lOMoARcPSD|31108752
CHN2 NCM
Nursing (Cañada College)
Studocu is not sponsored or endorsed by any college or university
Downloaded by Shadd Castro (shadddominic@gmail.com)
lOMoARcPSD|31108752
Is the science which deals with the study of the human population’s size, composition and
distribution in space.
NCM 113 CHN 2 Module Content:
Sources of Data
 Census is defined as an official and periodic enumeration of population. Demographic,
economic and social data are collected from specified population group.
UNIT 2 Health Statistics and Epidemiology
A. Tools
1. Demography
 Sources of Data
 Population Size
 Composition
 Distribution

2. Health Indicators
 crude ]Birth Rate
 Crude Death Rate
 Infant Mortality Rate
 Maternal Mortality Rate
 Specific Rate of Mortality
 Leading Causes of Morbidity
 Life Expectancy

Sample Survey . instead of census , demographic information collected from a sample of
a given population.

Registration system are those that collected by the civil registrar’s office deal with
recording of vital events in the community. Vital events refer to births, deaths, marriages,
divorce and the like. Other registration systems can also be used to describe specific
characteristics of the population.
Population Size
Refers to the number of people in a given place or area at a given time.
Composition
When the population is characterized in relation to certain variables such as age, sex,
occupation or educational level.
B. Philippine Health Situation
1. Demographic Profile
2. Health Profile
Distribution
It shows how people are distributed in a specific geographic location.
C. Epidemiology and the Nurse
1. Definitions and Related Terms
2. Natural Life History of Disease
3. Epidemiological Triangle
4. Epidemiological Process and Investigation
B.PHILIPPINE HEALTH SITUATION
1. Demographic Profile
2.Health Profile
ACTIVITY No. 1 : Interactive Discussion
MODULE 2 LECTURE:DISCUSSION :
Instruction: Please answer the following questions.
UNIT 2 Health Statistics and Epidemiology

A. TOOLS
Tools in measuring and analyzing community health problems were applied to form part of our
assessment tools in diagnosis of community health nursing problem.
1. Demography



What do you think is the importance of Statistical Epidemiology in community
health assessment?
What do you want to learn about statistical Epidemiology?
Prepare your written reaction.
Search and read for an article about Health Statistics and Epidemiology and
prepare for activities 2 and 3.
1
Downloaded by Shadd Castro (shadddominic@gmail.com)
lOMoARcPSD|31108752
LECTURE DISCUSSION :
2. HEALTH INDICATORS
The commonly used measures of health status reflects disease and mortality, rather than
health itself.
Mortality rate data are widely used to describe the health status of population.
Typically period life tables are constructed applying age-specific death rates of a given
population for a given year to a hypothetical cohort of 100,000 newborns.
 Crude Birth Rate
A measure of one characteristic of the natural growth or increase of a population
Total no. Of live births registered in a given calendar year
CBR = ------------------------------------------------------------------------------x1000
Estimated population of same year
 Crude Death Rate
A measure of one mortality from all causes which may result in a decrease population.
Total no. of deaths registered in a given calendar year
CDR = ------------------------------------------------------------------------------- x 1000
Estimated population as of same year
 Infant Mortality Rate
Measures the risk of dying during the 1st year of life. It is a good index of the general
health condition of a community since it reflects the changes in the environment and
medical condition of a community.
Total no. Of death under 1 year of age registered in a given calendar year
IMR =
-----------------------------------------------------------------------------------------------------x1
000
Total no. Of registered live births of same calendar year
 Maternal Mortality Rate
Measures the risk of dying from causes related to pregnancy, childbirth and
puerperium. It is an index of the obstetrical care needed and received by women in a
community
.
Total no. Of deaths from maternal causes registered for a given year
MMR =
--------------------------------------------------------------------------------------------------x100
0
Total no. Of live births registered of same year
 Specific Rate of Mortality
Describes more accurately the risk of exposure of certain classes or groups to
particular diseases. To understand the forces of mortality, the rates should be made
specific provided the data are available for both population and the event in their
specification.
 Leading Causes of Morbidity
Cause Specific Death Rate
Measures the no. Of deaths in specific cause registered in a a given year
CSDR =
--------------------------------------------------------------------------------------------------x100
0
Estimated population as of the same year
 Life Expectancy
is calculated by constructing a life table. A life table incorporates data on age-specific
death rates for the population in question, which requires enumeration data for the number
of people, and the number of deaths at each age for that population.
Life expectancy at birth is the total person-years lived beyond exact age 0 (newborns column 5 - Tx) divided by the number of newborns (100,000)
B.PHILIPPINE HEALTH SITUATION
1. Demographic Profile
2.Health Profile
Instruction:
2
Downloaded by Shadd Castro (shadddominic@gmail.com)
lOMoARcPSD|31108752
List down the Health Indicators and explain how you will integrate these in prevention
and control of disease in the community. Please use the Neo LMS assignment to answer
this activity.
8. Responsible for inventory and maintenance of epidemiology and surveillance unit (ESU)
equipment.
1. Natural Life History of Disease
C.EPIDEMIOLOGY AND THE NURSE
Epidemiology
- the study of of the occurrence and distribution of health conditions such as disease,
death, deformities, or disability on human population.
It also concerned with the study of probable factors that influence the development of
these health conditions.
Describing the natural history of the disease seeks to identify factors related to the course of a
disease once established in order to determine its duration and the probability of the various
possible outcomes such as recovery, death or specific complications.
Understanding the natural history of disease will help institute measure to prevent pathologic
processes from further evolving.
Stages of Natural History of Disease
USES OF EPIDEMIOLOGY

