Epidemiology in Public Health

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Epidemiology in Public Health

Abstract

This paper covers the field of epidemiology and its use in public health. First, the paper outlines the definition of epidemiology and its origin. This is followed by a description of the changes that occurred in the field of epidemiology over time. The paper also covers the essential elements of epidemiology. Moreover, it also delves into the epidemiological approach or the steps in the epidemiological process.  The paper then highlights the basic concepts in epidemiology that include natural history of disease, population at risk and levels of protection. Finally, the paper explains how epidemiology is being used in nursing in the practice of health in the community.

Epidemiology in Public Health

Epidemiology refers to the study that determines and influences how events and conditions related to health such as diseases are distributed (Last et al., 2001). In addition to that, epidemiology also factors in the control of diseases and other health-related issues by applying this study. Epidemiology is coined from three Greek words epi, demos, and logos (Webb et al., 2016). Epi means upon, demos, means people while logos means the study of (Webb et al., 2016). Epidemiology plays a crucial role in the promotion of public health by assisting in the definition and evaluation of risk factors for disease as well as in the identification of targets in preventive healthcare. The achievement of these objectives is facilitated by the inculcation of practice that is based on evidence and sound policy decisions in public health.

Epidemiology traces its roots back to the 400 B.C. where Hippocrates tried to portray the relationship between the emergence of diseases and the environment (CDC, 2012). In this period, Hippocrates tried to come up with a logical explanation for the occurrence of disease suggesting that diseases were as a result of factors related to the environment and the host of the disease. In 1662, John Graunt played a great role in the development of epidemiology by researching on the patterns of disease occurrence in London before the Great Plague (Kranz & Hau, 1980). Graunt’s work was modified by William Farr in 1800, who collected, evaluated and reported his findings on data to the health authorities and the public (Kranz & Hau, 1980).

John Snow’s incredible contribution to the epidemiology earned him the name “the father of epidemiology” (CDC, 2012). Snow researched on cholera outbreaks in London with the aim of establishing its cause and putting in place measures to curb its recurrence. Snow’s work was praised for its richness in epidemiology concepts such as descriptive epidemiology, generation of a hypothesis, analytic epidemiology, and the application of epidemiology (CDC, 2012). The implementation of the epidemiological methods postulated Snow began to be implemented in the mid-1800s where on most occasions they were used to treat infectious diseases that were deemed acute (Kranz & Hau, 1980). These methods were later rolled over to non-infectious diseases in the 1930s (Kranz & Hau, 1980). The use of epidemiologic methods in the 1960s was essential in the elimination of smallpox globally (Kranz & Hau, 1980).

 Later in the 1980s, the use of epidemiology was incorporated in research involving violence and injuries (CDC, 2012). The 1990s saw concentration shift to the aspects of genetic and molecular epidemiology (CDC, 2012). Due to the emergence of infectious and malignant diseases such as cancer, the 2000s have been characterized by epidemiological studies seeking to establish the relationship between the molecular pathologic characteristic of the disease and the infection of the disease (CDC, 2012). To date, the use of epidemiology has been proved useful in solving many health problems worldwide.

The essential elements of epidemiology include determinants, study, distribution, application, health-related events, and specified populations (Bhopal, 2016). A determinant may be defined as an event, characteristic or factor that influences change in a condition of health (Last et al., 2001). The determinants in epidemiology refer to the factors that contribute to the emergence of a disease (Last et al., 2001). In this element, analytical epidemiology is used to provide a basis for the occurrence of the disease. The study element indicates that in itself, epidemiology is a discipline in science that is driven by research.

Epidemiology is not only a quantitative method of research but also one that requires analytical evaluation through hypothesis testing and causal reasoning (Bhopal, 2016). In addition to that, epidemiology consists of a distribution element that focuses on the patterns and frequency of the health events that revolve around a particular population. The application element of epidemiology involves the adoption of the study based knowledge in the practical cases of health conditions. Moreover, the health-related events principle of epidemiology is essential since it delineates the scope of epidemiology. The other essential element of the epidemiology is specified populations which relate to the patient or people affected by a certain health condition.

