Essay Example on Unveiling Public Health: Exploring the Role of Epidemiology

Introduction

Epidemiology is a branch of medicine dealing with the occurrence, prevalence, patterns, and possible control of diseases, among other factors that relate to public health. Epidemiology serves a key role in public health by reason that epidemiologists (persons involved in epidemiological research), on the use of epidemiological methods, can conduct outbreak investigation, survey diseases, and subsequently identify risk factors of various diseases. The epidemiological study can take several forms and occurs in the general stages of preparation, finding cases and recording data, data analysis, development of hypotheses, and testing of the hypotheses epidemiologically. This paper will critically review three articles on three types of study designs; cross-sectional, cohort, and randomized controlled studies.

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Background

In the broader sense, epidemiology can be defined as the study of the distribution in terms of subject, location, and time, i.e., who, where, and when, determinants, and patterns of disease conditions in a population. Epidemiology sits at the heart of public health since the study assists in the identification of risk factors for various diseases and the preventive measures that can be taken up against the same.

Public health research occurs in a systematic process that takes the steps discussed hereunder before intervention for the public health issues can arrive. Firstly, the description of the problem has to be sufficient. It involves the confirmation of a given problem as a public health issue, that occurs through epidemiological research. Therefore it helps set out the nature and magnitude of the health issue at hand. This can be done through the measuring of incidences of disease, infection, or death in a population.

The next step in public health research is to identify the risk factors. This is important in that it serves to identify the group at the most significant risk of the health issue. This is followed by exploring the context and identity of determinants. Here, the focus is on describing social or behavioral aspects that lead to the risk factors discussed above, which is essential because most of the public health problems are resultant from human behavior. Research is needed to show why people behave the way they do. This is followed by the formulation and selection of possible interventions. This involves coming up with a solution to the identified problem. After the identification of the answer, the step that follows next is to test the interventions, which involves conducting studies to determine the efficacy and feasibility of the response to the recipient. An excellent example of how this can be done is through a clinical trial, say, for example, to test the impact of oral rehydration solutions in correcting diarrhea.

In the final stages of public health research, efficacy and effectiveness of the public health intervention are assessed. The assessment is through public health efficacy trials and public health effectiveness trials, done to determine the feasibility of the response. Further, it provides an impact statement of the health intervention on the ground. The final step is the implementation of the public health intervention if it passes all the checks, to solve the public health issue that had initially been identified.

As discussed above, in conducting public health research, various methods can be employed. The first method is the cross-sectional study design. This study deals with the examination of the relationship between the disease, infection, or other such health-related conditions and other variables that are of interest in a population at a point in time. The strengths associated with this study are that firstly, it is relatively quick and easy to conduct since data on the variables are all collected at once. Secondly, through this method, the prevalence of all factors under investigation can be measured, and incidentally, multiple outcomes can be studied. The weaknesses of this study, on the other hand, are that it gives the result on prevalence rather than incidence of diseases and that it is sometimes difficult to determine whether exposure followed outcome or outcome followed exposure. Additionally, it is least suited for studying short-term conditions.

The second method is the cohort study design, which involves having a group of individuals exposed to a putative risk factor and having a group of individuals not exposed to the risk factor, and following the two groups over time to determine the occurrence of a disease. Its strengths include that multiple outcomes can be measured for anyone's exposure, and unlike a cross-sectional study, it can measure both incidence and prevalence of a disease. The weaknesses associated with this study are that it is costly, time-consuming, and prone to bias due to loss of follow up. Additionally, there is the risk of participants moving between one exposure category and the participants' behavior being altered by being in the study.

The third method is the randomized controlled trial study design, which falls under the broad group of interventional studies, usually done in laboratories and clinical studies and trials to determine the effects of drugs or procedures. It is mostly employed to determine the cause-effect relationship between an intervention and an outcome. The strengths of this study include the fact that it is most suitable for assessing the effectiveness of a response from an epidemiological study and that additionally, it provides a strong basis for statistical reference. On the flip side, it is costly, time-consuming, and there is a threat of generalisability from the fact that results might not necessarily be representative of all individuals.

