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Epidemiology - study and analysis of the distribution and patterns of disease in populations and why they occur.

The analysis of above also supports control of health problems.

John Snow - "father of the field of epidemiology" carried out work in London in mid 1800s to discover the cause of cholera and prevent reoccurrence.

The development of epidemiological studies continued through the late 19th and early 20th centuries mainly focussing on infectious diseases.

Epidemiology developed rapidly in the second half of the 20th century and has been extended to cover non-infectious diseases such as cardiovascular disease and lung cancer's links with smoking tobacco.

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the occurrence of new cases over a specified period of time.

it therefore measures the rate at which new cases occur.

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proportion of a population affected by a medical condition at a specific time.

usually expressed as a percentage, fraction or number of cases per size of population.

For example - at the end of December 2020 there were 81520 recorded cases of COVID-19 in the UK. meaning a prevalence of 120 cases per 100000 population.

However, this is not an accurate figure for prevalence because it only includes only those who have had a positive covid test, as the true figure for prevalence includes everyone with the disease not just those who have been diagnosed.

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Morbidity - refers to any physical or psychological state thought to outside of normal wellbeing. Describes illness/ill health.

Often used to describe chronic disease or age-related illnesses. The greater a person's morbidity, the shorter their expected life span. Morbidity does not necessarily mean that the disease/illness is immediately life threatening.

Morbidity rate - a measure of the incidence and prevalence of a disease.

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Mortality - means death caused by a particular disease.

Often expressed as per number of population.

Mortality rate - is a measure of the death rate in a defined population within a specific time period.

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The purpose of epidemiology

is to help understand the cause and spread of disease so that strategies can be developed to prevent disease.

a systematic approach to count the numbers of cases of a disease; to calculate the rate of disease; compare rates, either over time or between different groups.

Epidemiology may support in identifying the cause of a disease.

By measuring the incidence and prevalence of a disease we get insights into the extent of the disease.

With data from incidence and frequency of a disease we can look at trends (is the disease increasing or decreasing?) and we can look at patterns (does the disease affect the elderly mostly, is it related to poverty or living conditions for example?)

Looking at trends and patterns can give an insight into how the disease spreads and what type of action is needed.

Epidemiology helps track the mortality rate of a disease. This gives an indication of how many times the disease progression is fatal and also effects of any treatments.

once we have an understanding of the cause of a disease, how it spreads and how quickly, we can start planning how to treat it (therapeutic measures, such as drug therapy) or preventative measures such as vaccination.

epidemiology methods allow us to monitor effectiveness of those measures so we can evaluate, and change or improve them if needed.

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Public health policy covers a wide range of issues, not just drug treatment and vaccination.

Reduction in morbidity and mortality rates have reduced in the last 100 years due to

medical advances

widespread vaccination campaigns

development of antibiotics

improved nutrition

improved sanitation (availability of fresh, clean water and removal of sewage)

improved housing (reduction in overcrowding where infectious diseases are more likely to spread)

improved access to basic healthcare (rather than just advances in medical technology).

Greater education

greater health promotion.

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Health promotion is not just about infectious diseases but also applies to lifestyle diseases

obesity and related conditions including type 2 diabetes.

cardiovascular disease

cirrhosis and other liver diseases

some types of cancer.

Health promotion can raise awareness of risks of the disease, making people aware of behaviours needed to improve their health or reduce their risk of disease.

Communication

Good communication is essential to health promotion.

Health promotion needs to have a clear, strong message that - is delivered in a way that will reach the target audience; is expressed in language that the recipients can relate to; does not cause unnecessary anxiety.

The way health promotion messages have been communicated over the years has changed. In 1980s - radio, newspapers and magazines, TV and posters were the main way this information was communicated. Now the internet and social media has provided more methods of communication.

Points to consider - are there any pros and cons to social media and the internet being a forum for potential health promotion/information?

Policy and Systems

Government and public policies can play an important role in health promotion, particularly by changing procedures, regulations or laws to enforce required behaviour.

examples

restricted access to drugs of abuse (cocaine, heroin)

restriction based on age on the sale of goods such as alcohol, high caffeine drinks, cigarettes, vapes.

restricted movement of people during COVID-19 pandemic, in and out of cities, regions of countries.

Education Programmes

An important part of health promotion is improving knowledge and empowering individuals to change their behaviour.

People are increasingly accessing the internet to help diagnose their symptoms or search for information. Use of internet searches are not an adequate substitute for visiting a doctor but it does show that people are using the internet for information about all aspects of their lives including health and wellbeing.

Some online learning is offered at organisations and universities (eLearning), some are aimed at professionals and others for the general public or non-specialists.

NHS website -

Health A-Z - articles on large number of medical conditions, symptoms and medications.

Live Well - covers advice, tips and tools to help make informed choices about health and wellbeing.

Mental Health - has a wealth of information supporting mental health issues.

Care and Support - guide to services for those who need help with day to day living due to illness or disability.

Various health apps which can support the work of the healthcare professionals and help individuals to manage their health.

Health promotion for specific diseases/disorders

Change4Life - social marketing campaign by Public Health England. Aimed at reducing childhood obesity by giving parents support and tools they need to make healthier choices for their families.

Annual flu vaccine - promoted through a range of media (posters at GP surgeries, radio/TV adverts, emails and letters to vulnerable groups, social media campaigns).

PHE (Public Health England) have more details on health promotion campaigns.

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From the chart you can see that angina is a symptoms of heart disease, which is a type of cardiovascular disease.

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The World Health Organisation (WHO) is an agency of the United Nations that promotes health and monitors disease in an attempt to achieve good health for all.

WHO established a Family of International Classifications (FIC) to provide a common language for health information worldwide.

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Good classification systems have multiple benefits.

provide a common language for reporting and monitoring of health and disease.

allow sharing and comparing of data. Making like-for-like comparisons possible.

allow rate and frequency of disease to be assessed.

support the development of possible treatments.