2. Purpose
➔ Effectively communicate terminology used
in social epidemiology in a manner by
which the general population can
understand.
➔ Improve knowledge and awareness of the
general population regarding social
epidemiology concepts.
3. Social Epidemiology
➔ “Comprehensive study of health, well-being, social conditions or problems,
and diseases and their determinants”
➔ Use of epidemiology and behavioral/social science to improve and promote
health
◆ Epidemiology: branch of medicine dealing with incidence, distribution,
and possible control of disease and related health factors
➔ Used to develop interventions, programs, policies, and institutions that
promote public health
➔ Studies: social distribution and social determinants of different states of
health
➔ Understanding: social variables and conditions can determine which
factors affect illness and health
◆ Emphasis: social factors
4. Chronic Illness
➔ A persistent or long-lasting disease that progresses slowly and is usually
controlled, but cannot be cured
➔ Alternation between symptomatic periods and periods of remission or
stability
◆ Remission: periods of relative health with little to no symptoms in
between symptomatic periods or episodes
◆ Some chronic illnesses have acute episodes with abrupt symptom
changes in between remission periods
● Acute episode/occurrence: abrupt onset of intense symptoms,
usually within a short duration
➔ Usually applied when the course of the disease lasts longer than 3 months
➔ Ex: Cancer, Ulcerative Colitis, HIV/AIDS, Epilepsy, Sickle Cell Anemia
5. Infectious Disease
➔ Caused by pathogenic microorganisms (bacteria, viruses, parasites, fungi)
➔ Can be spread and transmitted directly or indirectly
◆ Person to person
◆ Animal/Insect to person
◆ Ingestion of contaminated food or water
➔ Vaccines effectively prevent the spread of some infectious diseases
◆ Ex: Measles, chickenpox, smallpox, whooping cough
➔ Frequent and thorough handwashing prevents spread and transmission
➔ Recent rise of infectious diseases, especially in poverty-stricken countries
with environments conducive to spread and transmission
6. Risk & Protective Factors
Risk Factor
➔ Variable associated with an
increased probability of disease,
infection, or health behavior
problem
◆ Increased likelihood of
negative/undesirable outcome
➔ Host or environmental relation
➔ Immutable factors: age, race,
gender, ethnic background
➔ Adjustable factors: Change with
intervention
◆ Ex: attitudes, behaviors
Protective Factor
➔ Variable associated with a reduced
probability of disease, infection, or
health behavior problem
◆ Increased likelihood of
positive/desirable outcome
➔ Ex: family history, healthy
home/family environment, social
support, routine doctor visits, access
to resources
★ Both have cumulative effect on
development/reduced
development of health problems
7. Morbidity Rate
➔ Indicates rates of a disease,
behavior, or health problem
Morbidity Rate:
Total # of cases of disease/behavior
Estimated total population at the midpoint of time period
Mortality Rate:
Total # of deaths from disease/behavior
Estimated total population at the midpoint of time period
X 100,000
Morbidity & Mortality Rates
Mortality Rate
➔ Indicates rates of death from a specific
disease, behavior, or health problem
➔ Statistics collected by each country routinely:
basic information on health status
◆ Collected via death certificates and
coded by underlying cause of death
➔ Higher in young children, then decrease
➔ Increase again with age
◆ After age 40, increases by twofold for
every decade
➔ Young children (<4) and older adults (>65) at
highest risk during epidemics and outbreaks
8. Prevalence & Incidence Rates
Incidence Rate
➔ New cases: the current rate at which
a disease/health problem is being
reported
◆ Used to calculate morbidity
Prevalence Rate
➔ Existing case rates of a disease or
health problem in a population; the
spread or distribution of the problem
in a population
Incidence Rate:
# of people who contract the disease/condition in specified time period
# of people exposed to risk during this period
Prevalence Rate:
# of people with the disease or condition at that time
# of people in the population at risk at that time
9. Prevalence Rate
➔ Increased rate:
◆ long duration or short remission periods
◆ when incidence increases
◆ increased likelihood of contraction from
high-risk individuals via poor general
health
➔ Decreased rate:
◆ improved rate of cure
◆ short duration of illnesses
◆ fatality rates increase
◆ decline of infection rate
◆ immigration of healthy
population/emigration of ill population
Incidence Rate
➔ Estimate of the probability of an
individual, belonging to an exposed
population, developing a disease
