Integrating Epidemiology Education into Your Existing Curriculum

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Welcome to the
Young Epidemiology Scholars Teaching Units
Professional Development Workshop
Integrating Epidemiology Education into Your
Existing Curriculum
Reading High School, April 12, 2008
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YES Teaching Units Professional Development
Workshop
Handout
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Workshop
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YES Teaching Units Professional Development
Workshop
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Workshop
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Workshop Goal
To increase the frequency with which
the YES Teaching
Units are taught
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Workshop Objectives

• At the conclusion of the workshop, participants
  will have become more

• Enthusiastic about the prospect of teaching
  epidemiology.
• Likely to be an advocate for teaching
  epidemiology.
• Knowledgeable about the science of epidemiology.
• Capable of teaching epidemiology.
• Likely to teach epidemiology in the next three
  months.
• Likely to use the YES Teaching Units when
  teaching epidemiology.

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Pre-Workshop Assessment
Handout
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Workshop Objectives
At the conclusion of the June 12 workshop,
participants will be able to

1. Coherently describe the 12 enduring
   understandings that are fundamental to
   epidemiologic thinking.
2. Coherently and thoroughly describe how
   epidemiologic thinking makes it possible to
   identify patterns of health and disease in
   populations and formulate hypotheses to explain
   those patterns.
3. Teach two YES Teaching Units, from the
   perspectives of the disciplines of social
   studies, language arts, science, and mathematics,
   so that their students develop a comprehensive
   understanding of enduring understandings 2 and 3.

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Workshop Goal
YES Teaching Units Professional Development
Workshop
To create a professional community

that discusses new teacher materials and
strategies and that
supports the risk taking and
struggle entailed in transforming practice.
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Workshop Goal
YES Teaching Units Professional Development
Workshop
Name Tents
Introductions
Permissions
To create a professional community

that discusses new teacher materials and
strategies and that
supports the risk taking and
struggle entailed in transforming practice.
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Epidemiology is
DZ
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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.
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Epidemiology is
the blending of population thinking and group
comparisons in an integrated
theory
to appraise
health-related causal relationships
characterizes epidemiology.
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Epidemiology is
the blending of population thinking and group
comparisons in an integrated
theory
to appraise
health-related causal relationships
characterizes epidemiology.
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Epidemiology is
Handout
the blending of population thinking and group
comparisons in an integrated
theory
to appraise
health-related causal relationships
characterizes epidemiology.
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Teaching / Learning Epidemiology
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Top 8 Reasons to Teach / Learn about Epidemiology

• 1.
• 2.
• 3.
• 4.
• 5.

