These slides contain the lecture content for Week 3.

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Week 3 Lecture
Instructor: Gina Crosley-Corcoran, MPH
PBH 715 – Introduction to Social &
Behavioral Sciences

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Social Epidemiology

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Social Epidemiology
 In this section we discuss the importance and application
of social epidemiology in public health
 The fields of social, behavioral, and cultural epidemiology
are intended to
 Identify correlates
 Develop hypotheses
 Uncover causal mechanisms
 Design interventions
 All with an eye toward the social, behavioral, and ultural
aspects of human health rather than a more strictly
biological/physiological approach of traditional
epidemiology

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Social Epidemiology
 Study of the causes, distribution, and control of
diseases within and between populations
 Study of social and behavioral determinants of
disease incidence and prevalence
 Important terms
 Incidence: Number of new cases occurring in a given
population over a specified time period
 Prevalence: Number of cases present in a given population at
a specified point in time

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Behavioral & Cultural Epidemiology
 Behavioral Epidemiology
 Study of the behavioral or lifestyle factors affecting disease
causes, distribution, and control
 Realize that behaviors are not randomly distributed in the
population
 Cultural Epidemiology
 Study of cultural factors affecting disease causes,
distribution, and control
• Religion
• Cultural models of illness
• Cultural values regarding health and illness

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Variables
Dependent (Outcome)
• Mortality
• Morbidity
• Incidence
• Prevalence
• Life Expectancy
• Health status
Independent (Etiologic)
• Social Environmental
• Family structure
• neighborhood
• Racism
• Behavioral/Lifestyle
• Diet
• substance use/abuse
• exercise
• seat belt use
• Cultural
• Religion
• Ethnicity
• models of health and illness
• values and meanings of health and
illness

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Causal Continuum
 Focus on etiology
 How direct is the
effect on health
outcomes?
 Explores three
types of
determinants
Distal
(Upstream)
Intermediate
(Midstream)
Proximate
(Downstream)

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Proximate Determinants
 Have direct effect
 Biology
 Behavior
 Belief
 Attitudes
 Genetics
 Considered easiest to change
 Most common point for intervention
 Examples:
 High blood pressure (biology), Choices of diet, exercise, sleep
(behavior), “I am in control of my health.” (belief),
Optimism/Pessimism (attitudes), BRCA1 mutation (genetics)

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Intermediate Determinants
 Do not have direct influence
 Family organization
 Social support
 Social network ties
 Healthcare accessibility
 Family organization
 Occupation
 Neighborhood or community setting
 May serve as buffers for distal factors
 May operate as intervening variables

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Distal Determinants
Indirect impact on health
•Background or contextual factors
•Impact through other factors
•Considered fundamental or structural causes
•Often difficult to change
Ecological setting
•Urban/rural
Culture
•Ideology, social organization, technology
Demographic features
•Ethnicity
Political-economic organization
•Demographic features
•Political economy
•Social structure
•SES
•Culture

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Week 3 Assignments
Discussion Board
Read Mud Creek Medicine
for Week 3 Live Discussion