Integrating Epidemiology Education into Your Existing Curriculum Reading High School, April 12, 2008 Young Epidemiology Scholars Teaching Units Welcome.

Integrating Epidemiology Education into Your Existing Curriculum Reading High School, April 12, 2008 Young Epidemiology Scholars Teaching Units Welcome to the Professional Development Workshop

YES Teaching Units Professional Development Workshop Handout

YES Teaching Units Professional Development Workshop

To increase the frequency with which the YES Teaching Units are taught Workshop Goal YES Teaching Units Professional Development Workshop

At the conclusion of the workshop, participants will have become more: YES Teaching Units Professional Development Workshop Workshop Objectives 1.Enthusiastic about the prospect of teaching epidemiology. 2.Likely to be an advocate for teaching epidemiology. 3.Knowledgeable about the science of epidemiology. 4.Capable of teaching epidemiology. 5.Likely to teach epidemiology in the next three months. 6.Likely to use the YES Teaching Units when teaching epidemiology.

YES Teaching Units Professional Development Workshop Pre-Workshop Assessment Handout

1.Coherently describe the 12 enduring understandings that are fundamental to epidemiologic thinking. 2.Coherently and thoroughly describe how epidemiologic thinking makes it possible to identify patterns of health and disease in populations and formulate hypotheses to explain those patterns. 3.Teach two YES Teaching Units, from the perspectives of the disciplines of social studies, language arts, science, and mathematics, so that their students develop a comprehensive understanding of enduring understandings 2 and 3. YES Teaching Units Professional Development Workshop Workshop Objectives At the conclusion of the June 12 workshop, participants will be able to:

To create “… a professional community that discusses new teacher materials and strategies and that supports the risk taking and struggle entailed in transforming practice.” YES Teaching Units Professional Development Workshop Workshop Goal

To create “… a professional community that discusses new teacher materials and strategies and that supports the risk taking and struggle entailed in transforming practice.” YES Teaching Units Professional Development Workshop Workshop Goal YES Teaching Units Professional Development Workshop Introductions Name Tents Permissions

DZ Epidemiology is … YES Teaching Units Professional Development Workshop

… the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems. YES Teaching Units Professional Development Workshop Epidemiology is …

YES Teaching Units Professional Development Workshop Epidemiology is … “… the blending of population thinking and group comparisons in an integrated theory to appraise health-related causal relationships characterizes epidemiology.”

Handout Epidemiology is …

YES Teaching Units Professional Development Workshop Teaching / Learning Epidemiology

1. 2. 3. 4. 5. 6. 7. 8.. Empowers students to be scientifically literate participants in the democratic decision-making process concerning public health policy. Empowers students to make more informed personal health-related decisions. Increases students’ media literacy and their understanding of public health messages. Increases students’ understanding of the basis for determining risk. Improves students’ mathematical and scientific literacy. Expands students’ understanding of scientific methods and develops their critical thinking skills. Provides students with another mechanism for exploring important, real world questions about their health and the health of others. Introduces students to an array of career paths related to the public’s health. Top 8 Reasons to Teach / Learn about Epidemiology YES Teaching Units Professional Development Workshop

http://www.asph.org/document.cfm?page=1038

Goal Over a four year period, create a model Public Health School-to-Career Path in four Newark (NJ) high schools that motivates and prepares students to enter college public health programs and, upon graduation, enter the public health workforce. Professional Development ● Teachers attend professional development workshop addressing the four core courses ● Teachers shadow college professors teaching the core courses ● Teachers, with the college professors, team teach the core courses ● Teachers team teach the core courses Curriculum Development ● Develop four core: Introduction to Public Health, Introduction to Epidemiology, Health Disparities, and Health, Policy, and Politics ● Develop field study experience that immerses students in public health work in Newark and surrounding area and for which they are compensated. Process Evaluation ● Collaborations with stakeholders ● From electives to core courses ● Attract appropriate number of academically-able students Academic Outcomes Evaluation ● Core courses Grades ● Non-core course grades ● Field experience evaluation ● Intention to enter the field of public health Draft 1 Public Health School-to-Career Path (www.nps.k12.nj.us/HighSchoolResourceGuide.doc)

Workshop Objective YES Teaching Units Professional Development Workshop

YES Teaching Units Professional Development Workshop Handout

YES Teaching Units Working Group Diane-Marie St. George, Manuel Bayona, David Fraser, Mark Kaelin, Felicia McCrary, Flora Ichiou Huang, Mona Baumgarten, Chris Olsen, and Paul Stolley YES Teaching Units Professional Development Workshop YES Teaching Units

Stand Alone / Pick One Off the Shelf YES Teaching Units Professional Development Workshop YES Teaching Units

Professional Development Workshop

Stand Alone / Pick One Off the Shelf YES Teaching Units Professional Development Workshop YES Teaching Units

YES Teaching Units Professional Development Workshop http://www.montclair.edu/YESteachingunits/index.html YES Teaching Units