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 publics health.
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YES Teaching Units Professional Development
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http//www.asph.org/document.cfm?page1038
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Draft 1
Goal Over a four year period, create a model
Public Health School-to-Career Path
in
four Newark (NJ) high schools that motivates and
prepares students
to enter
college public health programs and, upon
graduation, enter the public health workforce.
Professional Development ? Teachers attend
professional development workshop addressing the
four core courses ? Teachers shadow college
professors teaching the
core courses ? Teachers, with the college
professors, team
teach the core courses ? Teachers team teach the
core courses
Curriculum Development ? Develop four core
Introduction to Public Health, Introduction to
Epidemiology, Health Disparities, and Health,
Policy, and Politics
? Develop field study experience
that immerses
students in public health work
in Newark and surrounding area
and for which they are
compensated.
Process Evaluation ? Collaborations with
stakeholders ? From electives to core courses ?
Attract appropriate number
of academically-able
students
Academic Outcomes Evaluation ? Core courses
Grades ? Non-core course grades ? Field
experience evaluation ? Intention to enter the
field of public health
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Workshop Objective
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YES Teaching Units
Handout
Professional Development Workshop
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YES Teaching Units
YES Teaching Units Working Group Diane-Marie St.
George, Manuel Bayona, David Fraser, Mark Kaelin,
Felicia McCrary, Flora
Ichiou Huang, Mona Baumgarten, Chris Olsen, and
Paul Stolley
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YES Teaching Units
Stand Alone / Pick One Off the Shelf
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YES Teaching Units
Professional Development Workshop
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YES Teaching Units
Professional Development Workshop
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YES Teaching Units
Professional Development Workshop
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YES Teaching Units
Stand Alone / Pick One Off the Shelf
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YES Teaching Units
http//www.montclair.edu/YESteachingunits/index.ht
ml
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YES Teaching Units
http//www.collegeboard.com/yes/index.html
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YES Teaching Units
Handout
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YES Teaching Units
Scholarship
Creativity
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Teaching the Teaching Units
Team 2
Team 1
Slave Trade
Casualties of War
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Report and Reflection Log
Handout
http//www.montclair.edu/YESteachingunits/YESRandR
form.php
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Pedagogical Basis
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.
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Pedagogical Basis
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 experts
content knowledge is structured around the major
organizing principles and core concepts of the
domain, the big ideas.
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Pedagogical Basis
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 experts
content knowledge is structured around the major
organizing principles and core concepts of the
domain, the big ideas. These big ideas lend
coherence to experts vast knowledge base help
them discern the deep structure of problems and,
on that basis, recognize similarities with
previously encountered problems.
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Workshop
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Pedagogical Basis
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 experts
content knowledge is structured around the major
organizing principles and core concepts of the
domain, the big ideas. These big ideas lend
coherence to experts vast knowledge base help
them discern the deep structure of problems and,
on that basis, recognize similarities with
previously encountered problems. experts
strategies for thinking and solving problems are
closely linked to rich, well-organized bodies of
knowledge about subject matter.
YES Teaching Units Professional Development
Workshop
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Pedagogical Basis
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 experts
content knowledge is structured around the major
organizing principles and core concepts of the
domain, the big ideas. These big ideas lend
coherence to experts vast knowledge base help
them discern the deep structure of problems and,
on that basis, recognize similarities with
previously encountered problems. experts
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.
YES Teaching Units Professional Development
Workshop
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Pedagogical Basis
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.
YES Teaching Units Professional Development
Workshop
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Pedagogical Basis
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 students
content knowledge is structured around the major
organizing principles and core concepts of the
domain, the big ideas. These big ideas lend
coherence to students vast knowledge base help
them discern the deep structure of problems and,
on that basis, recognize similarities with
previously encountered problems. students
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.
YES Teaching Units Professional Development
Workshop
43
Pedagogical Basis
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.
the big ideas.
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Enduring Epidemiological Understandings
will
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Enduring Understandings
distinguish between foundational concepts
and elaborations or
illustrations of those ideas.
National Research Council, Learning and
Understanding
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
Tied
Related
Associated
Linked
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Enduring Understandings
Suicide Higher in Areas with Guns
Smoking Linked to Youth Eating Disorders
Family Meals Are Good for
Mental Health
Study Concludes Movies Influence
Youth Smoking
Study Links Iron
Deficiency to Math
Scores
Lack of High School Diploma Tied to
US Death Rate
Study Links Spanking
to Aggression
Depressed Teens More Likely to Smoke
Snacks Key to Kids TV- Linked Obesity China
Study
Breakfast Each Day May Keep Colds Away
Pollution Linked with Birth Defects in US Study
Kids Who Watch R-Rated Movies More Likely to
Drink, Smoke
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Enduring Understandings
Tied
Related
Associated
Linked
What do we mean when we say that there is an
association between two things?
Things that are associatedare linked in some way

that makes them turn up together.
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Enduring Understandings
Things that are associated are linked in some way

that makes them turn up together.
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Enduring Understandings
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Enduring Understandings
Things that are associated are linked in some way

