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HLTH 380 Test 2 Ch 4
Descriptive Epi.: Person, Place, Time
43
Health Care
Undergraduate 3
02/22/2009

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Term
descriptive epidemiology
Definition
used to IDENTIFY A HEALTH PROBLEM that may exist; characterizes the amount and distribution of disease
Term
analytic epidemiology
Definition
follow descriptive studies and are used to IDENTIFY THE CAUSE OF THE HEALTH PROBLEM
Term
3 objectives of descriptive epidemiology
Definition
1. evaluate and compare trends in health and disease
2. to provide a basis for planning, provision, and evaluation of health services
3. to identify problems for analytic studies (creation of hypotheses)
Term
hypotheses
Definition
theories tested by gathering facts that lead to their acceptance or rejection
Term
three types of hypotheses
Definition
1. positive declaration (research hypo.)
2. negative declaration (null hypo.)
3. implicit question
Term
Mill's Canons of Inductive Reasoning
Definition
1. method of difference
2. method of agreement
3. method of concomitant variation
4. method of residues
Term
method of difference
Definition
all the factors in two or more places are the same except for a single factor
Term
method of agreement
Definition
a single factor is common to a variety of settings (ex.: air pollution)
Term
method of concomitant variation
Definition
the frequency of disease varies according to the potency of the factor
Term
method of residues
Definition
involves subtracting potential causal factors to determine which factor(s) have the greatest variation
Term
Method of Analogy (McMahon and Pugh)
Definition
-The mode of transmission and symptoms of a disease of unknown etiology bear a pattern similar to that of a known disease.
-This info. suggests similar etiologies for both diseases.
Term
3 approaches to descriptive epi.
Definition
1. case reports (counts)
2. case series - summarize characteristics of patients from major clinical settings
3. cross-sectional studies - surveys of the population to estimate the prevalence of a disease or exposure
Term
trends by age subgroup (childhood, teenage years, adulthood, older adults)
Definition
CHILDHOOD: developmental problems
TEENS: unplanned pregnancy, substance abuse
ADULTS: accidental injury, homicide, suicide
OLDER ADULTS: chronic diseases
Term
5 reasons for age associations
Definition
1. validity of diagnoses across the life span
2. multimodality of trends
3. latency effects
4. action of the "human biologic clock"
5. life cycle and behavioral phenomena
Term
validity of diagnoses
Definition
may be affected by classification errors; inaccuracies
Term
multimodality
Definition
several peaks and declines in the frequency of diseases at various ages; ex: TB - 2 peaks around 0-4 years (susceptibility to inf. dis.) and 20-29 years (changes from puberty or social interactions); also Hodgkin's disease - bimodal
Term
latency effects
Definition
long period of time between environmental exposures and the development of disease; ex: exposure to carcinogens; older people have had a greater opportunity to be exposed to multiple potential carcinogens; syphillis, Parkinson's, CVD
Term
biologic clock phenomenon
Definition
triggering of conditions with a genetic basis; ex: Alzheimer's in the elderly)
Term
What is an important risk factor second only to age?
Definition
gender
Term
Who has higher mortality rates, males or females?
Definition
males
Term
Who has higher morbidity rates, males or females?
Definition
females
Term
What is the leading cause of mortality among women?
Definition
coronary heart disease
Term
Is being married a risk factor or a protective factor?
Definition
protective
Term
marital status as a selective factor
Definition
people who marry may be healthier to begin with
Term
Of all racial groups studied, who had the highest rate of mortality?
Definition
african americans
Term
disparities among african americans
Definition
-increased blood pressure levels
-age-adj. death rate 1.3x rate of whites
-LE: white female, black female, white male, black male
Term
disparities in American Indians
Definition
-largely behavioral cause of death
-inf. disease 10th leading cause of death
-males 25-34, death rate 6.6x higher than for all races in the US
Term
disparities in Asians
Definition
-japanese have lower mortality rates
-lower rates of CHD and cancer (b/c of low-fat diets and stress-reducing strategies)
-high rates of TB among Asian/Pac. Islander groups
Term
acculturation
Definition
modifications that individuals or groups undergo when they come in contact with another country
-provide evidence of the influence of environmental and behavioral factors on chronic disease
Term
salmon bias effect (pg. 167)
Definition
persons who have immigrated to the US may return to original countries where they die, thus becoming "statistically immortal"
Term
nativity
Definition
place of origin of the individual; either foreign born or native born
Term
healthy migrant effect
Definition
observation that healthier, younger persons usually form the majority of migrants
Term
disease rates among Seventh Day Adventists
Definition
low rates of CHD and low mortality rates from other chronic diseases; lower brood pressures
Term
disease rates among Mormons
Definition
lower incidence and mortality rates due to cancer and other diseases due to restrictions on the intake of coffee, tea, and meats and lifestyle variables related to physical fitness, social support, and a stress-reducing religious ideology
Term
factors contributing to low SES
Definition
poor housing, crowding, racial disadvantages, low income, poor education, and unemployment
Term
variables of social class
Definition
occupational or social position, educational attainment, income
Term
cyclic fluctuations
Definition
periodic changes in the frequency of diseases and health conditions over time
Term
3 reasons for place variation in disease
Definition
1. gene/environment interaction
2. influence of climate
3. environmental factors
Term
determinants of cyclic fluctuation
Definition
1. lifestyle of the host
2. seasonal climatic changes
3. virulence of the infectious agent
Term
secular trends
Definition
gradual changes in the frequency of a disease over long time periods
Term
case clustering
Definition
unusual aggregation of health events grouped together in space and time
Term
temporal clustering
Definition
ex: post-vax reactions, postpartum depression
Term
spatial clustering
Definition
concentration of disease in a specific geog. area
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