YES Teaching Units Professional Development Workshop http://www.collegeboard.com/yes/index.html YES Teaching Units

YES Teaching Units Professional Development Workshop YES Teaching Units Handout

Scholarship Creativity YES Teaching Units Professional Development Workshop YES Teaching Units

Team 2 Slave Trade Team 1 Casualties of War Teaching the Teaching Units YES Teaching Units Professional Development Workshop

Report and Reflection Log YES Teaching Units Professional Development Workshop Handout http://www.montclair.edu/YESteachingunits/YESRandRform.php

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Pedagogical Basis YES Teaching Units Professional Development Workshop

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that experts’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ Pedagogical Basis YES Teaching Units Professional Development Workshop

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that experts’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to experts’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. Pedagogical Basis YES Teaching Units Professional Development Workshop

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that experts’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to experts’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … experts’ strategies for thinking and solving problems are closely linked to rich, well- organized bodies of knowledge about subject matter. Pedagogical Basis YES Teaching Units Professional Development Workshop

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that experts’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to experts’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … experts’ strategies for thinking and solving problems are closely linked to rich, well- organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable. Pedagogical Basis YES Teaching Units Professional Development Workshop

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that teachers’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to teachers’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … teachers’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable. Pedagogical Basis YES Teaching Units Professional Development Workshop

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that students’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to students’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … students’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable. Pedagogical Basis YES Teaching Units Professional Development Workshop

A rich body of content knowledge about a subject area is a necessary component of the ability to think and solve problems in the domain, but knowing many disconnected facts is not enough. Research clearly demonstrates that teachers’ content knowledge is structured around the major organizing principles and core concepts of the domain, the ‘big ideas.’ These big ideas lend coherence to teachers’ vast knowledge base; help them discern the deep structure of problems; and, on that basis, recognize similarities with previously encountered problems. … teachers’ strategies for thinking and solving problems are closely linked to rich, well-organized bodies of knowledge about subject matter. Their knowledge is connected and organized, and it is “conditionalized” to specify the context in which it is applicable. Pedagogical Basis YES Teaching Units Professional Development Workshop … the ‘big ideas.’

To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding other things like it that one may encounter. Jerome Bruner, The Process of Education, 1960 will YES Teaching Units Professional Development Workshop Enduring Epidemiological Understandings

Enduring Understandings YES Teaching Units Professional Development Workshop National Research Council, Learning and Understanding “… distinguish between foundational concepts and elaborations or illustrations of those ideas.”

Enduring Understandings YES Teaching Units Professional Development Workshop

Associated TiedRelated Linked Enduring Understandings YES Teaching Units Professional Development Workshop

Suicide Higher in Areas with Guns Smoking Linked to Youth Eating Disorders Snacks Key to Kids’ TV- Linked Obesity: China Study Family Meals Are Good for Mental Health Lack of High School Diploma Tied to US Death Rate Study Links Spanking to Aggression Breakfast Each Day May Keep Colds Away Study Concludes: Movies Influence Youth Smoking Study Links Iron Deficiency to Math Scores Kids Who Watch R-Rated Movies More Likely to Drink, Smoke Pollution Linked with Birth Defects in US Study Depressed Teens More Likely to Smoke Enduring Understandings YES Teaching Units Professional Development Workshop

What do we mean when we say that there is an association between two things? Associated TiedRelated Linked Things that are associated are linked in some way that makes them turn up together. Enduring Understandings YES Teaching Units Professional Development Workshop

Things that are associated are linked in some way that makes them turn up together. Enduring Understandings YES Teaching Units Professional Development Workshop

Handout Enduring Understandings YES Teaching Units Professional Development Workshop

Total No Coffee Coffee Pancreatic Cancer Label the table Enduring Understandings YES Teaching Units Professional Development Workshop

Place the data into the table 15 5 20 No Coffee Pancreatic Cancer Coffee Total Enduring Understandings YES Teaching Units Professional Development Workshop

15 5 20 No Coffee Pancreatic Cancer Coffee Total Enduring Understandings YES Teaching Units Professional Development Workshop

Which of the following statements can be made based on the above data: A: 15 of 20 patients, who had pancreatic cancer, drank coffee. B: 15 of 20 patients, who drank coffee, had pancreatic cancer. 15 5 20 No Coffee Pancreatic Cancer Coffee Total Enduring Understandings

Odds A ratio of the probability of occurrence of an event to that of its nonoccurrence. Enduring Understandings YES Teaching Units Professional Development Workshop

15 5 No Coffee Pancreatic Cancer Coffee Total A ratio of the probability of occurrence of an event to that of its nonoccurrence. 15 to 5 or 3 to 1 Odds 20 Enduring Understandings YES Teaching Units Professional Development Workshop

15 5 No Coffee Pancreatic Cancer Coffee Total 15 to 5 or 3 to 1 20 Study Links Coffee Use to Pancreatic Cancer Enduring Understandings YES Teaching Units Professional Development Workshop

