Yes a b (a+b) No c d (c+d) (A+C) (b+d) N Measurements of Disease (video) Ratio o One measure divided by another, no implicit relationship Proportion—those present in numerator are present in denominator Rate—disease occurring in population over specific period of time Risk o Accumulated effect of some rate of disease operating over certain timeframe o Probability that some event will occur, time frame is key component Risk ratio o Risk is occurring in certain group against those that don’t have exposure o Risk of lung cancer (smokers vs non smokers) Incidence o New cases of disease during time you are measuring o Incidence: # new cases/population at risk over timeframe o exact onset of disease uncertain so need to define onset, a ‘case’ definition o good for evaluating risk/probability, excluded people who have already had disease o Inc Exposed= a/(a+b) o Inc Unexposed= c/(c+d) cumulative incidence o number of new cases during a period of time / number of disease free individuals at beginning of observation period o # new cases/ # disease free @ beginning of observation period prevalence o what exists at time you are measuring o prevalence: total # cases/ total population at risk o P= (a+c)/N point prevalence o # cases at the instant in time you count relative risk o risk of one group with exposure compared to risk of another group not exposed o IR exposed / IR unexposed o RR=(A / (a+b))/ (c/(c+d)) Attributable risk o Amount of risk due to factor, excess risk 20
1/30/2018 Lecture 7 Culture o Culture is the lens through which we see/perceive the world “Explanatory Model” o Explanatory model of health and illness What people in a given culture believe about the nature, cause, prevention, and response to a health-related event o Reality is socially and culturally constructed from experiences interpreted in a particular environment/context o Explanatory models demonstrate the role of culture in shaping a person’s interpretation of the meaning of illness and disease o Types of explanatory models Focus on balance in: Energy (Shakra) Social Relationships Hot/cold Focus on relationships that are spiritual between: Humans (i.e. susto) Humans and non-humans/supernatural Focus on Environmental Forces Natural Elements Natural Forces Germs The biomedical model assumes illness is physical and that illness operated according to the causal principles of the physical world A Western Explanatory Model o The “Plumbing model” or metaphor of the body Body is a series of cavities/chambers (chest, stomach) connected by pipes or tubes (windpipe, intestines, blood vessels) To maintain health, all pipes must be clear to allow free flow (or air, blood, food, urine, feces) between cavities or to the outside Disease is the result of a blockage Laxatives or enemas relieve constipation; we clear/flush out the “system” by drinking a lot of water When under stress we “blow off steam” Arteries are “clogged” and need to be cleared Ear, nose are “plugged” Example: Public Health o
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- Spring '08