epidemiology 101 monday and tuesday, july 9 and 10, 2007 mark kaelin, edd montclair state university...
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Epidemiology 101Epidemiology 101
Monday and Tuesday, July 9 and 10, 2007
Mark Kaelin, EdDMontclair State University
Department of Health and Nutrition SciencesCollege of Education and Human Services
973-655-7123kaelinm@mail.montclair.edu
Public Health and Liberal Education Faculty Development Workshop
“They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those
ideas.
They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics
for others,
tell the right story, or raise a powerfully provocative question.”
Ken Bain, What the Best College Teachers Do
“They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those
ideas.
They realize where people are likely to face difficulties developing their own comprehension, and they can use that understanding to simplify and clarify complex topics
for others,
tell the right story, or raise a powerfully provocative question.”
Ken Bain, What the Best College Teachers Do
Epidemiology 101Epidemiology 101
Epidemiology is …
… the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the
control of health problems.
… the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the
control of health problems.
Epidemiology 101Epidemiology 101
“… the blending of population thinking and group comparisons in an integrated theory to appraise health-related causal relationships
characterizes epidemiology.”
Epidemiology is …
Epidemiology 101Epidemiology 101
Top 8 Reasons to Teach / Learn about Epidemiology
1.
2.
3.
4.
5.
6.
7.
8.
.
Empowers students to be scientifically literate participants in the democratic decision-making process concerning public health policy.
Empowers students to make more informed personal health-related decisions.
Increases students’ media literacy and their understanding of public health messages.
Increases students’ understanding of the basis for determining risk.
Improves students’ mathematical and scientific literacy.
Expands students’ understanding of scientific methods and develops their critical thinking skills.
Provides students with another mechanism for exploring important, real world questions about their health and the health of others.
Introduces students to an array of career paths related to the public’s health.
Epidemiology 101Epidemiology 101
Top 8 Reasons to Teach / Learn about Epidemiology
1.
2.
3.
4.
5.
6.
7.
8.
.
Empowers students to be scientifically literate participants in the democratic decision-making process concerning public health policy.
Empowers students to make more informed personal health-related decisions.
Increases students’ media literacy and their understanding of public health messages.
Increases students’ understanding of the basis for determining risk.
Improves students’ mathematical and scientific literacy.
Expands students’ understanding of scientific methods and develops their critical thinking skills.
Provides students with another mechanism for exploring important, real world questions about their health and the health of others.
Introduces students to an array of career paths related to the public’s health.
Epidemiology 101Epidemiology 101
On the first day of class, “Rather than laying out a set of requirements for students,
they usually talk about the promises of the course, about the kinds of questions the discipline will help students answer,
or about the intellectual, emotional, or physical abilities that it will help them develop.”
Ken Bain, What the Best College Teachers Do
On the first day of class, “Rather than laying out a set of requirements for students,
they usually talk about the promises of the course, about the kinds of questions the discipline will help students answer,
or about the intellectual, emotional, or physical abilities that it will help them develop.”
Ken Bain, What the Best College Teachers Do
A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that teachers’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to teachers’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … teachers’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable.
Epidemiology 101Epidemiology 101
Enduring Understandings
… the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.
Epidemiology 101Epidemiology 101
Epidemiological Factors
Person Place Time
Sex
Occupation
Age
SES
Residence
Events
Anatomical Site
Geographic Site
Year
Season
Day, etc.
Onset
Identifying Patterns of Health and Disease
Estimated Prevalence of Recent Illegal Drug Use by Race / Ethnicity: 1999-2000
Person
Identifying Patterns of Health and Disease
Epidemiological Factors
Person Place Time
Sex
Occupation
Age
SES
Residence
Events
Anatomical Site
Geographic Site
Year
Season
Day, etc.
Onset
Identifying Patterns of Health and Disease
Epidemiological Factors
Person Place Time
Sex
Occupation
Age
SES
Residence
Events
Anatomical Site
Geographic Site
Year
Season
Day, etc.
