Epidemiology Paper

Epidemiology is important to communities because it studies health and diseases to determine where they come from, educate on ways to stop epidemics from taking place or the spread of certain diseases. Epidemiology has also taken on the study of health in such things as heart disease, cancer, HIV/AIDs, etc and has formed education materials to be able to educate the community, cities, states, etc on ways to prevent certain illnesses. Without epidemiology we would all be blind to the health issues and illnesses etc, how they are spread or contracted and our mortality rates would be higher than what they are today. Epidemiology is important to communities to help keep them educated and healthy. This paper will discuss epidemiology, the steps and methods of epidemiology, the epidemiological triangle, the elderly and diabetes, and the relationship of the disease to various levels of prevention. What is Epidemiology

According to Stanhope and Lancaster (2012), epidemiology has been defined as “the study of the occurrence and distribution of health-related states or events in specified populations, including the study of the determinants influencing such states, and the application of this knowledge to control the health problems” (Stanhope & Lancaster, p.255, 2012). According to Stanhope and Lancaster (2012), in the past century the definition and scope of what epidemiology entails has broadened to now include things such as diabetes, cardiovascular disease and cancer, mental health and health related events such as accidents, injuries, and violence and occupational and environmental exposures, and also positive health states (Stanhope & Lancaster, p.255, 2012).

Steps and Methods of Epidemiology
There are many Americans and elderly community members that live with diabetes on a daily basis. It is important for the patients to understand what diabetes is, how it affects them, and how to manage their diabetes. Epidemiology is important to determine when there is a break out, where it came from, how it started, who it affects, where it affects, and how to stop or treat it. When there is an investigation being done by epidemiologists there are certain steps that are taken and methods that are used. There are three major techniques that are used by epidemiologist which are descriptive, experimental, and analytical (“National Center for Biotechnology Information”, 1996). All three of these methods can be used but descriptive epidemiology is the method that is most used (“National Center for Biotechnology Information”, 1996).

According to “Wise Geek” (2003-2012), the goal of epidemiology is “to establish casual factors for health issues in order to improve the health and safety of the whole populations” (What is Descriptive Epidemiology?). Descriptive epidemiology uses a method of cataloging and evaluating all surroundings and circumstances of a person affected by an event that has to do with their health (“Wise Geek”, 2003-2012). There are two primary considerations with descriptive epidemiology and those two considerations are pattern and frequency (“Wise Geek”, 2003-2012). When using descriptive epidemiology, frequency and pattern is obtained by being able to examine the place, time, and person that are connected to the health event (“Wise Geek”, 2003-2012).

According to “Think Quest” (n.d.), analytical epidemiology “concerns the how and the why questions of an epidemic-explaining how and why the epidemic occurs” (Analyzing Data). Analytical epidemiology can be further broken down by the different study designs. These study designs are cohort studies, prospective cohort studies, retrospective cohort studies, case-control studies, cross-sectional studies, and ecologic studies (Stanhope & Lancaster, 2012). There are several advantages and disadvantages to these different studies.

The third method is experimental epidemiology. According to The Free Dictionary (2012), experimental epidemiology is “a type of epidemiologic investigation that uses an experimental model for studies to confirm a casual relationship suggested by observational studies” (“Experimental Epidemiology,” 2012). So as we can see there are different types of studies and methods that are used depending upon the information or hypothesis that is being used.

Epidemiological Triangle
The epidemiological triangle is a model that was developed by scientists to help the study of different health problems or epidemics (“Bam.gov”, n.d.). The epidemiologic triangle can make it easier for one to understand about different infectious diseases and how they are spread from person to person, place to place, etc. (“Bam.gov”, n.d.). The triangle consist of three corners which represent the agent, the host, and the environment and how when these three things come together gives the disease the opportunity to multiply and spread.

Elderly and Diabetes
Diabetes is a metabolism disorder that is looked at as the way our body uses food that is digested for energy and growth (“Medical News Today”, 2004-2012). When one eats most of the food is broken down into what is known as glucose, which is in the blood as a form of sugar, which is also our number one source of fuel (“Medical News Today”, 2004-2012). Glucose is not able to enter into our cells without insulin which is a hormone that is produced within the pancreas. One is diagnosed with diabetes when the body is unable to cope with the levels of sugar in the blood and they are too high. This can be caused because the body is not producing an adequate amount of insulin, the body does not produce any insulin at all, or because the body’s cells do not know how to properly respond to the insulin that is being produced (“Medical News Today”, 2004-2012).

According to “Centers for Disease Control” (2012), there are more than 25.8 million people who are affected by diabetes which is 8.3% of the U.S. population; there are 18.8 million people who are diagnosed with diabetes, and 7.0 million people who are undiagnosed (National Diabetes Fact Sheet, 2011). Many elderly community members deal with diabetes. In 2010 it was estimated that 10.9 million or 26.9% U.S. residents 65 years and older had diabetes and in 2010 approximately 215,000 U.S. residents 20 and younger also had diabetes (“Centers for Disease Control”, 2012). The leading cause of new cases of blindness, kidney failure, and lower-limb amputation among adults is diabetes (“Centers for Disease Control”, 2012). According to the” Centers for Disease Control” (2012) diabetes is also the major cause of heart disease, stroke, and is the seventh leading cause of death within the United States (National Diabetes Fact Sheet, 2011).

