Epidemiology Epidemiology is an in integral part of Clinical Medicine

Clinical EpidemiologyBy Robert H. Fletcher, Suzanne W. Fletcher Clinical Medicine

Epidemiology Spectrum Though Epidemiology started out with the study of epidemics, it became clear multiple environmental, social, occupational, and personal factors where involved in chronic disease

Disease Factors

Disease Factors Specifics

Multiple levels interacted in Health

Variables and Health What's wrong with social epidemiology, and how can we make it better? Kaplan GA EPIDEMIOLOGIC REVIEWS Volume: 26 Pages: ; 2004

Epidemiological Fields of Research have Spread Out

Epidemiologic Field Spread James S.House, “Understanding Social Factors and Inequalities in Health: 20th Century Progress and 21st Century Prospects,” Journal of Health and Social Behavior, volume 43, number 2 (June 2002), pages 125–142

Epidemiology Divisions Environmental Nutritional Social Immunoepidemiology Genetic Molecular Occupational Qualitative vs. Quantiative

Environmental Epidemiology Population study Environmental exposures - air pollution, hazardous waste, metals, pesticides, radiation and so on Health and Disease effects - cancer, cardiovascular disease, neurologic effects, reproductive effects, etc.

Social Epidemiology Definition Examination of social factors in: development and progression of many important health problems the natural history of the risk factors for those diseases and conditions. What's wrong with social epidemiology, and how can we make it better? Kaplan GA EPIDEMIOLOGIC REVIEWS Volume: 26 Pages: ; 2004

Population Health Determinants “ Multilevel Approaches to Understanding Social Determinants,” by Michael Marmot, from Social Epidemiology, edited by Lisa Berkman and Ichiro Kawachi, copyright 1999 by Oxford University Press, Inc.

Multiple Health Links James S.House, “Understanding Social Factors and Inequalities in Health: 20th Century Progress and 21st Century Prospects,” Journal of Health and Social Behavior, volume 43, number 2 (June 2002), pages 125–142

World View of Risk in Heart Disease 3rd World Preventive Medicine, volume 29, by G. A. Kaplan and J. W. Lynch, “Socioeconomic Considerations in the Primordial Prevention of Cardiovascular Disease,” pages S30–S35, 1999

Nutritional Epidemiology Population study Nutritional Determinants of disease

Nutritional Epidemiology Example Willett W, Nutritional Epidemiology. Walter S. Willett 1989

Occupational Epidemiology Population of Workers Occupational exposures Health Risk reduction in workplace

Genetic Epidemiology Analyzes family clustering of disease for possible modes of inheritance Isolated population (Newfoundland rod cone dystrophy) Twin studies

Molecular Epidemiology Investigates the pattern of disease in families through DNA analysis.

Qualitative Epidemiology Participatory Epidemiology - involves field work intelligence gathering- observational; Uses rapid appraisal techniques Involves Ethnography - study of individuals in their natural environment Understand the “human factor” - attitudes, habits, group dynamics, reactions. Factors mitigating against random sampling and towards bias.

Quantitative Epidemiology Follows vital statistics and population data Uses statistical measures to determine relevance