Basic Science Of Public Health Research Articles

The High Importance Role of Epidemiology in Health Management

Epidemiology is a scientific discipline, sometimes called “the basic science of public health”. According to what it has done in the last 200 years, epidemiology is the science and practice. One of the areas that are less addressed in the literature is the important role of epidemiology in health management. The authors believed that one of the areas that epidemiologists can work is management debate.

Prevalence, Incidence, and Risk Factors for Tinnitus.

How many people are affected by tinnitus? Is the risk of developing tinnitus on the rise or has it been declining over time? What modifiable lifestyle factors could help to prevent tinnitus? These population-based questions can be addressed through epidemiological research. Epidemiology refers to the underlying and basic science of public health. It describes 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. There are two key concepts in epidemiology: (1) measures of frequency and (2) measures of effect. In this chapter, we introduce the two main measures of frequency, prevalence and incidence. We also introduce the notion of risk factors, critical for understanding measures of effect concerning the risk of developing a health condition. In both sections, we provide illustrative examples from the published literature on tinnitus. We end by offering a critical evaluation of the current status of epidemiological research on tinnitus and point to some promising future directions.

Putting Action into Population Health Science: Primary Care Interventions to Address Social Determinants of Health.

Concern about health equity and social determinants of illness (e.g., income inequalities, lack of education, food insecurity) figure prominently in many conceptions of population health. In order to illustrate how population health can actively translate science into action, we consider primary care interventions that promote healthy populations by addressing the social determinants of health. In the examples provided in this article, primary care and population health are linked in a way that reinforces each other, and these innovative interventions may lead to improved health outcomes. Population health science provides a variety of methods and approaches for designing and evaluating interventions that aim to link patients with community resources that can address social determinants of health and improve the quality of their lives. Population health can serve as an important bridge between primary care and the public health sector. Population health science has been defined as "the study of the conditions that shape distributions of health within and across populations, and of the mechanisms through which these conditions manifest as the health of individuals" (Keys, K.M. 2016). According to this perspective, population health science elucidates the mechanisms that produce disease and the discipline of public health then applies that information to promote health in populations. Put another way, population health can be seen as the basic science of public health (Galea, S., et al. 2018). Other conceptions of population health have a direct concern with the translation of science into actions, and view science and action as linked and reinforcing each other (Kindig, D., et al. 2003; Diez Roux, A.V, 2016). For example, Kindig & Stoddart (2003) differentiated population health from public health, health promotion, and social epidemiology and argued that "the field of population health includes health outcomes, patterns of health determinants, and policies and interventions that link these two." The thesis of this commentary is that population health science goes beyond studying the mechanisms that shape distributions within and across populations to include actions that promote health of the entire human population. In support of this thesis, examples are provided from the literature on interventions in primary care that promote healthy populations by addressing the social determinants of health.

Population Health Science as the Basic Science of Public Health: A Public Health of Consequence, October 2018.

"Population Health Science as the Basic Science of Public Health: A Public Health of Consequence, October 2018." , 108(10), pp. 1288–1289

Geschlechtersensible Forschung – ein Survey unter Epidemiologinnen und Epidemiologen in Deutschland

Epidemiology is the basic science of Public Health and has to provide high-quality scientific evidence for disease prevention and health care. Sex/Gender, as social and biological structure categories of population, play a central role in the analysis of epidemiological data. Whether and how epidemiologists incorporate sex/gender aspects in their research, their attitudes, needs and requirements they have in this context have hardly been investigated. These questions were addressed in a survey of epidemiologists in Germany. With the support of the respective scientific societies, an online survey was conducted of German epidemiologists, and the data subjected to descriptive analysis. Approximately 64% of the 276 participants (response rate 25%) were female and 75% worked in the academic field. 70% reported having had experience in sex/gender-sensitive research and 83% expressed future interest in this topic. Issues mentioned as important were interaction of gender aspects and other factors of social inequality as well as the inclusion of sex and gender in all phases of the research process. Women and younger participants reported more experience and more needs concerning sex/gender sensitive research. To facilitate further incorporation of sex/gender-sensitive research in epidemiology, special workshops/tutorials at the respective scientific societies' annual meetings and online information materials were rated as important. Due to the low response rate, a positive selection of participants cannot be ruled out. The results show that, while a large group of epidemiologists had experience and interest in gender-sensitive research, there are some with less interest. Possible starting points for the strengthening of sex/gender-sensitivity research include further training and involvement of scientific societies in the process.