during a specific time period
➔ Calculation of new cases that occur
within a specific time frame
➔ Incidence rate is used to calculate
prevalence rate
◆ P= I x D
● P: Prevalence rate
● I: Incidence rate
● D: Average duration of
disease
Prevalence & Incidence Rates
10. Case Fatality Rate
➔ Expresses severity of symptoms and the likelihood that the
disease/behavior/health problem will result in death
➔ Percentage of people diagnosed with the disease, who die within a
specified time period after onset, in which the disease is diagnosed as
underlying cause of death
➔ Case fatality rate vs. mortality rate:
◆ Mortality rate: denominator is total population
◆ Case fatality rate: denominator is number of people who have the
disease of interest
Case Fatality Rate:
# of deaths from the disease/behavior within a specific time period after onset
Total # of cases identified during the same time period
11. Survival Rate
➔ Number of patients over a specific time period who are still alive at the end
of said time period
➔ Usually reported after longer periods of time
◆ More appropriate for chronic illnesses with long incubation periods
➔ Usually calculated as one or five year cumulative survival rate:
Cumulative survival rate:
# of patients surviving
total # of cases at the beginning of the period
12. Self-Efficacy
➔ Key element in how people change
behavior that goes beyond the
mechanistic conditioning process of
change
◆ Gives individuals a role in their own
change
➔ A person’s belief in his or her ability to
take action and confidence to overcome
obstacles
13. Reciprocal Determinism
➔ Behavior is part of a continuous interactive cycle that includes individuals
and their social environment
➔ Interactive process: a person acts based on individual factors or
social/environmental cues, receives a response from the environment,
adjusts behavior accordingly, and acts again.
14. Health Disparities
➔ The differences in health status between the majority population and population subgroups
◆ Ex: race, ethnicity, socioeconomic status
➔ Exist in terms of:
◆ Quality health care
◆ Access to health care
◆ Levels and types of care
◆ Clinical conditions (cancer, mental health, etc.)
➔ Identified in several health outcomes:
◆ Life expectancy
◆ Overall life status
◆ Infant mortality
◆ Cancer
◆ HIV/AIDS
◆ Violence
◆ Diabetes
15. Health Disparities: Causes
➔ Causes of health disparities:
◆ Socioeconomic status
◆ Lack of access to resources
◆ High poverty levels
◆ Immigration
◆ Cultural beliefs/attitudes
◆ Lack of health care coverage
◆ Mistrust towards
government/physicians
◆ Discrimination
◆ Environmental risks
◆ Social exclusion
◆ Lack of cultural competence
◆ Housing segregation
◆ Neighborhood
characteristics and physical
environment
16. ➔ Individual approach
◆ address individual knowledge and awareness among a specific population
◆ Use theories to structure education and intervention
➔ Social, community, and group approaches
◆ Community mobilization or advocacy
● Ex: improve access to healthcare, remove environmental risk affecting
a minority community
◆ Health communications strategies, social network, and cultural approaches
● Used to address shared norms, beliefs, and attitudes of a population
◆ Community mobilization with ecological approaches
● Used as part of a coordinated community strategy in order to reduce
socioeconomic disparities
Addressing Health Disparities
17. Addressing Health Disparities
➔ Organizational theory
◆ Improve organizations or systems, resulting in improved access and care
for disparities populations
◆ Local, state, or national level
➔ Multilevel approaches
➔ Lack of coordination hinders improvement in health disparities:
communication is key
18. Epidemiological Triangle
➔ Basic model developed in order to study
health problems
➔ 3 factors: Host, Agent, and Environment
➔ Disease is produced by exposure of a
susceptible host to a noxious agent in the
presence of environmental factors that aid or
hinder agents of disease
19. Epidemiological Triangle
➔ Host: the person/animal harboring the infectious agent, acted upon by
noxious noninfectious agent, or has experienced event/behavior of interest
◆ the “who” of the triangle
➔ Agent: infectious microorganism, chemical, or vulnerable substance
◆ the “what” of the triangle
◆ Ex: lead, radiation, excess/deficiency of nutritional elements such as
calories, carbs, or iron
➔ Environmental Factors: external conditions that promote or hinder the
action of an agent on a susceptible host
◆ the “where” of the disease
◆ Ex: drought, high temperatures, rain
20. Impact Application
➔ Slideshare: upload of presentation to public presentation database
➔ Studyblue: upload of presentation to public study material site
