Title Page......Page 1
Copyright Page......Page 2
Contents......Page 3
New to This Edition......Page 9
Introduction......Page 13
Preface......Page 17
Acknowledgments......Page 19
About the Authors......Page 23
Chapter 1: History and Scope of Epidemiology......Page 25
Introduction......Page 26
Epidemiology Defined......Page 32
Foundations of Epidemiology......Page 39
Historical Antecedents of Epidemiology......Page 47
Recent Applications of Epidemiology......Page 65
Conclusion......Page 72
Study Questions and Exercises......Page 73
References......Page 75
Chapter 2: Practical Applications of Epidemiology......Page 79
Introduction......Page 80
Applications for the Assessment of the Health Status of Populations and Delivery of Health Services......Page 83
Applications Relevant to Disease Etiology......Page 107
Study Questions and Exercises......Page 125
References......Page 128
Chapter 3: Measures of Morbidity and Mortality Used in Epidemiology......Page 131
Definitions of Count, Ratio, Proportion, and Rate......Page 132
Risk Versus Rate; Cumulative Incidence......Page 145
Interrelationship Between Prevalence and Incidence......Page 148
Crude Rates......Page 150
Specific Rates and Proportional Mortality Ratio......Page 162
Adjusted Rates......Page 168
Conclusion......Page 175
Study Questions and Exercises......Page 176
References......Page 179
Chapter 4: Descriptive Epidemiology: Person, Place, Time......Page 181
Introduction......Page 182
Characteristics of Persons......Page 187
Characteristics of Place......Page 227
Characteristics of Time......Page 241
Study Questions and Exercises......Page 247
References......Page 249
Appendix 4βProject: Descriptive Epidemiology of a Selected Health Problem......Page 257
Chapter 5: Sources of Data for Use in Epidemiology......Page 259
Introduction......Page 260
Criteria for the Quality and Utility of Epidemiologic Data......Page 263
Online Sources of Epidemiologic Data......Page 265
Confidentiality, Sharing of Data, and Record Linkage......Page 268
Statistics Derived from the Vital Registration System......Page 271
Reportable Disease Statistics......Page 278
Screening Surveys......Page 283
Disease Registries......Page 284
Morbidity Surveys of the General Population......Page 286
Clinical Data Sources......Page 291
Absenteeism Data......Page 295
Morbidity in the Armed Forces: Data on Active Personnel and Veterans......Page 296
Other Sources: Census Data......Page 297
Study Questions and Exercises......Page 298
References......Page 300
Chapter 6: Study Designs: Ecologic, Cross-Sectional, Case-Control......Page 303
Introduction......Page 304
Observational Versus Experimental Approaches in Epidemiology......Page 305
Overview of Study Designs Used in Epidemiology......Page 306
Ecologic Studies......Page 311
Cross-Sectional Studies......Page 318
Case-Control Studies......Page 327
Study Questions and Exercises......Page 341
References......Page 343
Chapter 7: Study Designs: Cohort Studies......Page 347
Introduction......Page 348
Cohort Studies Defined......Page 349
Sampling and Cohort Formation Options......Page 359
Temporal Differences in Cohort Designs......Page 365
Practical Considerations......Page 368
Measures of Effect: Their Interpretation and Examples......Page 371
Summary of Cohort Studies......Page 382
Conclusion......Page 383
Study Questions and Exercises......Page 386
References......Page 387
Chapter 8: Experimental Study Designs......Page 391
Introduction......Page 392
Hierarchy of Study Designs......Page 395
Intervention Studies......Page 397
Clinical Trials......Page 398
Community Trials......Page 416
Conclusion......Page 428
Study Questions and Exercises......Page 429
References......Page 430
Chapter 9: Measures of Effect......Page 433
Absolute Effects......Page 434
Relative Effects......Page 438
Statistical Measures of Effect......Page 444
Evaluating Epidemiologic Associations......Page 447
Models of Causal Relationships......Page 449
Conclusion......Page 454
Study Questions and Exercises......Page 455
References......Page 456
Appendix 9βCohort Study Data for Coffee Use and Anxiety......Page 457