Elderly patients can either be plagued by Type I diabetes, which is insulin dependent, or Type II diabetes, which is non insulin dependent. Type I diabetics or insulin dependent diabetics need to receive insulin regimens on a daily basis to help control their sugar levels. Type II or non insulin dependent diabetics do not require insulin regimens to control their sugars but they either take oral medications to assist with controlling their sugar levels, watch their diet to control sugar levels, or a combination of the two. It is important for patients to follow all medical advice to control sugar levels in order to prevent long term affects from uncontrolled sugar levels in the body.

Both analytical and descriptive epidemiology can be used in the study of diabetes as well as morbidity surveys, cohort studies, retrospective cohort studies, and case-controlled studies depending upon what type of data or information the study is looking for. Scientists are uncovering new facts, causes, treatments, etc. for different diseases all the time including diabetes.

Levels of Prevention and Diabetes
Many people have misconceptions about diabetes, what causes it, how it can be treated, and how it can be prevented. There are different levels of prevention known as primary prevention, secondary prevention, and tertiary prevention. It is important for patients who are diagnosed with diabetes to understand prevention as well as people who are not diagnosed with diabetes.

Primary prevention would be to focus on those who are at an increased risk for developing diabetes (“Ehow”, 1999-2012). The goal for these patients is to start prevention before they are ever diagnosed (“Ehow”, 1999-2012). There is no data or studies to prove that there is a way to prevent type I diabetes but that through some lifestyle changes that prevention of type 2 diabetes just might be possible (“Ehow”, 1999-2012). Some things to include in primary prevention of diabetes are to exercise regularly, eat a well balanced diet, by pass sugary and hig-carb foods.

With secondary prevention one is looking at catching a disease, or in this case diabetes, at an early stage and putting interventions into place to prevent progression, worsening, or adverse effects from the disease due to non-compliance or not managing the diagnosis well (“Ehow”, 1999-2012). Once someone has been diagnosed with diabetes it is very important to watch blood sugar levels and maintain them at optimal levels to reduce complications later on down the road. Steps to include in secondary prevention would be to continue and avoid snacks that are high in sugar and carbs, watch portion sizes, watch calories, and monitor blood sugar levels after meals (“Ehow”, 1999-2012). If a patient is having trouble with these steps or interventions they need to make an appointment with their physician and maybe a dietician or diabetic counselor.

The last step of prevention is the tertiary prevention. This step focuses on patients who have serious complications related to their diabetes and patients who have had the disease for a long time (“Ehow”, 1999-2012). Some of these complications can include heart disease, lower limb amputations, neuropathy, kidney disease, kidney failure, eye trouble such as glaucoma, etc. These patients need to continue to monitor feet daily for any types of injuries or infections, need to monitor blood sugar levels closely and after every meal, take medications or insulin as ordered, continue to have regular eye and dental exams, continue to go to all appointments as instructed or set up by physicians, and continue to have all lab test drawn as ordered and monitored by a physician (“Ehow”, 1999-2012).

Conclusion
Diabetes can be a debilitating disease for the elderly or any age or race. Many elderly patients are not able to manage their diabetes on their own and have care givers or family members help them with this. Diabetes affects many people and will affect many more in the future. Epidemiology plays an important role in different diseases and illnesses. Epidemiology assist with determining how different diseases or illnesses are started, transmitted, where they are started, who they affect, etc. Without epidemiology and the studies that are conducted by epidemiologist there would be an increased number of victims and mortality. There is lots of education available to the public on how to prevent and keep themselves and their loved one’s safe because of the studies and work done by epidemiologist. This paper has looked at epidemiology and what it is, what types of studies are used by epidemiologist in their studies, who and how many people are affected by diabetes, the epidemiologic triangle, and primary, secondary, and tertiary preventions for diabetes.

References
Bam.gov. (n.d.). Retrieved from http://www.bam.gov/teachers/activities/epi_1_triangle.pdf Centers for Disease Control. (2012). Retrieved from http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf eHow. (1999-2012). Retrieved from http://www.ehow.com/way_5664235_primary_-_amp_-tertiary-prevention-diabetes.html Experimental Epidemiology. (2012). In The Free Dictionary. Retrieved from http://medical-dictionary.thefreedictionary.com/experimental+epidemiology Medical News Today. (2004-2012). Retrieved from http://www.medicalnewstoday.com/info/diabetes/ National Center for Biotechnology Information. (1996). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK7993/ Stanhope, M., & Lancaster, J. (2012). Public Health Nursing Population-Centered Health Care in the Community (8th ed.). Retrieved from The University of Phoenix eBook Collection database. Think Quest. (n.d.). Retrieved from http://library.thinkquest.org/06aug/01865/analytical_epidemiology_1.html