that makes them turn up together.
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Enduring Understandings
Handout
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Enduring Understandings
Pancreatic Cancer
Label the table
Coffee
No Coffee
Total
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Enduring Understandings
Pancreatic Cancer
Place the data into the table
15
Coffee
No Coffee
5
20
Total
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Enduring Understandings
Pancreatic Cancer
15
Coffee
No Coffee
5
20
Total
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Enduring Understandings
Pancreatic Cancer
15
Coffee
No Coffee
5
20
Total
Which of the following statements can be made
based on the above data A 15 of 20
patients, who had pancreatic cancer, drank
coffee. B 15 of 20 patients, who drank
coffee, had pancreatic cancer.
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Enduring Understandings
Odds   A ratio of the probability of occurrence
of an event to
that of its nonoccurrence.
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Enduring Understandings
Pancreatic Cancer
A ratio of the
probability of occurrence of an event
to that of its
nonoccurrence.
15
Coffee
No Coffee
5
15 to 5 or 3 to 1
20
Total
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Enduring Understandings
Pancreatic Cancer
15
Coffee
No Coffee
5
15 to 5 or 3 to 1
20
Total
Study Links Coffee Use to Pancreatic Cancer
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Enduring Understandings
Pancreatic Cancer
15
Coffee
Nothing
No Coffee
5
15 to 5 or 3 to 1
20
Total
Study Links Coffee Use to Pancreatic Cancer
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Enduring Understandings
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Enduring Understandings
Pancreatic Cancer
15
Coffee
Nothing
Compared to what?
No Coffee
5
15 to 5 or 3 to 1
20
Total
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Enduring Understandings
Pancreatic Cancer
15
Coffee
Nothing
Compared to what?
No Coffee
5
15 to 5 or 3 to 1
20
Total
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Enduring Understandings
Case-Control Study   A type of observational
analytical epidemiological investigation
in which the subjects are selected on the basis
of whether they do
(cases) or do not (controls)
have a particular
disease under study.
The groups are compared
with respect to the proportion
having a history of an exposure or characteristic
of interest.
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Enduring Understandings
Case-Control Study
DZ
Time
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Enduring Understandings
Place the data into the 2x2 Table
Pancreatic Cancer
15
10
Coffee
No Coffee
5
30
10 to 30 or 1 to 3
15 to 5 or 3 to 1
20
40
Total
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Enduring Understandings
Pancreatic Cancer
15
10
Coffee
No Coffee
5
30
10 to 30 or 1 to 3
15 to 5 or 3 to 1
20
40
Total
What mathematical computation would allow them to
complete the statement The odds of drinking
coffee were ____ times greater among patients
who had pancreatic
cancer compared to patients who did not have
pancreatic cancer.
What mathematical computation would allow you to
complete the statement
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Enduring Understandings
Pancreatic Cancer
15
10
Coffee
No Coffee
5
30
10 to 30 or 1 to 3
15 to 5 or 3 to 1
20
40
Total
3 / .33 9
3 / 1 3
1 / 3 .33
What mathematical computation would allow them to
complete the statement The odds of drinking
coffee were ____ times greater among patients
who had pancreatic
cancer compared to patients who did not have
pancreatic cancer.
9
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Enduring Understandings
Odds Ratio   Ratio of odds in favor of exposure
among cases
to the odds in favor of exposure among controls.
Relative Odds
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Enduring Understandings
Study Links Coffee Use to Pancreatic Cancer
Pancreatic Cancer
15
10
Coffee
No Coffee
5
30
10 to 30 or 1 to 3
15 to 5 or 3 to 1
20
40
Total
3 / .33 9
3 / 1 3
1 / 3 .33
What mathematical computation would allow them to
complete the statement The odds of drinking
coffee were ____ times greater among patients
who had pancreatic
cancer compared to patients who did not have
pancreatic cancer.
9
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Enduring Understandings
Study Links Coffee Use to Pancreatic Cancer
Pancreatic Cancer
15
35
Coffee
Odds Ratio
No Coffee
5
5
20
40
Total
What mathematical computation would allow them to
complete the statement The odds of drinking
coffee were ____ times greater among patients
who had pancreatic
cancer compared to patients who did not have
pancreatic cancer.
.43
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Enduring Understandings
Study Links Coffee Use to Pancreatic Cancer
Pancreatic Cancer
15
30
Coffee
Odds Ratio
No Coffee
5
10
20
40
Total
What mathematical computation would allow them to
complete the statement The odds of drinking
coffee were ____ times greater among patients
who had pancreatic
cancer compared to patients who did not have
pancreatic cancer.
1
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Enduring Understandings
Study Links Coffee Use to Pancreatic Cancer
Pancreatic Cancer
347
555
Coffee
Odds Ratio
No Coffee
20
88
367
643
Total
What mathematical computation would allow them to
complete the statement The odds of drinking
coffee were ____ times greater among patients
who had pancreatic
cancer compared to patients who did not have
pancreatic cancer.
2.75
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Enduring Understandings
4 Basic Epidemiological Study Designs
Case-Control Study
Randomized Controlled Trial
Cohort Study
Cross-Sectional Study
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
Study Links Coffee Use to Pancreatic Cancer
1.
Cause
2.
Confounding
3.
Reverse Time Order
Chance
4.
5.
Bias
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Enduring Understandings
Handout
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Enduring Understandings
Handout
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Enduring Understandings
Study Links Coffee Use to Pancreatic Cancer
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?
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
Sir Austin Bradford Hill
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.
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Enduring Understandings
Offsetting Effects
Other risks that are created
by implementing a
risk management strategy.
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Enduring Understandings
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Enduring Understandings
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Enduring Understandings
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Handout
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Enduring Understandings
In general,

exceptional teachers begin with simple
generalizations and
then move toward both complexity and specificity.
They use familiar language

before trying to introduce
specialized vocabulary. Ken Bain, What the Best
College Teachers Do
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Enduring Understandings 2 and 3
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5 W Questions
What?
Who?
Where?
When?
Why?
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When investigating a crime, police detectives
attempt to answer the 5 W questions.Detectives
want to know whodunit so that they can stop
the crime from happening again.
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When investigating disease occurrence,
epidemiologists attempt to answer the 5 W
questions.Epidemiologists want to know
whatdunit so that they can stop or slow down
the disease occurrence.
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Snow on Cholera

• The father of Epidemiology
• Classic Epidemiologic Investigation, 1854
• At the time, the predominant theory of disease
  causation was the miasma theorydisease came from
  bad air

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Snow investigation Which Ws did he know?

