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Public Health, Epidemiology,�& Models

MMED 2024�Carl Pearson

https://doi.org/10.6084/m9.figshare.5038769.v3

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Goals

Define Public Health, Epidemiology, & Models
Discuss how they relate
Set up future sessions

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Practical!

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It is immediately time to get to work: over the next 15 minutes, you’re going to do a small exercise.

Get into small groups, 3-4 people. You will be joined by a faculty member, mentor, or faculty observer. Introduce yourselves briefly; there will be a quiz.

Write down a series of bullet points for each of “Public Health”, “Epidemiology”, and “Modelling”, identifying “is” and “isn’t” features. There will also be a quiz on this part. Also, actually write them down - we want a copy of your answers later. The faculty/mentor/observer may answer questions (but not “What is the definition of Public Health?” or other I-wish-for-infinite-wishes style attempts to get out of this exercise).

Regarding the quiz: your group should be ready to provide example is / isn’t for each of the terms.

Any questions? Then your 10 minutes begins now.

At 8 minutes, give two minutes warning. Once ten minutes up:

Alright groups, we’re now going to through each of the groups, twice.

Each time, I’m going to ask you to supply a new answer in one of the remaining spots under each of the terms.

First time through, tell me something about your faculty members name

Second time though, tell me something interesting about them

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Modeling

Is:

approximation / prediction
scientific representation of a phenomenon to study it
mathematical description of a system

Isn’t:

exact representation
data collection
only mathematical representation of a phenomenon

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Public Health

Is:

total well-being of whole population
citizens activity to control spread of infectious disease
science of prevention of diseases, promoting health

Isn’t:

everyone having access to healthy lifestyle
the story of individuals health
for animals

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Epidemiology

Is:

study of transmission infectious diseases
involves modeling
helps curb spread of diseases

Isn’t:

which vaccine is used for treatment
study of chronic diseases
exclusive to infectious disease

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Modeling

Is:

Formal / rules-based description
Possible to use / implement as tool(s)
An abstraction / generalization across circumstances

Isn’t:

True or inclusive of all plausible phenomena
Necessarily a series of equations
An experiment

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Public Health

Is:

Focused on outcomes for whole group(s)
Conscious of tradeoffs / competing concerns
About what to *do*

Isn’t:

Individual diagnosis of a particular patient
“Do no harm” or generally about an easy “right way”
Only restricted to medical interventions

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Epidemiology

Is:

Creation, collection, & curation of data
about distribution & determinants of health-related states / events in populations
To identify causal factors of disease & non-disease

Isn’t:

Medicine, e.g. not treatment of patients
(Health) policy making or control activities
Expert in health-dependent states / measures / &c

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How are they distinct?

How do they fit together?

Why should we care?

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Public�Health

Epidemiology

Modeling

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An example:

COVID-19

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Public�Health

Epidemiology

Modeling

How will Y rate of vaccine coverage, started at time t, impact cumulative incidence?

Assuming branching process distribution / timing, how long until X cases?

Given detection rate, how many infections when first case notified?

If response reduces R0 by Y%, what will be peak incidence?

If we allocate vaccine this vs that way, which minimize deaths?

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Epidemiology

Modeling

Public�Health

Is this new pathogen a threat?

How much should / can we spend?

Who do we prioritize for care / vaccine?

Do we need to increase healthcare system capacity? Can we?

Should we change vaccine approval policy?

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Public�Health

Modeling

Epidemiology

How does transmission happen?

What is time course of infection / disease?

How accurately does testing perform?

How well does a vaccine work at preventing infection? Disease? Death?

What is the mortality rate? The asymptomatic rate?

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Public�Health

Epidemiology

Modeling

If we allocate vaccine this vs that way, which minimize deaths?

Who do we prioritize for care / vaccine?

How well does a vaccine work at preventing infection? Disease? Death?

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Tension!

There’s a finite amount of vaccine - who gets it first?*
Highest risk of death? Those Necessary to re-open economic activity?
Epidemiology can tell us e.g. disease risk (after some time), modeling project impact (w/ data & assumptions), but public health has to integrate many factors

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Summary

Public Health, Epidemiology, & Models - different definitions, for different activities, serving different ends
Overlapping elements – typically need each other to “do well” – but worthwhile to remember distinctions
MMED aim: work on the intersection of the categories!

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Questions?

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This presentation is made available through a Creative Commons Attribution-Noncommercial license. Details of the license and permitted uses are available at� http://creativecommons.org/licenses/by/3.0/

Attribution:

Clinic on the Meaningful Modeling of Epidemiological Data