Cross-Sectional Study Analysis

The objective of this study was to determine the relationship between time perspective and hazardous alcohol consumption. Concerning time perspective, individuals who have a more future-oriented time perspective tend to consider the future outcomes of their present actions, unlike their counterparts with a more present-oriented time perspective.

The study was a cross-sectional study of the association between future time perspective and hazardous alcohol consumption, which took place from February to April 2008 in two faculties at a University in Northern England, UK.

The participants were three hundred and twenty-two undergraduate students. Any student registered in a course with a taught component was eligible to take part in the study. For the recruitment of the participants, Deans in the two Faculties of Humanities and Social Science and Agriculture and Engineering invited staff to volunteer a few minutes of their lecture time into the study. The lecturers who heeded to the call made available a lecture of their choice, and students registered for these lectures were invited to take part in the survey. The background characteristics considered in this study were the participants' ages, genders, years of research, religions, ethnicity, and socio-economic position. For gender, there were both men and women; for the year of study, there were first, second, and third-year students; for religion, there were atheists, Christians, and others, while for ethnic groups, there were White British and others.

The research took place through the distribution of questionnaires to the participants. The variables in the surveys were future time perspective and hazardous alcohol consumption. Future time perspective was measured using the Consideration of Future Consequences Scale. Higher scores in the scale indicate a more significant consideration of future consequences for immediate actions, while a lower score would indicate less attention to future outcomes. Hazardous Alcohol Consumption, on the other hand, was measured using the Alcohol Use Disorders Identification Test (AUDIT). The scale identified harmful and hazardous drinking, as well as the possibility of dependence. Any score greater than or equal to eight (8) marked dangerous alcohol consumption.

The key findings in this cross-sectional study were that the undergraduate student participants with a more oriented future time perspective were less likely to score above the threshold that marked hazardous alcohol consumption. On the contrary, a higher incidence of dangerous alcohol consumption was found in students who had less oriented future time perspectives.

The strengths of the study to include well-tested and thus more accurate and reliable measures employed to determine future time perspective (the Consideration of Future Consequences Scale) and hazardous alcohol consumption (the Alcohol Use Disorders Identification Test).

Limitations identified included the setting in which the data was collected, which may have allowed bias on the grounds of social desirability since it was impossible to be entirely sure that the participants did not discuss the answers before completing the questionnaires. There was also the possibility of the participants underreporting or over-reporting their alcohol consumption to suit social norms. Another limitation was the possibility of non-response bias since only 70% of students registered for the lectures took part in the study, unlike the 97% attendance rate. Additionally, religious and ethnic groups in small numbers were lumped together, which leads to the possibility of inaccurate statistics. Finally, data obtained was entirely cross-sectional, and no conclusion could, therefore, be drawn on the direction of causation between future time perspective and alcohol consumption.

The authors indicate the value of the research to be as hypothesized, that future time perspective is related to hazardous alcohol consumption, and that students with more future-oriented time perspective were less likely to meet the threshold of dangerous alcohol consumption. The authors, however, acknowledge that the findings cannot be confirmed to be generalizable due to the limitations discussed. Finally, the authors recommend the implementation of interventions to help students focus more on the future outcomes of their immediate actions if it is confirmed that future time perspective is indeed related to hazardous alcohol consumption.

Cohort Study Analysis

The study aimed to determine which factors affect alcohol counseling practices among medical students. Three core questions were asked: For about how many days in the past month, did you drink an alcoholic beverage? On average, on the days that you drank, about how many drinks did you take? In the past month, how often did you have five or more drinks on one occasion?

The study here was a cohort study done on medical students in 16 US medical schools, who graduated in the year 2003. All medical students graduating in the year 2003 were eligible to participate in the study, which was to occur in three parts: in the first year of orientation (summer/autumn 1999), entrance towards (usually in the second or third year, depending on the school) and in the final year. The background characteristics of the participants were age, gender, ethnicity, and marital status, among other considerations like school size, medical school research ranking from the US National Institutes of Health, the strength of religious identity, and whether the medical school was private or public. Forage, the average age was 24 years for first-year students; the genders used in the study were both female and male, while for ethnicity, there was Black/African American, Asian, Hispanic, White, and Other. Concerning marital s...