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| New to This Edition | p. ix |
| Introduction | p. xi |
| Preface | p. xv |
| Acknowledgments | p. xvii |
| About the Authors | p. xxi |
| History and Scope of Epidemiology | p. 1 |
| Introduction | p. 2 |
| Epidemiology Defined | p. 6 |
| Foundations of Epidemiology | p. 13 |
| Historical Antecedents of Epidemiology | p. 20 |
| Recent Applicat... MORE | p. 37 |
| Conclusion | p. 43 |
| Practical Applications of Epidemiology | p. 49 |
| Introduction | p. 50 |
| Applications for the Assessment of the Health Status of Populations and Delivery of Health Services | p. 52 |
| Applications Relevant to Disease Etiology | p. 71 |
| Conclusion | p. 87 |
| Leading Causes of Death and Rates for Those Causes in 1900 and 2003 | p. 92 |
| Measures of Morbidity and Mortality Used in Epidemiology | p. 93 |
| Introduction | p. 94 |
| Definitions of Count, Ratio, Proportion, and Rate | p. 94 |
| Risk Versus Rate | p. 104 |
| Interrelationship Between Prevalence and Incidence | p. 106 |
| Applications of Incidence Data | p. 108 |
| Crude Rates | p. 108 |
| Specific Rates | p. 118 |
| Adjusted Rates | p. 123 |
| Conclusion | p. 133 |
| Data for Study Questions 2 Through 4 | p. 138 |
| Descriptive Epidemiology: Person, Place, Time | p. 141 |
| Introduction | p. 142 |
| Characteristics of Persons | p. 146 |
| Characteristics of Place | p. 175 |
| Characteristics of Time | p. 187 |
| Conclusion | p. 193 |
| Project: Descriptive Epidemiology of a Selected Health Problem | p. 201 |
| Sources of Data for Use in Epidemiology | p. 203 |
| Introduction | p. 204 |
| Criteria for the Quality and Utility of Epidemiologic Data | p. 205 |
| Computerized Bibliographic Databases | p. 206 |
| Confidentiality, Sharing of Data, and Record Linkage | p. 207 |
| Statistics Derived from the Vital Registration System | p. 215 |
| Reportable Disease Statistics | p. 216 |
| Screening Surveys | p. 223 |
| Disease Registries | p. 223 |
| Morbidity Surveys of the General Population | p. 225 |
| Insurance Data | p. 229 |
| Hospital Data | p. 230 |
| Diseases Treated in Special Clinics and Hospitals | p. 231 |
| Data from Physicians' Practices | p. 232 |
| Absenteeism Data | p. 233 |
| School Health Programs | p. 233 |
| Morbidity in the Armed Forces: Data on Active Personnel and Veterans | p. 234 |
| Other Sources of Data Relevant to Epidemiologic Studies | p. 235 |
| Conclusion | p. 236 |
| Study Designs: Ecologic, Cross-Sectional, Case-Control | p. 241 |
| Introduction | p. 242 |
| Observational Versus Experimental Approaches in Epidemiology | p. 243 |
| Overview of Study Designs Used in Epidemiology | p. 244 |
| Ecologic Studies | p. 249 |
| Cross-Sectional Studies | p. 256 |
| Case-Control Studies | p. 262 |
| Conclusion | p. 276 |
| Study Designs: Cohort Studies | p. 283 |
| Introduction | p. 284 |
| Cohort Studies Defined | p. 284 |
| Sampling and Cohort Formation Options | p. 295 |
| Temporal Differences in Cohort Designs | p. 301 |
| Practical Considerations | p. 303 |
| Measures of Interpretation and Examples | p. 307 |
| Summary of Cohort Studies | p. 318 |
| Comparisons of Observational Designs | p. 319 |
| Conclusion | p. 319 |
| Experimental Study Designs | p. 327 |
| Introduction | p. 328 |
| Hierarchy of Study Designs | p. 328 |
| Intervention Studies | p. 330 |
| Clinical Trials | p. 331 |
| Community Trials | p. 344 |
| Conclusion | p. 356 |
| Measures of Effect | p. 361 |
| Introduction | p. 362 |
| Absolute Effects | p. 362 |
| Relative Effects | p. 365 |
| Statistical Measures of Effect | p. 371 |
| Evaluating Epidemiologic Associations | p. 374 |
| Models of Causal Relationships | p. 376 |
| Conclusion | p. 381 |
| Cohort Study Data for Coffee Use and Anxiety | p. 384 |
