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Epidemiology in Public Health: Key Functions and Essential Components

Understand the impact of epidemiology in public health, including core functions, essential services, types of studies, measurement errors, and disease frequency measures. Explore the role of epidemiology in driving program planning and resource allocation.

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Epidemiology in Public Health: Key Functions and Essential Components

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  1. The Impact of Epidemiology in Public Health Robert Hirokawa, DrPH Epidemiologist, Science and Research Group HHI / TSP, Hawaii Department of Health

  2. 3 Core Functions of Public Health • The Institutes  of Medicine (IOM) defines the three core functions of public health as: • Assessment • Policy development • Assurance

  3. 10 Essential Public Health Services • Monitor health status to identify community problems. • Diagnose and investigate health problems and health hazards in the community. • Inform, educate, and empower people about health issues. • Evaluate effectiveness, accessibility, and quality of personal and population- based health services. • Research for new insights and innovative solutions to health problems.

  4. 10 Essential Public Health Services • Mobilize community partnerships and action to identify and solve health problems. • Develop policies and plans that support individual and community health efforts. • Enforce laws and regulations that protect health and ensure safety. • Link people to needed personal health services and assure the provision of  health care when otherwise unavailable. • Assure a competent public health and personal health care workforce.

  5. Epidemiology Defined • The study of distribution and determinants of health and disease in human populations

  6. 3 Essential Components of Epidemiology • Disease distribution – person, place, time • Disease determinants – causal relationships • Disease frequency • Expected levels • Endemic • Epidemic • Pandemic

  7. Types of Epidemiologic Studies • Descriptive • Analytic

  8. Descriptive Studies • Frequency of occurrence of a particular condition • Patterns of occurrence • Person • Place • Time

  9. Hawaii crude adult obesity (BMI > 30) prevalence (%) by race/ethnicity, BRFSS, 2005

  10. Hawaii crude adult obesity (BMI > 30) prevalence (%), BRFSS, 2005

  11. Hawaii Obesity and Diabetes Trends 1. Percentage of Hawaii adults that are obese, BRFSS 1990 - 2006 2. Percentage of Hawaii adults who have been diagnosed with diabetes, BRFSS 1995 - 2006

  12. Analytic Studies • Observational Studies (exposure not controlled) • Cross-sectional • Case-control • Cohort • Experimental (exposure controlled)

  13. Cross-sectional Study (Observational) • Tests the association between variables of interest • Example: obesity and asthma • Temporal relationship not taken into account

  14. Case-Control Study (Observational) Exposure Disease ??? Group 1 has disease (Cases) ??? Group 2 disease free (Controls)

  15. Cohort Study (Observational) Exposure Disease Group 1 has exposure ??? Group 2 not exposed ???

  16. Basic Presentation of Results Smoke? Lung CA? Relative Risk = Proportion of disease among those exposed divided by the proportion of disease among those not exposed

  17. Basic Presentation of Results Smoke? Lung CA? RR = 40/100 divided by 10/100 = .4/.1 = 4

  18. Measurement Errors • Bias • Recall • Misclassification • Confounding • Statistical Errors

  19. Cause – Effect Relationship • Strength of association • Consistency • Temporality • Biological plausibility • Gradient (dose – response)

  20. Measures of Disease Frequency • Prevalence = # of existing cases / total population • Incidence = # of new cases / total population at risk

  21. Commonly Used Measures • Crude • Category-specific (age, gender, geography) • Age-adjusted

  22. Experimental Study • Clinical Trial • Exposure is controlled

  23. In Summary: Impact of Epidemiology in Public Health • Improved understanding of the distribution and determinants of health and disease in human populations • Used to drive program planning, resource allocation, interventions, and evaluation

  24. Thank you!

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