10)
• The epidemiologic transition of the 20th
century
• Acute and contagious chronic and non-
contagions
• Decrease mortality rates
• Morbidity shifted to older age groups and
“degenerative diseases”
§1.3 Epidemiologic Transition
of the 20th century
Leading Causes of Death, 1900 and 1990
1900 1990
1 Pneumonia / influenza Heart disease
2 TB Neoplasms
3 Diarrhea Cerbrovascular
(Fig. 1.3, p. 9)
Life Expectancy at Birth (Fig. 1.4, p. 10)
§1.4 Selected Historical Figures
and Events
• Understanding medical history is an
important part of epidemiology
• This section divided into three eras
• 400BC – 1850
• 1850 - 1900
• Twentieth century epi
The role of Western Civilization
and “The Scientific Revolution”
• Age of Enlightenment and Western
Civilization
• Science liberates itself from philosophy,
morality, and religion
• Recommended reading:
Demographic Approach
(pp. 12–14)