Study the history population and the rise and fall of diseases and changes in their character

Diagnose the health of the community and the condition of people to measure the
distribution and dimension of illness in terms of incidence, prevalence, disability and
mortality, to set health problems in perspective and to define their relative importance and
to identify groups needing special attention.
A. Pre- symptomatic disease or early pathogenesis - individual has no symptoms that
indicate presence of illness.

Study the work of health services with a view of improving them. Operational research
shows how community expectations can result in the actual provisions of service.
B. Discernible lesions - changes maybe detectable through sophisticated laboratory test, during
this period the early signs and symptoms of disease are developing.

Estimate the risk of disease, accident, defects, and the chances of avoiding them.identify
syndrome by describing the distribution and association of clinical phenomena in the
population.
C. Advanced disease - anatomical and functional changes have produced recognizable signs
and symptoms

Complete the clinical picture of chronic disease and describe their natural history.
These stages have relevance to the concept of levels of disease prevention.
LEVELS OF PREVENTION OF HEALTH PROBLEMS

Search for causes of health and disease by comparing the experience of groups that are
clearly defined by their composition, inheritance, experiences, behavior and environments.
FUNCTION OF THE EPIDEMIOLOGY NURSE
1. Implement public health surveillance
2. Monitor local health personnel conducting disease surveillance
3. Conduct and/or assist other health personnel in outbreak investigation
4. Assist in the conduct of rapid surveys, and surveillance during disaster
5. Assist in the conduct of surveys, program evaluations, and other epidemiology studies.
6. Assist in the conduct of training course in epidemiology
7. Assist the epidemiologist in preparing the annual report and financial plan
1. Prepathogenesis or susceptibility - in this stage, disease has not developed but factors
that favors its occurrence are present
2. Pathogenesis- disease has developed and has 3 sub- stages:
1. Primary Prevention
It is directed to the healthy population, focusing on prevention of emergence of risk factors and
removal of the risk factors or reduction of their levels (specific protection)
2. Secondary Prevention
Aims to identify and treat existing health problems at the earliest possible time.
3. Tertiary Prevention
Limits disability progression. Rehabilitation and maintenance of health.
3
Downloaded by Shadd Castro (shadddominic@gmail.com)
lOMoARcPSD|31108752
DISTRIBUTION-Describes the distribution of health status in terms of gender, race,
geography, time and so on might be considered in an expansion of the discipline of
demography to health and disease.
DETERMINANTS-Involves explanation of the patterns of disease distribution in terms of
causal factors.
3.Epidemiological Triangle
Components of Epidemiological Triangle
Agent is the intrinsic property of microorganism to survive and multiply in the environment to
produce disease.
Causative agent is the infectious agent or its toxic component that is transmitted from the
source of infection to the susceptible body
Host is any organism that harbors and provides nourishment for another organism.
Environment
-is the sum total of all external condition and influences that affects the development of an
organism which can be biological, social and physical. It affects both the agent and the host.
-For example, the temperature in a given location might affect an agent’s ability to thrive, as
might the quality of drinking water or the accessibility of adequate medical facilities.
Three components of the Environment
1. Physical environment is composed of the inanimate surroundings such as the
geophysical conditions of the climate.
2. Biological environment makes up the living things around us such as plants and animal
life.
3. . Socio-economic environment which maybe in the form of level of economic
development of the community.
4. Epidemiological Process and Investigation
EPIDEMIOLOGICAL STUDIES
The purpose of an analytic study in epidemiology is to identify and quantify the relationship
between an exposure and a health outcome. The hallmark of such a study is the presence of at
least two groups, one of which serves as a comparison group.
CATEGORIES
EXPERIMENTAL STUDIES In an experimental study, the investigator determines the
exposure for the study subjects;
OBSERVATIONAL STUDIES in an observational study, the subjects are exposed under
more natural conditions.