• At 2 Emerson Place, on 3rd August, the wife of an
  engineer, aged 30, cholera 2 days, Southwark and
  Vauxhall.
• At 34 Charlotte Street, on 29th July, a
  stockmaker, aged 29, cholera 18 hours, Lambeth.

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http//www.ph.ucla.edu/epi/snow/outbreak/outbreakU
NC.html
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Source Health US 2007
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Transatlantic slave trade

• Inhumane conditions on slave ships
• Discussion of mortality onboard
• Activity designed to get them to consider the
  descriptive epidemiology of slave ship mortality
• Person, place and time factors considered
• Gender
• Country of origin
• Length of voyage

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5 W Questions
What? Health condition disease, wellness, injury, disability
Who? Person age, gender, race/ethnicity, religion, diet, behaviors
Where? Place rurality, country, city
When? Time annual cycles, long-term trends, time of day
Why? 1. Generate hypotheses 2. Analytic epidemiology
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• Remember that 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.
• Descriptive epidemiology
• Describe the distribution of a health condition
• Generate hypotheses about determinants of disease
• Analytic epidemiology
• Test hypotheses about determinants of disease

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Surveillance

• the ongoing systematic collection, analysis and
  interpretation of health data essential to the
  planning, implementation, and evaluation of
  public health practice, closely integrated with
  the timely dissemination of these data to those
  responsible for prevention and control
• Thacker Berkelman, 1988

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Purpose of Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
• Source Slide from CDC Public Health Surveillance
  http//www.cdc.gov/ncphi/disss/nndss/phs/overview.
  htm

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Surveillance Events

• Outcomes STDs, lead poisoning, birth defects,
  cancer, infant mortality, LCDs, motor vehicle
  fatalities, occupational injuries
• Risk factors Smoking, nutrition, screening
  tests, physical activity
• Hazards Pollutants, toxic chemicals

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Sources of Surveillance Data

• State/Local Health Department
• CDC
• Birth and Death certificates
• Laboratories
• Hospital billing databases
• Providers offices

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Sources of Surveillance Data

• Registries
• State and national (SEER) cancer
• WTC health registry 71k to be followed for 20
  years
• Nagasaki and Hiroshima being followed since the
  late 1950s

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Nagasaki and Hiroshima

• Create timeline of key events of WWII
• Events leading to end of WWII
• Short- and long-term consequences of war gt
  morbidity and mortality
• Surveillance of bomb survivors
• Introduce surveillance data

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Cancer surveillance data (1977-1979)
Incidence rate/100,000
Males
Hiroshima 239.6
Nagasaki 257.6
All of Japan 209.4
Females
Hiroshima 162.3
Nagasaki 175.9
All of Japan 138.5
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• Which one shows evidence of a relationship
  between radiation exposure and increased risk of
  cancer?

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• Disease rates vs disease counts
• Adjustment for alternate explanations (city, sex,
  age) for the radiation-cancer association

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Enduring Understandings the big ideas that
reside at the heart of a discipline and have
lasting value outside the classroom.
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Descriptive epidemiology in the classroom

• Demonstration of a student exercise

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Video Review
Hiroshima
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Video Review
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Metacognition
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.
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Metacognition
They realize where people are likely to face

difficulties developing their own comprehension
.
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Metacognition
and they can use that understanding

to simplify and clarify complex topics for
others, tell the right story, or raise a
powerfully provocative question.
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Understanding by Design
Handout
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Reading Health Department - Larry Sunburg
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coffee and pancreatic cancer
At first glance these articles are
about _____________________________ but,
based on our understanding of
epidemiology, we can see that they are about
person, place, and time, counting, dividing, and
comparing, numerators and denominators,
associations, causation, confounding, prevention,
and policy.
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E. Coli and spinach
At first glance these articles are
about _____________________________ but,
based on our understanding of
epidemiology, we can see that they are about
person, place, and time, counting, dividing, and
comparing, numerators and denominators,
associations, causation, confounding, prevention,
and policy.
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Give people fish, they have food for a day,
Teach people how to fish, they have food for a
lifetime.
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Understanding
To understand something as a specific instance
of a more general case
is to
have learned not only a specific thing
but also a model for
understanding other things like it that one may
encounter.
will
J. Bruner, The Process of Education, 1960
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Teaching the Teaching Units
Team 2
Team 1
Slave Trade
Casualties of War
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Post-Workshop Assessment
they can distinguish between foundational
concepts and
elaborations or illustrations of those ideas.
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Enduring Understandings
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Workshop Objectives
At the conclusion of the June 12 workshop,
participants will be able to