An epidemiological approach refers to a well laid out procedure that is followed in the practice of epidemiology (Last et al., 2001). The epidemiological approach also refers to the steps in the epidemiological process. An epidemiological approach includes counting, dividing, and comparing (Bhopal, 2016). In this systematic approach, the epidemiologist first establishes a case. This is followed by the counting of the cases at hand. The cases are then allocated a description according to the place of incidence, the time of occurrence, and the individual affected. This is then followed by the division of the cases at hand with an appropriated denominator to come up with the rates of occurrence (Bhopal, 2016).  The final step in the epidemiological approach is usually to create a platform for the comparison of the calculated rates with the period. Additionally, the calculated rates can be compared among different groups of individuals (Bhopal, 2016).

The fundamental concepts of epidemiology include the population at risk, levels of protection and the natural history of the disease (Webb et al., 2016). The concept of the natural history of a disease entails the prevalence and progression of a disease over time due to the lack of an individual receiving treatment (Webb et al., 2016). Four stages are involved in the occurrence of natural progression of a disease. They include susceptibility, adaptation, early pathogenesis, and clinical disease (Webb et al., 2016). The concept of the population at risk involves the total number of people that are predisposed to the disease or heath condition that is under research. The concept of the levels of protection deals with the ability to prevent the spread of a health condition or a disease to other people who are not yet infected.

Epidemiology plays a key role in improving nursing, particularly in the community health practice. One of the roles of epidemiology is the evaluation of health in the community (Whitehead, 2000). Nurses can research on health conditions that are likely to occur in a community as a result of epidemiology (Maria, 2008). In addition to that, it is easy for nurses to identify the areas that are likely to be affected and also the population that is predisposed to the health condition (Maria, 2008). Thus, it is essential in the decision making processes of nurses in combating diseases and health conditions in the society.

Moreover, epidemiology facilitates the recommendation and implementation of sound policies to senior health officials in the community. Epidemiology has also been effective in the surveillance of public health in the community (Savitz et al., 1999). The surveillance of public health has helped in the prevention and control of diseases (Savitz et al., 1999). Also, the use of epidemiology has promoted the improvement of analytical studies in community healthcare. Another aspect that has been boosted by the use of epidemiology in nursing is the field investigation aspect. Furthermore, the working of nurses together in epidemiology has created linkages of health conditions thus making it easier to solve the problem.

All in all, epidemiology has been influential in tackling diseases and health conditions in the community. The use of epidemiology in nursing has facilitated the formulation of sound policies, the surveillance of public health, the improvement of analytical studies, field investigations, and the development of linkages in health conditions.

References

Bhopal, R. S. (2016). Concepts of epidemiology: integrating the ideas, theories, principles, and methods of epidemiology. Kuala Lumpur: Oxford University Press.

CDC. (2012, 18). Principles of Epidemiology: Lesson 1, Section 2|Self-Study Course SS1978|CDC. Retrieved from https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section2.html

Kranz, J., & Hau, B. (1980). Systems analysis in epidemiology. Annual Review of Phytopathology18(1), 67-83.

Last, J. M., Abramson, J. H., & Freidman, G. D. (Eds.). (2001). A dictionary of epidemiology (Vol. 4). New York: Oxford University Press.

Maria, R. N. (2008). Teaching epidemiology: the role of the public health nurse. Journal of Nursing Education47(5), 227.

Savitz, D. A., Poole, C., & Miller, W. C. (1999). Reassessing the role of epidemiology in public health. American Journal of Public Health89(8), 1158-1161.

Webb, P., Bain, C., & Page, A. (2016). Essential epidemiology: an introduction for students and health professionals. London: Cambridge University Press.

Whitehead, D. (2000). Is there a place for epidemiology in nursing?. Nursing Standard14(42), 35-39.

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