1. Compare and contrast clinical health services to public health and epidemiology in terms of a) how they are defined, b) goals, c) their target focus and d) functions.
  2. Managerial epidemiology is integrated through general management functions. Explain each of the management functions in terms of the managerial epidemiology, i.e., what are the:
  1. Planning functions, example(s)?
  2. Directing functions, example(s)?
  3. Controlling functions, example(s)?
  4. Organizing functions, example(s)?
  5. Financing function, example(s)?
  6. Describe the “natural history of disease” and disease progression from its inception to its resolution
  7. What are some of the many epidemiologic contributions to quality assurance in healthcare and public health?
  8. December 31, 2009:  A 48 year old male computer technician with hypertension, smoker, sedentary lifestyle, who does not do any aerobic exercise, enjoys fast food, eating it three times per day, with a family history of coronary artery disease (CAD), and a personal history of high cholesterol has a stressful deadline at work, which requires him to travel 17 hours on a plan to go on location in Australia.  Unfortunately, he suffers an acute myocardial infarction in route to location and dies.  He is now part of our epidemiology population mortality statistics.  Calculate the U.S. Mortality Rates, which includes our computer technician in terms of crude rate of mortality, adjusted mortality rates and cause-Specific mortality rate using the 2009 statistics.

    Input Data for Calculations:
    ___________________

-2009 U.S. Census: 305,529,237 Total
-2009 U.S. Census:  Males 148,094,000
-2009 U.S. Census:  Females 153,388,000
Population by Age and Sex: 2009
Age Both sexes Male Female
Number Percent Number Percent Number Percent
   .35 to 39 20,445 6.8 10,169 6.9 10,275 6.7
   .40 to 44 20,877 6.9 10,322 7.0 10,556 6.9
   .45 to 49 22,712 7.5 11,162 7.5 11,550 7.5
   .50 to 54 21,654 7.2 10,611 7.2 11,043 7.2
   .55 to 59 18,755 6.2 9,083 6.1 9,671 6.3
___________________
-2009 U.S. Deaths:  2,436,682
-2009 U.S. Male Deaths 1,217,047
-2009 U.S. Female Deaths 1,219,635
___________________
2009 Deaths By Gender/Age All races, male

All ages……………1,217,047
1-4 years………………14,872
5-14 years………………2,507
15-24 years…….………3,244
25-34 years…..………22,294
35-44 years……………29,150
45-54 years……………46,498
55-64 years…….……114,615
65-74 years…….……183,945
75-74 years…….……225,740
75-84 years…….……311,135
>=85  years…….……262,839
Not stated……………………206

2009 CVD/ Heart Attack Mortality,

Male/Age

Age (All) 186,464
35-44 55,957
45-54 115,615
55-64 276,844
65-74 677,598

Source:  CDC (2009)

________________

Case Questions:

a. Calculate the Crude mortality rate for the entire U.S. in 2009.

b. Calculate a total adjusted mortality rates by gender for all men (males-only).

c. Calculate an age/sex adjusted mortality rate using the demographics of the diseased computer technician.

d. Compare b) morality rate calculated with c) mortality rate calculated.  Is the adjusted mortality rate for males, age 45-54 years of age higher or lower than for all males, all ages?

e. Calculate a Cause-Specific mortality rate for deaths related to Cardiovascular Disease (Heart Attacks), using the demographics of our computer technician.

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