Download EPID XXX

EPID 6XX
Chronic Diseases
Course Objectives:
As a result of taking this course students will be able to
Describe the shift from illnesses mainly due to infectious diseases in the mid 20 th century to
diseases manly due to chronic illness by the beginning of the 21st century
Students will be able to describe the impending failure of health systems around the world due to
the cost of treating chronic diseases
Students will be ale to describe the impact of chronic heart diseases, strokes, COPD, diabetes,
cancers and arthritis on populations
Students will be able to describe the potential for reduction in both incidence and prevalence of
chronic disease by use of appropriate primary and secondary preventive interventions..
Students will be able to describe the world wide impact of chronic diseases
Students will be ale to describe the roles of behavioral interventions, the value of surveillance
systems, and the use of registries, and diet in combating these diseases.
Students will be able to describe how aging affects the incidence and prevalence of chronic
disease.
Course design:
The introductory session of the course will describe how the WHO and selected national health
systems are financially and organizationally affected by the rising prevalence of chronic disease.
The course will also describe how the increase in the proportion of elderly individuals are
contributing to the problem.
The course will the focus on five major groups of chronic disease, describe the incidence and
prevalence, changes in death and disability outcome of the diseases and potential for future
change.
Finally the course will focus on potential public health policies that can accelerate reduction in
these diseases.
Principles:
The course development should include ideas from the basic science researchers, the clinical
specialists, the behavioral sciences, and geneticists and health administration.
Epidemiologic Models: Examples, others to be suggested by working group.
The gold standard is cohort studies of large groups.
Framingham
http://www.nhlbi.nih.gov/about/framingham/
http://www.cdc.gov/nccdphp/bb_heartdisease/index.htm
European Heart Study
http://www.escardio.org/knowledge/ehs/survey/
http://www.hi.se/English/heart.shtm
VA High Blood Pressure studies
Womens’ Heart studies
http://www.nhlbi.nih.gov/whi/
Diabetes Studies
Cancer & Seer studies, BRFSS
Topics/concepts to integrate
Genetics (role of genes in chronic diseases found at birth and during development, John Quillin
and Joann Bodurtha)
Aging – Starts and birth and continues
Disappearance of common infectious diseases
Change of infectious disease from acute to chronic (TB, Leprosy, AIDS)
Compression of Morbidity
Mental Health issues, particularly depression
Role of behaviors that contribute to chronic disease development
The population (Ecological approach)
Examples
Session 1
Buttery: Intro- How do we get here – 50 years of Progress!
What are the Chronic Diseases
Start with conception, go to Death
Who says they are important?
The World View (WHO)
The US/UK View health people 2010, The UK health People Plan
The State Plan
A Practice Plan
Where do we look for Data
For each of the following areas the students needs to learn about 50 years of changing
epidemiology.
The standout intervention Trials.
Gaps (women vs Men, Race vs Race)
Cultural problems.
Belief problems,
Dietary Problems,
Genetics problems.
Where do we seem to be headed, What should be see in the next 10-20 years.
The following are potential topics. Order can be changed , emphasis can be changed.
Start out by assigning groups to collate and study a particular chronic disease
Cost of Chronic Disease on the HC System.
Mental Illness
Epidemiology of Cardiovascular Disease, primary & secondary inter4vention
Epidemiology of Diabetes
Epidemiology of Neurological diseases
Mid term Group discussions.
Epidemiology of COPD. Emphysema,
Occupational contributions
Epidemiology of Arthritides
Community Systems and Chronic Disease Prevention.
Nutrition & Physical activity
Session Dental Diseases.
Session To a Healthier US – Politics of chronic i
Final Exam (essays or group discussion.)