Public health and epidemiology at a glance PDF
Preview Public health and epidemiology at a glance
Public Health and Epidemiology at a Glance Public Health and Epidemiology at a Glance Margaret Somerville MD, MRCP, FFPH Director of Public Health and Health Policy NHS Highland Inverness, UK K. Kumaran DM, FFPH Consultant in Public Health Medicine NHS Somerset Somerset, UK Rob Anderson PhD, MSc, MA(Econ.) Peninsula Technology Assessment Group (PenTAG) Institute of Health Service Research Peninsula Medical School Exeter, UK A John Wiley & Sons, Ltd., Publication This edition first published 2012 © 2012 by John Wiley & Sons, Ltd. Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing. Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www. wiley.com/wiley-blackwell. The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Somerville, Margaret, Dr. Public health and epidemiology at a glance / Margaret Somerville, Kalyanaraman Kumaran, Robert Anderson. p. ; cm. – (At a glance) Includes bibliographical references and index. ISBN-13: 978-0-470-65445-3 (pbk. : alk. paper) ISBN-10: 0-470-65445-7 (pbk. : alk. paper) I. Kumaran, Kalyanaraman. II. Anderson, Robert, 1967- III. Title. IV. Series: At a glance series (Oxford, England). [DNLM: 1. Epidemiologic Methods. 2. Public Health. 3. Needs Assessment. WA 105] LC classification not assigned 614.4–dc23 2011028910 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Set in 9 on 11.5 pt Times by Toppan Best-set Premedia Limited 1 2012 Contents Preface 6 23 Principles of disease transmission 52 Acknowledgements 7 24 Communicable disease control 54 About the authors 7 25 Surveillance 56 26 Immunisation 58 1 Introduction to public health 8 27 Screening principles 60 28 Screening programmes 62 Epidemiology and Evidence-Based Practice 29 Health promotion 64 2 Incidence and prevalence 10 30 Changing behaviour 66 3 Risks and odds 12 4 Hierarchy of evidence and investigating causation 14 Health Economics 5 Bias, confounding and chance in epidemiological studies 16 31 Economic perspectives on health 68 6 Standardisation 18 32 Economic evaluation 70 7 Ecological and cross-sectional studies 20 33 Economic perspectives on measuring health-related 8 Case-control and cohort studies 22 outcomes 72 9 Trials (experimental studies) 24 34 Economics of public health problems 74 10 Systematic reviews and meta-analysis 26 11 Diagnostic tests 28 Effective Health Care 35 Health care systems 76 Assessing Population Health 36 Planning health services 78 12 Health and illness 30 37 Health care evaluation 80 13 Demography 32 14 Epidemiological transition 34 Self-Assessment 15 Health information 36 Self-assessment questions 82 16 Measuring population health status 38 Self-assessment answers 84 17 Lifestyle determinants of health 40 18 Environmental determinants of health 42 Appendix: Practical issues in conducting epidemiological 19 Inequalities in health 44 studies 85 20 Socio-economic inequalities in health 46 Further reading 87 21 Health needs assessment 48 Index 88 Improving and Protecting Health 22 Disease prevention 50 Contents 5 Preface This book has arisen from our experience of developing a new active clinicians in other fields. We have tried to ensure that this undergraduate medical course for the Peninsula Medical School. book covers public health topics, and particularly epidemiology, In the early days, we were conscious of staying just one step ahead in such a way that the practical applications of theory and princi- of the students in terms of planning the next stage of the curricu- ples to public health service work can be seen. We would recom- lum. Now that the course is well-established, we are inevitably mend that students whose interest is sparked by this book should reflecting on where and how in the curriculum public health and actively seek out public health professionals (who can be found in epidemiology are best delivered. The GMC guidance in Tomorrow’s many different places, not just the health service) to find out about Doctors stresses the fundamental importance of public health as a their everyday work. core element of medical training; consequently our considered view is that learning about public health principles and practice Margaret Somerville MD, MRCP, FFPH should be fully integrated into all aspects of clinical learning. K. Kumaran DM, FFPH Another important principle is that students should learn from Rob Anderson PhD, MSc, MA(Econ.) people working in service public health, just as they learn from 6 Preface Acknowledgements We had the support and guidance of many people in developing statistics. Any misrepresentation of their original contributions to the Peninsula Medical School course and we have used much of the teaching material is entirely our responsibility. the material as the basis for the chapters in this book, but we We are also very grateful for the help and guidance from Wiley- would particularly like to thank Stuart Paynter, Graham Taylor, Blackwell, particularly Laura Murphy and Elizabeth Johnston, in Stuart Logan and Ken Stein for their help with parts of the cur- getting this book from ideas to finished product. riculum relating to epidemiology, evidence-based practice and About the authors Margaret Somerville School. Previously, in his substantive part-time role at the medical school, he was involved in the development and delivery of the Margaret Somerville is Director of Public Health and Health undergraduate public health curriculum between 2004 and 2010 Policy for NHS Highland, a post she took up in 2010. Previously, working with other colleagues. she was Director of Public Health Learning at the Peninsula Medical School, where she developed the public health aspects of Rob Anderson the integrated undergraduate medical curriculum from the outset of the course in 2002. Rob Anderson is Associate Professor of Health Economics and Evaluation within the Peninsula Medical School, at the University K. Kumaran of Exeter. With others, he has developed and taught the health economics and related components of the undergraduate medical Kumaran is a Consultant in Communicable Disease Control at curriculum at the medical school since 2005. His research involves the South West (South) Health Protection Unit and a Consultant the evaluation and economic evaluation of health technologies and in Public Health at NHS Somerset. He also holds an honorary public health policies and programmes to inform national policy. academic post as Clinical Lecturer at the Peninsula Medical About the authors 7 flast01.indd 7 1/16/2012 4:21:03 PM 1 Introduction to public health (a) An illustration of the ‘downstream’ approach of health care services in rescuing people who have fallen into the river, instead of moving ‘upstream’ to find out why people have fallen in (b) The UK Faculty of Public Health’s domains of public health Health protection Infectious diseases Chemicals and poisons Radiation Emergency response Environmental health Health improvement hazards Improving services Inequalities Education Clinical effectiveness Housing Efficiency Employment Service planning Family/community Audit and evaluation Lifestyles Clinical governance Surveillance and monitoring Equity of specific diseases and risk factors Source: Faculty of Public Health, www.fph.org.uk. Accessed 25 March 2011 Public Health and Epidemiology at a Glance, First Edition. Margaret Somerville, K. Kumaran, Rob Anderson. 8 © 2012 John Wiley & Sons, Ltd. Published 2012 by John Wiley & Sons, Ltd.
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