Congruence Between Position Descriptions for Public Health Nursing Directors and Supervisors With National Professional Standards and Competencies

This study described the extent to which position descriptions (PDs) for public health directors of nursing (DONs) and non-DON public health nursing (PHN) supervisors in Ohio local health departments incorporate national standards of PHN practice and competencies for public health managers. Ninety-four PDs were obtained from 66 local health departments. Statements in each PD were analyzed for congruence with the 2007 American Nurses Association Public Health Nursing Scope and Standards of Practice (ANA Standards) and the Council on Linkages Core Competencies for Public Health Professionals (COL Competencies). Health department and PD characteristics were also obtained. COL Competencies within each COL skill domain were pooled for analysis. Position descriptions addressed an average of 7.6 of the 20 ANA Standards/Substandards (range, 1-15). The most commonly addressed ANA Standards were Leadership, Regulatory Activities, Collegiality and Professional Relationships, and Planning; the least often addressed were Population Diagnosis and Priorities, Professional Practice Evaluation, Outcomes Identification, Advocacy, and Evaluation. Position descriptions addressed an average of 3.6 of the 8 COL skill domains (range, 0-6). Financial Planning and Management, Policy Development/Program Planning, Community Dimensions of Practice, and Analytic/Assessment were the most commonly addressed COL skill domains, whereas Cultural Competence and Basic Public Health Sciences were the least commonly addressed. About 75% of the PDs included task statements that did not correspond to any of the ANA Standards or COL Competencies. Results indicate that PDs do not reflect compliance with professional mandates for the practice of PHN. This lack of fit between PDs and nationally recognized standards of practice and competencies suggest that PHN may be undifferentiated as a public health discipline and as a nursing specialty.

Competencies for Preceptorship in the Brazilian Health Care System

Preceptorship is an emerging component of the Brazilian health care system for human resources education. This study attempted to identify competencies for preceptorship in this system. An exploratory descriptive study was conducted with the Delphi technique. The participants were primary health care professionals from the South of Brazil who were working in nine professional areas, including nursing. The participants had served as preceptors in an educational program promoted by the Ministries of Education and Health. Forty-three competencies were identified and classified into nine domains: education, professional values, basic public health sciences, management, health care, teamwork, communication, community orientation, and professional development. The findings showed that preceptors were committed to the education of future health care professionals. The development of pedagogical skills was emphasized, as was the necessity of education before preceptorship. These competencies constitute a useful reference for continuing professional education.

Epidemiology of satellite anomalies and failures: A subsystem-centric approach

Epidemiology is the basic science of public health and it investigates the distribution, frequency, rates, and drivers of health-related states and illnesses in specific populations. We adopt in this article some of Epidemiology's concepts and approaches, and instead of human population and diseases, we focus on a satellite population and its on-orbit anomalies and failures. We analyze an extensive database of geosynchronous satellite anomalies and failures (retrospective cohort study) and develop for each spacecraft subsystem a health scorecard synthesizing its track record of on-orbit failure events. We include results on the severity of the failure events in each subsystem's health scorecard (distribution and rates). We also provide for each subsystem its failure concentration ratio or the extent to which a single satellite in our population has experienced multiple failure events from the same subsystem. Next, having derived health scorecards for ten satellite subsystems identified in the database, we conduct a comparative analysis of the propensity and severity of failures between these subsystems. We identify for example several major subsystems driving on-orbit failure events, such as the Thruster/Fuel, the Solar Array, the Payload, and the Telemetry Tracking and Command (TTC) subsystems. In addition, we find that the Control Processor, the Mechanisms, and the Solar Array Deployment subsystems are sufficiently robust and contribute a minor share to the overall failure events on orbit. Furthermore, we find for example that while the attitude control subsystem and the batteries exhibit roughly similar average failure rates, they have very different behaviors in terms of the severity of anomalies they experience: the former primarily failing “soft” (minor anomaly), whereas the latter, the batteries most often fail “hard” with major non-repairable degradations that affect operation of a satellite on a permanent basis. The results here provided should prove helpful to satellite manufacturers by allowing them to hone in on problematic subsystems that would benefit most from reliability improvements.

Epidemiology and public health in primary care: looking back and forward - 30 years after Alma Ata.