1. Coherently describe the 12 enduring
   understandings that are fundamental to
   epidemiologic thinking.
2. Coherently and thoroughly describe how
   epidemiologic thinking makes it possible to
   identify patterns of health and disease in
   populations and formulate hypotheses to explain
   those patterns.
3. Teach two YES Teaching Units, from the
   perspectives of the disciplines of social
   studies, language arts, science, and mathematics,
   so that their students develop a comprehensive
   understanding of enduring understandings 2 and 3.

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Post-Workshop Assessment
Post-Workshop Questionnaire
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Thank You
Young Epidemiology Scholars Teaching Units
Professional Development Workshop
Integrating Epidemiology Education into Your
Existing Curriculum
Reading High School, April 12, 2008
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Enduring Understandings 2 and 3
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5 W Questions
What?
Who?
Where?
When?
Why?
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When investigating a crime, police detectives
attempt to answer the 5 W questions.Detectives
want to know whodunit so that they can stop
the crime from happening again.
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When investigating disease occurrence,
epidemiologists attempt to answer the 5 W
questions.Epidemiologists want to know
whatdunit so that they can stop or slow down
the disease occurrence.
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Snow on Cholera

• The father of Epidemiology
• Classic Epidemiologic Investigation, 1854
• At the time, the predominant theory of disease
  causation was the miasma theorydisease came from
  bad air

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Snow investigation

• At 2 Emerson Place, on 3rd August, the wife of an
  engineer, aged 30, cholera 2 days, Southwark and
  Vauxhall.
• At 34 Charlotte Street, on 29th July, a
  stockmaker, aged 29, cholera 18 hours, Lambeth.

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http//www.ph.ucla.edu/epi/snow/outbreak/outbreakU
NC.html
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Activity

• Each pair of teachers will receive a case study
• What patterns do you see? Who? What? Where? When?
• Why do you think the patterns appear that way?
• Example ADHD

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Activity

• Each pair of teachers will receive a case study
• What patterns do you see? Who? What? Where? When?
• Why do you think the patterns appear that way?
• Please take about ten minutes to review the
  assigned data

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Activity

• What patterns do you see? Who? What? Where? When?
• Why do you think the patterns appear that way?

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5 W Questions
What? Health condition disease, wellness, injury, disability
Who? Person age, gender, race/ethnicity, religion, diet, behaviors
Where? Place rurality, country, city
When? Time annual cycles, long-term trends, time of day
Why? 1. Generate hypotheses 2. Analytic epidemiology
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• Remember that 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.
• Descriptive epidemiology
• Describe the distribution of a health condition
• Generate hypotheses about determinants of disease
• Analytic epidemiology
• Test hypotheses about determinants of disease

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Surveillance

• the ongoing systematic collection, analysis and
  interpretation of health data essential to the
  planning, implementation, and evaluation of
  public health practice, closely integrated with
  the timely dissemination of these data to those
  responsible for prevention and control
• Thacker Berkelman, 1988

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Purpose of Surveillance

• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
• Source Slide from CDC Public Health Surveillance
  http//www.cdc.gov/ncphi/disss/nndss/phs/overview.
  htm

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Surveillance Events

• Outcomes STDs, lead poisoning, birth defects,
  cancer, infant mortality, LCDs, motor vehicle
  fatalities, occupational injuries
• Risk factors Smoking, nutrition, screening
  tests, physical activity
• Hazards Pollutants, toxic chemicals

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Types of Surveillance Systems

• Passive surveillance
• agency waits to receive case reports
• Active surveillance
• agency contacts to providers, labs, etc.

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Sources of Surveillance Data

• State/Local Health Department
• CDC
• Death certificates
• Birth certificates
• Fire incident reports
• Laboratories
• Hospital billing databases
• Providers offices

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Enduring Understandings the big ideas that
reside at the heart of a discipline and have
lasting value outside the classroom.
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Descriptive epidemiology in the classroom

• Demonstration of a student exercise

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Enduring Epidemiological Understandings
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Learners presented with vast amounts of
content knowledge that
is not organized into meaningful patterns

are likely to forget what they have learned

and to be unable to apply the
knowledge
to new problems or
unfamiliar contexts. National Research Council
, Learning and Understanding
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Diane Marie
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Video Review
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