Epidemiology of Diseases


Epidemiology of Diseases

1. Please answer the following questions as completely as you can. You may use your notes, lecture slides,

text books:
1.Kenrad E. Nelson, Carolyn Williams (2007). Infectious Disease Epidemiology: Theory and Practice, Second Edition. Sudbury, MA: Jones and Bartlett
2. Randall E. Harris (2013). Epidemiology of Chronic Disease. Sudbury, MA: Jones and Bartlett)

,research studies (provide full reference) and any other materials you need. Please type your answers directly into this document and use font size 12.

1. (10 points) Define and discuss the “epidemiological transition” described in Chapter 1 (100 words)

a. (5 points) Name threechronic diseases/conditions and describe risk factors, symptoms, prognosis, and treatmentsfor each (100words)

b. (5 points) Discuss the morbidity and mortality rates for each of the diseases dicussed in 2.a and how rates have changed since treatments have been developed. (100 words)

Survival after breast cancer diagnosis has improved dramatically since screening by mammography was recommended as standard care. However, not all women receive annual mammograms. Many things can affect a woman’s decision to get screened for breast cancer. As a result, the mortality rates from breast cancer vary by community. Using the table below, answer the following questions:

a. (3 points) Calculate mortality rates for each community and fill in the blanks in the table. Which community had the highest mortality rate?______
Which had the lowest mortality rate?______

b. (3 points) Name three barriers that might affect a woman’s decision to receive a mammogram.

c. (4 points) Select one of the barriers you listed in b above. Describe how a public health department may address this barrier, and increase the receipt of mammograms in women who face this barrier (50-100 words).

Community Number Deaths Population Mortality Rate
(per 100,000)
A 562 1,950,000 28.8
B 82 1,210,000
C 303 1,480,000
D 686 1,400,000
E 1630 1,020,000
F 3457 730,000
G 635 580,000
H 443 990,000

4. (10 points) Why have morbidity and mortality rates from myocardial infarction declined sharply in the US population in recent years?Discuss three reasons. (100 words)

5. Using the table below,fill in the remaining cells with numbersindicated in the following description of this study, and calculate the odds ratio.

In a case-control study, an epidemiologist is studying the impact of a stressfuljob (exposure) onhaving a stroke (disease). There are 141 cases and 346 controls. In the case group, 52 people had a stressful job, and suffered a stroke. The remaining 89 cases did not have a stressful job. In the control group, 106 had a stressful job. HINT: Double check the wording in this problem to be sure you have inserted the right number in the right cell below. Also, the column totals are total numbers of cases and controls and the row totalsare total numbers of those with stressful jobs and without stressful jobs. You can fill in missing information by knowing this.

Exposure CASES
(had a stroke) CONTROLS
(did not have a stroke) TOTAL
Stressful Job 52
Not Stressful Job

a. (4 points)
Odds Ratio (OR) =
(Show all work)

b. (3 points)
The Odds Ratio shows: (Choose one)
1. There is a positive association between a stressful job and having a stroke
2. There is a negative association between a stressful job and having a stroke
3. There is no association between a stressful job and having a stroke

c. (3 points)
This means that a stressful job: (Choose one)
1. increases the risk of having a stroke
2. decreases the risk of having a stroke
3. has no effect on the risk of having a stroke

6. (10 points) Discuss two strategies for the prevention of lung cancer. In your answer, consider the risk factorsfor lung cancer, as well as how a public health department could control those risk factors and protect the community from developing lung cancer. (100 words).
a. (3 points) List at least three risk factors for Type 1 diabetes.

b. (7 points) List at least three risk factors for Type 2 diabetes. After each risk factor, provide a short paragraph (about50 words) about how a public health department could control this risk factor in the community.

8. (10 points) Obesity is strongly associated with increased morbidity, mortality, disability and impaired quality of life. Recent cause-specific mortality data reported by the World Health Organization suggest that obesity is responsible for 2.8 million deaths annually, ranking fifth among the top ten leading causes of death worldwide.

Thinking about how obesity is related to a person’s overall health and survival (including the diseases it is associated with), name and describe THREEways in which obesity can increase morbidity and mortality rates. Make sure to explain how each one increases morbidity and mortality.

a. (5 points) Discuss strategies for the treatment of schizophrenia. Make sure to describe various treatment methods available, which are most effective, and what the barriers are to receiving treatment.
b.(5 points) Is there any evidence that schizophrenia is hereditary? Yes____ No____

10. (10 points) Stopping the spread of malaria is a multifaceted process, involving both treatment and prevention strategies. Discuss the barriers faced by areas with great poverty in reducingand treating malaria, such as the village in Kenya outlined in the BBC documentary “Return to Fever Road” (this was the 9 part documentary series we started in class and you finished at home – see homework Week 5).(150 words)

You must use at least one other source to address this question. The source must be a published journal article or research study. Provide full references for any articles or studies you use.