Epidemiology is the basic science of public health, and an epidemiologist has been described as someone with a brilliant mind but dirty hands! The dirty hands come from the essential ability to count, collate and analyse raw data in order to give meaning to it. This ability to synthesise research evidence and transform health service activity data into simple and clear information for health service managers is what makes epidemiology an essential link between research and health policy. One of the key aims of the London Journal of Primary Care is to facilitate the transfer of good research evidence and best practice into London primary care, as well as helping to build up the evidence base to support clinical practice from a variety of sources including local audits and experiential learning. As the Epidemiology Editor, I look forward to reviewing articles that are grounded in both qualitative and quantitative research methodology, but will also encourage articles with simpler methodologies where the focus is on improving clinical quality and systems. London is a unique city – not only in the financial, arts and multi-cultural realms, but in its contribution to the history and development of epidemiology and public health in the United Kingdom and rest of the world. It is not surprising therefore that London is home to some ‘national treasures’ ranging from great medical and social science institutions, research centres, health observatories, prisons, air and sea ports to unique and prestigious government departments. These have one thing in common – they are a rich source of routine data which could be used to improve the health of Londoners in various ways ranging from infectious disease surveillance, to monitoring trends in patterns and distribution of morbidity, mortality and health inequalities across the capital. The epidemiology team will seek to build collaborations between the journal and these London institutions so that the journal becomes an important vehicle for disseminating information relevant to the health of Londoners. We will also welcome articles from other metropolitan cities across the world with similar demographic profiles to that of London. This year marks the 30th anniversary of the WHO declaration of the Alma Ata principles which emphasised the central role of primary health care (PHC) in any given health system. Many of the issues specifically addressed in that declaration such as the need for appropriate social and cultural systems to support health care, involving individuals and communities in health care decisions, the need for affordable health care, health inequalities, the link between poverty and health and the menace from vaccine preventable childhood illnesses are still very much important health issues in London today. The next issue of the London Journal of Primary Care will focus on the Alma Ata declaration and I would like to invite articles that demonstrate relevant lessons learnt across primary care from different perspectives. That includes articles that look forward using these lessons, derived from the familiar research methods to case studies and relevant experiences over the past 30 years in settings relevant to a metropolitan city.

Epidemiology Competencies and Preventive Medicine Residencies: Do They Mix and Map?

[corrected] This article maps the program requirements of the University of Michigan preventive medicine residency (PMR) to the newly established Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs) to determine the feasibility and utility of using these competencies to assess the training of physician epidemiologists. The academic and practicum requirements of the PMR are mapped against the 38 AECs for Tier 2, or mid-level epidemiologists. The process of mapping was done by reviewing academic course syllabi/content and practicum tasks to determine how closely they aligned with the AECs. This process allowed us to identify competencies that are relative training strengths and weaknesses of the residency. Overall, the current program requirements of the PMR generally satisfy the AECs, although one competency was not met in either the academic or practicum year, and another was only met in a single, required academic course. The areas in which AECs were fulfilled by many activities in the residency were in domain 1 (assessment and analysis) and domain 2 (basic public health sciences). The areas in which competencies were met by few activities were primarily in domain 6 (financial and operational planning and management) and domain 7 (leadership and systems thinking). We found that the process of mapping an academically rigorous epidemiology training program (the PMR) to the AEC was feasible and useful. It permitted us to identify training strengths and gaps in our program and consider modifications that will strengthen the level of competency of our physician graduates.

Research methods in psychiatric epidemiology: an overview.

To provide an introduction to the concepts and methods of psychiatric epidemiology for non-specialist readers. An overview of concepts and research procedures based on the published literature. Psychiatric epidemiology is a key mental health discipline that has adopted and developed a variety of methods and procedures for the study of complex mental disorders. In its future development, psychiatric epidemiology is likely to seek an integration of the conceptual and methodological advances of molecular biology and neuroscience within the population-based and social framework of epidemiology as a basic science of public health.

Reassessing the role of epidemiology in public health.

This commentary examines the scope of epidemiology and delineates the role of epidemiology in relation to public health. Epidemiology is a science; public health is a mission that is implemented through societal action. The implications of this difference are considered, and the sufficiency of epidemiology for guiding public health is evaluated in relation to other scientific disciplines and nonscientific considerations. The authors conclude that epidemiology is not the basic science of public health but one of many contributors to guiding action. The need for public health decisions despite scientific uncertainty and the potential for epidemiologic certainty's failing to provide clear guidance to public health action emphasize the distinctiveness of these endeavors. Criticisms that epidemiology fails to solve major public health problems, such as tobacco use; that it overemphasizes methods; that it fails to meet the needs of public health practitioners; and that it isolates itself from public health ethics are unwarranted. However, epidemiology should focus on addressing issues that directly affect public health decisions and should clearly communicate information about such issues to public health workers. Public health is far more complex than merely applying epidemiology.

The failure of academic epidemiology: witness for the prosecution.