| Data Interpretation Issues | p. 385 |
| Introduction | p. 386 |
| Validity of Study Designs | p. 386 |
| Sources of Error in Epidemiologic Research | p. 390 |
| Techniques to Reduce Bias | p. 396 |
| Methods to Control Confounding | p. 399 |
| Bias in Analysis and Publication | p. 403 |
| Conclusion | p. 404 |
| Screening for Disease in the Community | p. 409 |
| Introduction | p. 410 |
| Screening for Disease | p. 410 |
| Appropriate Situations for Screening Tests and Programs | p. 414 |
| Characteristics of a Good Screening Test | p. 417 |
| Evaluation of Screening Tests | p. 418 |
| Sources of Unreliability and Invalidity | p. 421 |
| Measures of the Validity of Screening Tests | p. 422 |
| Effects of Prevalence of Disease on Screening Test Results | p. 424 |
| Relationship Between Sensitivity and Specificity | p. 426 |
| Evaluation of Screening Programs | p. 428 |
| Issues in the Classification of Morbidity and Mortality | p. 429 |
| Conclusion | p. 432 |
| Data for Problem 6 | p. 436 |
| Epidemiology of Infectious Diseases | p. 437 |
| Introduction | p. 438 |
| Agents of Infectious Disease | p. 439 |
| Characteristics of Infectious Disease Agents | p. 441 |
| Host | p. 442 |
| The Environment | p. 445 |
| Means of Transmission: Directly or Indirectly from Reservoir | p. 446 |
| Measures of Disease Outbreaks | p. 451 |
| Procedures Used in the Investigation of Infectious Disease Outbreaks | p. 456 |
| Epidemiologically Significant Infectious Diseases in the Community | p. 457 |
| Conclusion | p. 482 |
| Data from a Foodborne Illness Outbreak in a College Cafeteria | p. 488 |
| Epidemiologic Aspects of Work and the Environment | p. 489 |
| Introduction | p. 490 |
| Health Effects Associated with Environmental Hazards | p. 491 |
| Study Designs Used in Environmental Epidemiology | p. 491 |
| Toxicologic Concepts Related to Environmental Epidemiology | p. 495 |
| Types of Agents | p. 497 |
| Environmental Hazards Found in the Work Setting | p. 506 |
| Noteworthy Community Environmental Health Hazards | p. 509 |
| Conclusion | p. 519 |
| Molecular and Genetic Epidemiology | p. 529 |
| Introduction | p. 530 |
| Definitions and Distinctions: Molecular Versus Genetic Epidemiology | p. 531 |
| Epidemiologic Evidence for Genetic Factors | p. 539 |
| Causes of Familial Aggregation | p. 540 |
| Shared Family Environment and Familial Aggregation | p. 542 |
| Gene Mapping: Segregation and Linkage Analysis | p. 545 |
| Genome-Wide Association Studies (GWAS) | p. 553 |
| Linkage Disequilibrium Revisited: Haplotypes | p. 556 |
| Application of Genes in Epidemiologic Designs | p. 558 |
| Genetics and Public Health | p. 565 |
| Conclusion | p. 568 |
| Psychologic, Behavioral, and Social Epidemiology | p. 575 |
| Introduction | p. 576 |
| Research Designs Used in Psychologic, Behavioral, and Social Epidemiology | p. 580 |
| The Social Context of Health | p. 581 |
| Independent Variables | p. 582 |
| Moderating Factors in the Stress-Illness Relationship | p. 588 |
| Outcome Variables: Physical Health, Mental Health, Affective States | p. 600 |
| Conclusion | p. 605 |
| Epidemiology as a Profession | p. 613 |
| Introduction | p. 614 |
| Specializations Within Epidemiology | p. 615 |
| Career Roles for Epidemiologists | p. 617 |
| Epidemiology Associations and Journals | p. 620 |
| Competencies Required of Epidemiologists | p. 624 |
| Resources for Education and Employment | p. 625 |
| Professional Ethics in Epidemiology | p. 627 |
| Conclusion | p. 632 |
| Guide to the Critical Appraisal of an Epidemiologic/Public Health Research Article | p. 635 |
| Answers to Selected Study Questions | p. 641 |
| Glossary | p. 651 |
| Index | p. 668 |
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