epidemiology 101 monday and tuesday, july 9 and 10, 2007 mark kaelin, edd montclair state university...

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

[email protected]

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.”



DZ

Epidemiology is …


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.


“… the blending of population thinking and group comparisons in an integrated theory to appraise health-related causal relationships

characterizes epidemiology.”

Epidemiology is …


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.


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.


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.”


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.”


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.


http://www.collegeboard.com/yes/index.html


Enduring Understandings

… the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.


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


Estimated Prevalence of Recent Illegal Drug Use by Race / Ethnicity: 1999-2000

Person



Person Place Time

Sex

Occupation

Age

SES

Residence

Events

Anatomical Site

Geographic Site

Year

Season

Day, etc.

Onset



Place


Person Place Time

Sex

Occupation

Age

SES

Residence

Events

Anatomical Site

Geographic Site

Year

Season

Day, etc.

Onset


Surveillance


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.


Person Place Time

Sex

Occupation

Age

SES

Residence

Events

Anatomical Site

Geographic Site

Year

Season

Day, etc.

Onset


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%

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


Time

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Controlled Trial

Time

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Cohort Study

Time

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Case-Control Study

Time

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Cross-Sectional Study


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




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.



Things that are associated are linked in some way that makes them turn up

together.


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


Suicide Higher in Areas

with Guns

Study Concludes: Movies

Influence Youth Smoking

Cause

Confounding

Bias

Chance

Reverse Time Order

1.

2.

3.

4.

5.

Diagram

2x2 Table

DZ DZ

X

X

a bc d


Unobserved Exposure

CocaineTobacco Alcohol

Marijuana

Confounder


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.


=

Population

a

25 cards

b c d

25 cards25 cards25 cards

=a b

c d

Odd #

Even #

No Marijuana

No Marijuana Total


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.


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?


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 101 monday and tuesday, july 9 and 10, 2007 mark kaelin, edd montclair state university...

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