Chapter 10: Data Interpretation Issues......Page 459
Introduction......Page 460
Validity of Study Designs......Page 461
Sources of Error in Epidemiologic Research......Page 464
Techniques to Reduce Bias......Page 473
Methods to Control Confounding......Page 474
Bias in Analysis and Publication......Page 478
Study Questions and Exercises......Page 480
References......Page 482
Chapter 11: Screening for Disease in the Community......Page 485
Introduction......Page 486
Screening for Disease......Page 488
Appropriate Situations for Screening Tests and Programs......Page 492
Evaluation of Screening Tests......Page 495
Measures of the Validity of Screening Tests......Page 500
Effects of Prevalence of Disease on Screening Test Results......Page 503
Relationship Between Sensitivity and Specificity......Page 506
Evaluation of Screening Programs......Page 507
Issues in the Classification of Morbidity and Mortality......Page 509
Conclusion......Page 510
Study Questions and Exercises......Page 511
References......Page 512
Appendix 11βData for Problem 6......Page 514
Chapter 12: Epidemiology of Infectious Diseases......Page 515
Introduction......Page 516
Agents of Infectious Disease......Page 517
Characteristics of Infectious Disease Agents......Page 520
Host......Page 521
The Environment......Page 523
Means of Transmission: Directly or Indirectly from Reservoir......Page 524
Measures of Disease Outbreaks......Page 530
Procedures Used in the Investigation of Infectious Disease Outbreaks......Page 535
Epidemiologically Significant Infectious Diseases in the Community......Page 537
Study Questions and Exercises......Page 563
References......Page 566
Appendix 12βData from a Foodborne Illness Outbreak in a College Cafeteria......Page 569
Chapter 13: Epidemiologic Aspects of Work in the Environment......Page 571
Introduction......Page 572
Study Designs Used in Environmental Epidemiology......Page 574
Toxicologic Concepts Related to Environmental Epidemiology......Page 579
Types of Agents......Page 581
Environmental Hazards Found in the Work Setting......Page 595
Noteworthy Community Environmental Health Hazards......Page 599
Conclusion......Page 612
Study Questions and Exercises......Page 615
References......Page 616
Chapter 14: Molecular and Genetic Epidemiology......Page 623
Introduction......Page 624
Definitions and Distinctions: Molecular Versus Genetic Epidemiology......Page 629
Epidemiologic Evidence for Genetic Factors......Page 633
Causes of Familial Aggregation......Page 634
Shared Family Environment and Familial Aggregation......Page 636
Gene Mapping: Segregation and Linkage Analysis......Page 640
Genome-Wide Association Studies (GWAS)......Page 650
Linkage Disequilibrium Revisited: Haplotypes......Page 652
Application of Genes in Epidemiologic Designs......Page 655
Genetics and Public Health......Page 662
Study Questions and Exercises......Page 666
References......Page 667
Chapter 15: Social, Behavioral, and Psychosocial Epidemiology......Page 673
Introduction......Page 674
Research Designs Used in Psychosocial, Behavioral, and Social Epidemiology......Page 679
The Social Context of Health......Page 681
Independent Variables......Page 684
Moderating Variables......Page 693
Dependent (Outcome) Variables: Physical and Mental Health......Page 708
Conclusion......Page 715
Study Questions and Exercises......Page 716
References......Page 718
Chapter 16: Epidemiology as a Profession......Page 725
Introduction......Page 726
Specializations within Epidemiology......Page 727
Career Roles for Epidemiologists......Page 729
Epidemiology Associations and Journals......Page 732
Competencies Required of Epidemiologists......Page 735
Resources for Education and Employment......Page 736
Professional Ethics in Epidemiology......Page 738
Conclusion......Page 743
Study Questions and Exercises......Page 744
References......Page 745
Appendix A: Guide to the Critical Appraisal of an Epidemiologic/Public Health Research Article......Page 747
Appendix B: Answers to Selected Study Questions......Page 751
Glossary......Page 761
Index......Page 783