Observational cohort study
subjects are enrolled or grouped on the basis of their exposure, then are followed to document
occurrence of disease. Differences in disease rates between the exposed and unexposed groups
lead investigators to conclude that exposure is associated with disease
 Observational case-control study,
subjects are enrolled according to whether they have the disease or not, then are questioned or
tested to determine their prior exposure. Differences in exposure prevalence between the case
and control groups allow investigators to conclude that the exposure is associated with the
disease.
 Cross-sectional studies
measure exposure and disease status at the same time, and are better suited to descriptive
epidemiology than causation.
 Approach to disease and Determinants
The present epidemiology approach is based on the interaction of the causative agent and the
environment. Essentially , epidemiology patterns depend upon these factors which influence
the probability of contact between an infectious agent and susceptible host.
2 MAIN AREAS OF INVESTIGATION

The study of the distribution of diseases

The search for determinants (causes) of disease and it's observed distributions
4
Downloaded by Shadd Castro (shadddominic@gmail.com)
lOMoARcPSD|31108752
 Disease distribution
The method and technique of epidemiology are desired to detect the cause of a disease in
relation to the characteristic of the person who has it or to a factor present in his environment.
Tuberculosis is endemic in all specific areas of the country.
EPIDEMIC OCCURRENCE
-is of unusually large number of cases in a relatively short period of time.
-Bird’s flu, there has been no case in any area of the country, the occurrence of few cases in a
given area in a given time would constitute a bird’s flu epidemic.
PANDEMIC OCCURRENCE
is the simultaneous occurrence of epidemic of the same disease in several countries. It is
another pattern of occurrence from an international persperctive.
Corona Virus has been existed and with diffrent pattern of occurrence in the present as we
call it now COVID-19
Since neither population and environment of different times or places are similar, these
characteristics and factors are called epidemiologic variables.
these variables are studied since they determine the individuals and populations at greatest risks
of acquiring particular disease, and knowledge of these association may have predictive value.
For the purpose of analyzing epidemiology data , it has been found helpful to organize that data
according to the valuables of:
TIME
refers both to the period during which the cases of disease being studied were exposed to the
source of infection and the period during which the illness occurred.


Instruction:
Share and discuss with your classmates the ideas on Philippine Health Status and the
importance of epidemiology in the role of the nurse in protecting the public health.
Please use the Neo LMS assignment to answer this activity.
PERSON
refer to the characteristics of the individual who were exposed and who contacted the infection
of the disease in question.
PLACE
-refers to the features, factor or conditions which existed in or described the environment in
which the diseases occurred.
-Urban/ Rural Differences: diseases spread more rapid in urban areas than in rural areas
primarily because of the greater population.
Patterns of Occurrences and Distribution
The variables of disease as to person, time and place are reflected in distinct patterns of
occurrence and distribution in given community.
The following are the characteristic of patterns of disease occurrence;
SPORADIC OCCURRENCE
-Intermittent occurrence of a few isolated and unrelated cases in a given locality.
-The cases are few and scattered, not related, occur on and off, intermittently
Rabies occurs sporadically in the Philippines, he cases are scattered throughout the country, so
that the cases are not related at all to the cases in other areas.
ENDEMIC OCCURRENCE
-is the continuous occurrence throughout a period of time, of the usual number of cases in a
given locality.
5
Downloaded by Shadd Castro (shadddominic@gmail.com)