Week 1: Introduction to Epidemiology and Population Health
Imagine walking out of your home to a chaotic scene of disaster relief personnel dressed in hazmat suits. Hollywood has long played upon fears of a catastrophic epidemic with movies such as Outbreak (1995) and Contagion (2011). In films such as these, the protagonist races to identify the origin of a fast-spreading disease, determine the potential course of the outbreak, and develop a method to control the spread of harm. Although these films are designed to entertain, they show how epidemiologic methods can be used to analyze and control a health event that has the potential to debilitate a large population.
It is important to note, however, that epidemiology relates to more than just acute outbreaks of illness; it addresses many chronic population health problems that nurses and health care professionals deal with every day, such as obesity, cardiovascular disease, and cancer. This first week of the course introduces the principles of epidemiology, as well as how epidemiology is used to study and address population health problems. As a nurse engaged in advanced practice, it is essential that you understand these concepts and appreciate the importance of epidemiology.
This week, you will examine one of the great success stories of the application of epidemiology to improve population health: the eradication of smallpox. You use this historic example to explore current population health problems, and you will consider how epidemiologic principles can be applied to address them. Finally, you will begin to consider the cost-effectiveness of addressing a health problem at the population level versus the individual level.
Learning Objectives
Students will:
· Apply principles of epidemiology to population health problems
· Evaluate the cost-effectiveness of population healthcare versus individual healthcare
 
Learning Resources
Required Readings
Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.

Chapter 1, -History and Scope of Epidemiology 

Epidemiology is defined and introduced in Chapter 1. This chapter also presents an interesting historical overview that explains the emergence of the field.  

Chapter 2, “Practical Applications of Epidemiology” (pp. 52-85)

The assigned section of Chapter 2 addresses several uses of epidemiology.
Nash, D. B., Skoufalos, A., Fabius, R. J. & Oglesby, W. H.  (2021). Optimistic culture for healthCare: Population health from philosophy to practice. In Population Health: Creating a culture of wellness (3rd ed., pp. xviii–xxxii). Jones & Bartlett Learning.
In this introductory section, Dr. Stephen Klasko challenges us to stop talking about population health and make it happen! He guides us through the various issues facing us today and the challenges we face in bringing knowledge to practice.  
Nash, D. B., Skoufalos, A., Fabius, R. J. & Oglesby, W. H. (2021). The population health promise. In Population Health: Creating a culture of wellness (3rd ed.). Jones & Bartlett Learning.
In Chapter 1, the authors examine the promise of population health. They discuss the current state of population health and introduce the initiatives guiding current public health efforts. The four pillars of population health a) chronic care management, b) quality and safety, (c) public health, and (d) health policy are explored in relation to education and practice.
Nash, D. B., Skoufalos, A., Fabius, R. J. & Oglesby, W. H. (2021). Building cultures of health and wellness within organizations. In Population Health: Creating a culture of wellness (3rd ed.). Jones & Bartlett Learning.
In Chapter 14, the authors explore how a culture of health and wellness can contribute to supporting health initiatives within organizations. They introduce the components of a benchmark organization.
Larkin, H. (2010). Managing population health. Hospitals & Health Networks, 84(10), 28-32.
This article uses examples from a diabetes pilot program to demonstrate the value of population health management. The author discusses how the application of individual patient interventions can positively affect the entire target population, as well as improve the cost effectiveness of management programs.
Center for Global Development. (n.d.). Case 1: Eradicating smallpox. Retrieved March 5, 2012, from http://www.cgdev.org/doc/millions/MS_case_1.pdf
This reading presents the eradication of smallpox in the form of a case study. Many lessons can be learned from the successful global effort to eliminate smallpox.
Centers for Disease Control and Prevention. (2011). Morbidity and mortality weekly report. Retrieved from http://www.cdc.gov/mmwr/
The Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological report distributed by the U.S. Centers for Disease Control and Prevention (CDC) to provide, according to the MMWR website, timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations. It is one of the most important sources of timely public health data published anywhere.
World Health Organization. (2001). Smallpox. Retrieved from http://www.who.int/topics/smallpox/en/
The World Health Organization provides a succinct overview of the eradication of smallpox and its impact on population health.

