Browsing Health by Publisher "Springer International Publishing"
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Demography in public health intelligenceDemography is the scientific study of human population. For the last few decades, demographic models and methods have been frequently used to analyse or measure the births, deaths and migration within human populations. Public health practitioners and public health analysts regularly require information about health demography, which deals with the contents and methods of demography within the context of health and healthcare. In other words, health demography deals with the demographic attributes that may infl uence or concern health status and health behaviour, as well as the health-related phenomena which infl uence the demographic attributes of the population (Pol and Thomas 2013). Following an overview of health demography, this chapter will discuss the nature and extent of public health problems within the context of present and future patterns of demographic change. This chapter will also highlight some applications, concepts and methods related to health. After reading this chapter you should be able to: • Define the concept and meaning of populations • Discuss the nature and extent of public health problems within the context of present and future patterns of demographic change • Examine sources of population data and their strengths and weaknesses.
Epidemiology and public health intelligenceThis chapter provides an introduction to epidemiology. It covers the key epidemiological concepts such as bias and confounding, as well as providing an overview of the nature, history and types of epidemiology. The main epidemiological study designs are described, including case series, ecological, cross-sectional, case-control, cohort, randomised controlled trial and systematic review. The advantages and disadvantages of each are summarised, and some of the ethical issues in doing research are considered. The 'hierarchy of evidence' framework is contrasted with an approach which recognises the most appropriate study design to answer different questions about population health. This chapter will examine the role of epidemiology in public health intelligence and develop students' or learners' knowledge and skills to carry out thorough, rigorous and meaningful research and investigation relevant to public health. After reading this chapter you should be able to: • Define epidemiology and differentiate between descriptive epidemiology and analytical epidemiology • Describe the basic study designs, principles and methods used in epidemiology • Explore key issues related to the design and conduct of studies • Recognise the role of epidemiology in public health intelligence.
Public health intelligence: an overviewThe notion that medical statistics could be used to assess and then identify potential risks or associated factors to be able to prevent avoidable human loss emerged sometime in the early seventeenth century (http://www.hsj.co.uk/ Journals/2/Files/2010/5/24/APHO%20supplement.pdf). John Snow's work in studying the pattern of disease in order to trace the source of a cholera outbreak in London in 1854 established many of the concepts of modern epidemiology and demonstrated the link between data analysis and the necessary action to tackle the underlying causes of disease and ill health. More recently, the emergence of public health intelligence as a specific public health discipline is a response to the increasing recognition of the need to ensure that the development of appropriate strategies and policies to improve the health of the population and reduce health inequalities is underpinned by a rigorous and robust evidence base. The manner in which public health intelligence has emerged as an accepted public health discipline means that it is not easy to identify a precise starting point or arrive at a commonly accepted definition. However, it is increasingly acknowledged that public health intelligence requires the application of a distinctive range and blend of analytic, critical and interpretive skills in order to generate meaningful information for decision-making. Many of the skills and techniques used to generate public health intelligence are shared with other domains of public health, such as epidemiology, and there is already a substantial body of literature and educational resources on these areas of practice. However, there is very little evidence and few resources available in the specific area of public health intelligence. By the end of this chapter, you should be able to: • Understand the concepts of public health and public health intelligence • Explore the nature and roles of public health intelligence in measuring health and health outcomes of a defined population • Examine some opportunities and challenging aspects of public health intelligence.
Synthesising public health evidencePublic Health research is multi-disciplinary, complex and tries to understand problems in a 'real-world' context and this can make it hard to apply to practice and services that aim to improve health outcomes. Increasingly it has been realised that the mass of health evidence generated needs to be synthesised effectively. This chapter will explore the growing focus on this issue, the tools developed to synthesis evidence well and examples of evidence synthesis in practice. After reading this chapter you will be able to: • Define the meaning of research and research process • Understand the need for public health evidence synthesis • Describe the tools and techniques used to synthesise evidence effectively Before we can start to synth esise evidence we need to have some understanding of what evidence is and where the new evidence being explored comes from. Fundamentally as Lomas et al. (2005, p. 1) suggest 'evidence concerns facts (actual or asserted) intended for use in support of a conclusion.' Decision makers tend to view evidence colloquially, that is evidence is anything that can give a reason for believing something relevant is considered evidence. Researchers will tend to view evidence scientifically, it must be produced by robust, systematic and replicable methods that are clearly defined. So evidence is something that can be used to support a conclusion, but it is not the same as a conclusion (Lomas et al. 2005). Evidence can, and should, support decision making but the collection of evidence alone is not going to make the decisions. Evidence for Public Health impacts and interventions is generated through the process of research Research is about generating new information, doing some-thing new, collecting information to answer specific research questions and testing ideas or hypotheses. There are several characteristics of good research It should be: • Systematic: there is an agreed system for performing observations and measurement • Rigorous: the agreed system is followed exactly. • Reproducible: all the techniques, apparatus and materials used in making observations and measurements are written down in enough detail to allow other to reproduce the same process. • Repeatable: researchers often repeat their observations and measurements several times in order to increase the reliability of the data. (Bruce et al. 2008).