Onset
Identifying Patterns of Health and Disease
Surveillance
Identifying Patterns of Health and Disease
The ongoing systematic collection, analysis, and interpretation of outcome-specific data
for use in planning, implementation, and evaluation of public health practice
closely integrated with the timely dissemination of these data to those who need to know.
Epidemiological Factors
Person Place Time
Sex
Occupation
Age
SES
Residence
Events
Anatomical Site
Geographic Site
Year
Season
Day, etc.
Onset
Identifying Patterns of Health and Disease
1995
Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1995, 2005
(*BMI 30, or about 30 lbs overweight for 5’4” person)
2005
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Enduring Understandings
… the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.
Epidemiology 101Epidemiology 101
A hypothesis can be tested by comparing the frequency of disease in selected groups of people with and without an exposure
to determine if the exposure and the disease are associated.
b
d
a
c
E
E
DZ DZ
Epidemiology 101Epidemiology 101
Time
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Controlled Trial
Time
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Cohort Study
Time
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Case-Control Study
Time
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Cross-Sectional Study
Epidemiology 101Epidemiology 101
Comparing Exposed and Unexposed
Healthy PeopleHealthy People
E
Random Assignment
E
DZ
DZ
DZ
DZ
DZ
DZ
E
E
E
E
Healthy PeopleHealthy People
E
E
DZ
DZ
DZ
DZ
E
E
DZ
DZ
Enduring Understandings
… the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.
Epidemiology 101Epidemiology 101
Explanations for Associations
What do we mean when we say that there is an association between two things?
Associated
Tied Related
Linked
Things that are associatedare linked in some way that makes them
turn up together.
Epidemiology 101Epidemiology 101
Explanations for Associations
Things that are associated are linked in some way that makes them turn up
together.
Epidemiology 101Epidemiology 101
Study Links Spanking to Aggression
Snacks Key to Kids’ TV- Linked Obesity: China
Study
Depressed Teens More
Likely to Smoke
Study Links Iron
Deficiency to Math Scores
Explanations for Associations
Suicide Higher in Areas
with Guns
Study Concludes: Movies
Influence Youth Smoking
Cause
Confounding
Bias
Chance
Reverse Time Order
1.
2.
3.
4.
5.
1. Selection Bias
Error due to systematic differences in characteristics between those who take part in a study
and those who do not.
2. Information Bias
A flaw in measuring exposure or outcome data that results in different quality of data
between comparison groups.
Epidemiology 101Epidemiology 101
=
Population
a
25 cards
b c d
25 cards25 cards25 cards
=a b
c d
Odd #
Even #
No Marijuana
No Marijuana Total
Epidemiology 101Epidemiology 101
Violent Video Games
No Violent Video Games
Aggression
No Aggression
Cross Sectional Study
Violent Video
Games Can
Increase
Aggression
Time
Playing violent
video games
often may well
cause increases
in aggressive
behavior.
Violent Video Games
Aggression
It could be that … highly aggressive individuals are especially attracted to violent video games.
Epidemiology 101Epidemiology 101
Enduring Understandings
… the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.
Epidemiology 101Epidemiology 101
Explanations for Associations
Does evidence from an aggregate of studies support a cause-effect relationship?
1. What is the strength of the association between the risk factor and the disease?
2. Can a biological gradient be demonstrated?
3. Is the finding consistent? Has it been replicated by others in other places?
4. Have studies established that the risk factor precedes the disease?
5. Is the risk factor associated with one disease or many different diseases?
6. Is the new finding coherent with earlier knowledge about the risk factor and the m disease?
7. Are the implications of the observed findings biological sensible?
8. Is there experimental evidence, in humans or animals, in which the disease has m been produced by controlled administration of the risk factor?
Epidemiology 101Epidemiology 101
All scientific work is incomplete – whether it be observational or
experimental. All scientific work is liable to be upset or
modified by advancing knowledge. That does not confer upon us the freedom to ignore
the knowledge we already have, or to postpone the action that it
appears to demand at a given time.
Sir Austin Bradford Hill “The Environment and Disease:
Association or Causation?” Proceedings of the Royal Society of Medicine
January 14, 1965
Epidemiology 101Epidemiology 101
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