Academic epidemiology has failed to develop the scientific methods and the knowledge base to support the fundamental public health mission of preventing disease and promoting health through organized community efforts. As a basic science of public health, epidemiology should attempt to understand health and disease from a community and ecologic perspective as a consequence of how society is organized and behaves, what impact social and economic forces have on disease incidence rates, and what community actions will be effective in altering incidence rates. However, as taught in most textbooks and as widely practiced by academicians, epidemiology has become a biomedical discipline focused on the distribution and determinants of disease in groups of individuals who happen to have some common characteristics, exposures, or diseases. The ecology of human health has not been addressed, and the societal context in which disease occurs has been either disregarded or deliberately abstracted from consideration. By essentially assuming that risk factors for disease in individuals can be summed to understand the causes of disease in populations, academic epidemiology has limited itself to a narrow biomedical perspective, thereby committing the bio-medical fallacy of inferring that disease in populations can be understood by studying risk factors for disease in individuals. Epidemiology should be redefined as a study of the distribution and societal determinants of the health status of populations. This definition provides a stronger link to be the primary mission of public health and places an appropriate emphasis on the social, economic, environmental, and cultural determinants of population health. Epidemiology must cross the boundaries of other population sciences and add to its scope a macro-epidemiology, a study of causes from a truly population perspective, considering health and disease within the context of the total human environment.

The Role of Psychiatric Epidemiology in Correctional Medicine

Epidemiology is the basic science of public health. Since WWII, epidemiology has changed its focus from infectious diseases to an understanding of organic and functional problems, including psychiatric illness, within various social and organizational contexts. More recently, epidemiologists have studied special populations. However, the authors argue that correctional populations have, as yet, been neglected. For example, the purpose of psychiatric epidemiological investigations is to discover etiological associations between biological, social, psychological, and environmental risk factors to disease. While many authors have described the effects of prisonization on mental health, socioenvironmental factors present in correctional settings have not been systematically studied as risk factors for mental illness. Current knowledge of the epidemiology of mental disorders must be extended beyond that gathered in mental hospital and normal populations to correctional settings. In order to accomplish this, there is a need to resolve several basic issues so that comparable data can be identified across different populations. First, there must be agreement on what constitutes a case. Second, standardized case finding methods that are appropriate to the range of pathology in correctional settings must be developed. Third, in addition to studying prevalence and incidence, we must begin to compare differences in the duration, disability, and outcome of illness across different populations. Finally, there is a need to evaluate the effects of policy decisions on the flow of mental patients to justice and correctional settings.

The changing role and legitimate boundaries of epidemiology: community-based prevention programmes

Epidemiology is the basic science of public health. It combines medical and social sciences, both of which are developing with new inventions. Therefore, the role of epidemiology and its boundaries are also changing over time. An important role of epidemiology is to develop and implement community-based control programmes for major diseases in the community. Such programmes are essential for large scale public health policy. It is necessary that epidemiological research can as freely as possible test new methods of disease prevention and health promotion. The first community-based control programme for cardiovascular diseases, the North Karelia Project is reviewed against this background. At present, it is still possible to define the boundaries of epidemiology geographically and culturally, but in the future, however, it will become more difficult. There is no doubt that epidemiology will remain as the basic science of public health but the scope of public health problems are growing much wider. These include the prevention of the final epidemic—the destruction of our planet by nuclear bombs. In the control of the existing epidemics and in the prevention of new ones the boundaries of epidemiology cannot stay rigid but they must be changing as new facts about the emerging public health problems are identified.

Public Health in the Next Decade

,9Zq how to do for the public's health, we have done very little. And it goes without saying that the greatest threat to people, the arms race, has expanded unabated. What can we expect in the next decade? Are there major breakthroughs over the horizon? Will we apply what we know how to do? Will we demand the power and resources that we need? Will governments respond to our demands? In short, the question is whether or not public health people will challenge the social forces that preserve the conditions that cause disease, disability, and death. Improved knowledge is not sufficient! Epidemiology is the basic science of public health. It continues to give us improved understanding of the causes of disease, disability, and death. We can identify the populations at risk. And we have learned the ways to protect these people and to prevent disease. We are not lacking for targets and achievable goals for intervention. A simple analysis, comparing health indices for populations in the same country, suggests that improvements in health status are within the means of national government. Similar differences often occur in much smaller geographic areas, making the problems amenable to local government intervention. To grasp what prevention can accomplish, I have looked at the geographic, social class, and racial differences in total and cause-specific mortality in the United States. The age-adjusted death rate for black men in 1982 was 10.5 /1000 and for white men, 7.1, a 32 percent difference. In 1977 the death rate in West Virginia for all individuals age 45-64 was approximately 1.5 times as high as in Utah. The death rates in Kentucky and North Carolina were almost as high as in West Virginia. It should be