Chapter 2 Epidemiological Tools for Health Promotion

Chapter Overview

Key Issues and Learning Outcomes

Key issues within this chapter:
  • Epidemiology provides the scientific basis for determining the distribution and determinants of health and disease in communities and the scope for promotion of health.
  • Assessment of health promotion needs involves assessing the extent of the health and disease in a community, the trends, seriousness, and the feasibility for prevention and control.
  • Prevention can be done at three levels - primary, secondary and tertiary.
  • Primary prevention requires an understanding of causes of ill health which comes from application of analytical epidemiology and assessment of evidence for causality.
  • Secondary prevention involves understanding the scope for early detection of disease and the appropriateness of initiating screening programmes.
By the end of this chapter you should be able to:
  • use epidemiological tools to describe the health situation in communities and determine health promotion needs.
  • understand the methods used to determine the cause and risk factors for a health issue and the scope for prevention.
  • understand the contribution of health promotion in screening programmes.

Test your Knowledge

Having read the chapter can you now answer the following questions?

  1. What questions does descriptive epidemiology ask in seeking to establish the health problem?
  2. Why is it important to fully appreciate the concept of 'need' in planning health promotion?
  3. How would you establish priority for a particular invention within a community?
  4. What is meant by the term 'subjective wellbeing'?
  5. Explain the difference between a 'cause' and a 'risk factor'.
  6. Why are randomized controlled trials difficult in health promotion?
  7. Identify at least three reasons why the application of epidemiology is important in health promotion.

Internet Links

General sources of information on health issues

Dictionary of epidemiology - copyright of Jonathan Swinton and a useful reference source.
http://www.swintons.net/jonathan/Academic/glossary.html

Healthneeds assessment: A practical guide. London: Department of Health, 2005. http://www.nice.org.uk/page.aspx?o=1846290090

The Health Protection Agency has the designated national role of protecting the public from infectious diseases and in preventing harm when hazards involving chemicals, poisons or radiation occur. Its web site has background material on a wide range of diseases and health issues.
http://www.hpa.org.uk/

Statistical resources on the web - health. A very comprehensive links page provided by the library of the University of Michigan. http://www.lib.umich.edu/govdocs/sthealth.html

Supercourse. This site has over a hundred tutorial programmes on epidemiology, specific diseases and health promotion. An ideal way to learn about something through a structured online programme.
http://www.lib.umich.edu/govdocs/sthealth.html

Centre for Disease Control at Atlanta, Georgia, is an authoritative source of information on a wide range of health topics.
http://www.cdc.gov/

Epidemiology for the uninitiated. A very useful introductory textbook from the British Medical Journal on epidemiology available on line to download. http://www.bmj.com/epidem/epid.html

The Social Medicine Portaldeveloped by faculty members of the Department of Family and Social Medicine of the Albert Einstein College of Medicine contains over a hundred links to websites, documents and presentations devoted to Social Medicine. http://www.socialmedicine.org/

Miscellaneous epidemiological issues

Department of Work and Pension discussion of use of CASP-19 scale for measuring subjective wellbeing in older persons. http://www.dwp.gov.uk/opportunity_age/indicators/indicator1.asp

English Longitudinal Study of Ageing (ELSA) is the first study in the UK to connect the full range of topics necessary to understand the economic, social, psychological, and health elements of the ageing process. The CASP scale was developed by: http://www.ifs.org.uk/elsa/index.php

Doll, R., Hill, A.B. (1954). 'The mortality of doctors in relation to their smoking habits: a preliminary report.' British Medical Journal 1, 1451-55. http://www.bmj.com/cgi/reprint/328/7455/1529

Tudor Hart, J. (1971). 'The Inverse Care Law.' The Lancet, 29, 405-412. http://www.sochealth.co.uk/history/inversecare.htm

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