Note: Explore population health issues presented at the websites below as you prepare for this week’s Discussion and Assignment:
American Public Health Association. (2011). Retrieved from http://www.apha.org/
Centers for Disease Control and Prevention. (2011). Retrieved from http://www.cdc.gov/
Food and Agricultural Organization of the United Nations. (2011). Retrieved from http://www.fao.org/index_en.htm
U.S. Food and Drug Administration. (2011). Retrieved from http://www.fda.gov/
Healthy People 2020. (2011). Global health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=16
U.S. Food and Drug Administration. (2011). Public health focus. Retrieved from http://www.fda.gov/NewsEvents/PublicHealthFocus/default.htm
Required Media
Laureate Education (Producer). (2012). Epidemiology and population health: Introduction to epidemiology and population health [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 6 minutes.
In this week’s program, Introduction to Epidemiology and Population Health, Dr Hull and Dr Frerich introduce foundational concepts related to epidemiology, noting that this scientific arena focuses on the study of human populations rather than individuals.
Accessible player “–Downloads– Download Video w/CC Download Audio Download Transcript” 
Laureate Education (Producer). (2012). Epidemiology and population health: Epidemiology in nursing practice [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 4 minutes.
In “Epidemiology in Nursing Practice” Dr Rebecca Lee, Dr Donna Shambley-Ebron, and Dr Missie Willmarth discuss how epidemiology is utilized in nursing practice and, in particular, why it is salient for DNP-prepared nurses.
Accessible player –Downloads– Download Video w/CC Download Audio Download Transcript  
Credit: Provided courtesy of the Laureate International Network of Universities.
Optional Resources
Long, D. A., & Sheehan, P. (2010). A case study of population health improvement at a Midwest regional hospital employer. Population Health Management, 13(3), 163-173.
Oudin, Åström D., Bertfil, F., & Joacim R. (2011). Heat wave impact on morbidity and mortality in the elderly population: A review of recent studies. Occupational and Environmental Medicine, 69(2), 99-105.
Excite. (2004). An introduction to epidemiology. Retrieved from http://www.cdc.gov/excite/classroom/intro_epi.htm
 
Discussion: Epidemiology and Population Health
Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population? What would be the long-term benefits of eliminating that one illness?
The eradication of smallpox by 1979 provides an excellent example of this scenario. This eradication came about as a result of global collaborative efforts involving many countries and organizations, as well as the application of epidemiologic methods. In spite of high initial financial costs, it is estimated that millions of dollars continue to be saved around the world each year as a result of the eradication of this disease.
The eradication of smallpox illustrates the rich history of epidemiology and demonstrates the cost/benefits and implications of improving health at the population level. The application of epidemiologic methods and principles to other critical population health issues continues to play an essential role in improving health and health outcomes.
For this Discussion, you will identify a current population health problem, and you will examine how, and if, the problem is being addressed through the application of epidemiologic principles. You will also discuss the cost-effectiveness of dealing with the problem at the population level.
To prepare:
· Review the Learning Resources, focusing on the smallpox epidemic of the 1960s and 1970s and how health organizations applied principles of epidemiology to eradicate this disease.
· In light of this example, consider the coscost-effectiveness addressing smallpox at the population level.
· Using the Learning Resources, research a current population health problem (local or global). Select one on which to focus for this Discussion.
· Think about how principles of epidemiology are being applied or could be applied to address the problem.
· What lessons from the use of epidemiology in the eradication of smallpox might be applicable to this selected problem? What are the financial benefits of addressing this issue at the population level as opposed to the individual level?
By Day 3
Post a cohesive response that addresses the following:
· Briefly summarize your selected population health problem and describe how principles of epidemiology are being applied or could be applied to address the problem.
· Are there any lessons learned from the use of epidemiology in the eradication of smallpox that can be applied to your selected problem?
· Evaluate the cost-effectiveness addressing this health problem at the population level versus the individual level.
2 pages in APA and cite at least 5 sources of the given sources in this week.
https://www.cdc.gov/mmwr/index.html
https://www.who.int/health-topics/smallpox#tab=tab_1
https://www.apha.org
https://www.fao.org/home/en/
https://www.fda.gov
https://www.cdc.gov
https://www.fda.gov/news-events/public-health-focus
https://www.healthypeople.gov/2020/topics-objectives/topic/global-health?t
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 1 Discussion

Week in Review
This week, you evaluated the cost-effectiveness of population health care versus individual health care and applied principles of epidemiology to population health problems.
Next week, you will be introduced to descriptive epidemiologic research studies and examine the purposes of descriptive epidemiology, which provides a picture of the distribution of disease in terms of person, place, and time.