REVIEW!
1) What are the two major types of
epidemiology?
2) Which one is concerned with
causation?
3) Which allows us to test
hypotheses?
Assumptions of Epidemiology
• Human disease does not occur at random
(Hippocrates fans!)
• Causal and preventive factors can be identified
• Subgroups of populations in different places and times
Descriptive Epidmiology
• Describes the existing distribution of variables without
considering causation
• Measure prevalence, incidence of disease
• Generates hypotheses for analytic studies
Examples
• Person: age, sex, race/ethnicity, SES,
occupation, lifestyle
• Place: neighborhood, state, country, environment
• Time: date of exposure, date of diagnosis, etc.
Who gets disease? Example-Breast Cancer
incidence and mortality by race/ethnicity
Place: Is there a geographic pattern?
Example: Breast Cancer Incidence by State
Time: When is the disease occurring?
• Short-term fluctuations
• Example?
• Cyclic patterns
• Example?
• Secular trend- Wait! What is this?
• Example?
What is a “secular trend”?
“A trend associated with some characteristic or
phenomenon that is not cyclical or seasonal but exists
over a relatively long period.”
Make sense? Ok, back to our regularly scheduled
programming…
…So, what is an example of a “secular trend” in
diseases we study?
Time: When is the disease occurring?
• Short-term fluctuations
• Food borne outbreak
• Cyclic patterns
• Annual increases in influenza in cold months
• Secular trends
• Long term changes over decades of heart disease,
cancer
Examples of secular trends
• Diagnostic/detection bias
• Management of disease after diagnosis
• Long-term food production or consumption
• Tobacco popularity
“Your Health Depends on Where you Live”:
real-life examples of descriptive epi
Environmental Factors:
• https://www.ted.com/talks/bill_davenhall_your_health_depends_on_where_yo
u_live
(through 6 min.)
Social Factors:
• https://www.pbs.org/wgbh/frontline/film/doctor-hotspot/
As you watch, notice examples of person, place and time
https://www.youtube.com/watch?v=dJEwC4wCM70&list=PLOGi5-
fAu8bEOV9XSktM8EJwK2Hx1Qdf5 (Rishi Manchanda TED Talk)
How do these examples of “upstream factors” in individual patients be
extrapolated to the larger population and descriptive data collection