15 5 No Coffee Pancreatic Cancer Coffee Total 15 to 5 or 3 to 1 20 Nothing Study Links Coffee Use to Pancreatic Cancer Enduring Understandings YES Teaching Units Professional Development Workshop

CompareDivideCount Enduring Understandings YES Teaching Units Professional Development Workshop

15 5 No Coffee Pancreatic Cancer Coffee Total 15 to 5 or 3 to 1 20 Nothing Compared to what? Enduring Understandings YES Teaching Units Professional Development Workshop

15 5 No Coffee Pancreatic Cancer Coffee Total 15 to 5 or 3 to 1 20 Nothing Compared to what? No Pancreatic Cancer Enduring Understandings YES Teaching Units Professional Development Workshop

Case-Control Study A type of observational analytical epidemiological investigation in which the subjects are selected on the basis of whether they do (cases) or do not (controls) have a particular disease under study. The groups are compared with respect to the proportion having a history of an exposure or characteristic of interest. Enduring Understandings YES Teaching Units Professional Development Workshop

Case-Control Study Time DZ E E E E Enduring Understandings YES Teaching Units Professional Development Workshop

15 5 No Coffee Pancreatic Cancer Coffee Total 15 to 5 or 3 to 1 20 No Pancreatic Cancer 10 30 40 10 to 30 or 1 to 3 Enduring Understandings YES Teaching Units Professional Development Workshop Place the data into the 2x2 Table

15 5 No Coffee Pancreatic Cancer Coffee Total 15 to 5 or 3 to 1 20 No Pancreatic Cancer 10 30 40 10 to 30 or 1 to 3 What mathematical computation would allow them to complete the statement: The odds of drinking coffee were ____ times greater among patients who had pancreatic cancer compared to patients who did not have pancreatic cancer. What mathematical computation would allow you to complete the statement: Enduring Understandings

15 5 No Coffee Pancreatic Cancer Coffee Total 15 to 5 or 3 to 1 20 No Pancreatic Cancer 10 30 40 10 to 30 or 1 to 3 What mathematical computation would allow them to complete the statement: The odds of drinking coffee were ____ times greater among patients who had pancreatic cancer compared to patients who did not have pancreatic cancer. 3 / 1 = 3 1 / 3 =.33 3 /.33 = 9 9 Enduring Understandings

Odds Ratio Ratio of odds in favor of exposure among cases to the odds in favor of exposure among controls. Relative Odds Enduring Understandings YES Teaching Units Professional Development Workshop

15 5 No Coffee Pancreatic Cancer Coffee Total 15 to 5 or 3 to 1 20 No Pancreatic Cancer 10 30 40 10 to 30 or 1 to 3 What mathematical computation would allow them to complete the statement: The odds of drinking coffee were ____ times greater among patients who had pancreatic cancer compared to patients who did not have pancreatic cancer. 3 / 1 = 3 1 / 3 =.33 3 /.33 = 9 9 Study Links Coffee Use to Pancreatic Cancer Enduring Understandings

15 5 No Coffee Pancreatic Cancer Coffee Total 20 No Pancreatic Cancer What mathematical computation would allow them to complete the statement: The odds of drinking coffee were ____ times greater among patients who had pancreatic cancer compared to patients who did not have pancreatic cancer. 35 5.43 Odds Ratio 40 Study Links Coffee Use to Pancreatic Cancer Enduring Understandings

15 5 No Coffee Pancreatic Cancer Coffee Total 20 No Pancreatic Cancer What mathematical computation would allow them to complete the statement: The odds of drinking coffee were ____ times greater among patients who had pancreatic cancer compared to patients who did not have pancreatic cancer. 40 30 10 1 Odds Ratio Study Links Coffee Use to Pancreatic Cancer Enduring Understandings

347 20 No Coffee Pancreatic Cancer Coffee Total 367 No Pancreatic Cancer What mathematical computation would allow them to complete the statement: The odds of drinking coffee were ____ times greater among patients who had pancreatic cancer compared to patients who did not have pancreatic cancer. 643 555 88 2.75 Odds Ratio Study Links Coffee Use to Pancreatic Cancer Enduring Understandings

Timeline Cohort Study Randomized Controlled Trial Timeline Case-Control Study Timeline Cross-Sectional Study Timeline E E O O O O E E E E Healthy People E Random Assignment E O O O O Healthy People E E O O O O 4 Basic Epidemiological Study Designs Enduring Understandings YES Teaching Units Professional Development Workshop

1.Cause 2.Confounding 3.Reverse Time Order 4. Chance 5.Bias Study Links Coffee Use to Pancreatic Cancer Enduring Understandings YES Teaching Units Professional Development Workshop

Enduring Understandings YES Teaching Units Professional Development Workshop Handout

Does evidence from an aggregate of studies support a cause-effect relationship? Study Links Coffee Use to Pancreatic Cancer 1. What is the strength of the association between the risk factor and the disease? 2. Can a biological gradient be demonstrated? 3. Is the finding consistent? Has it been replicated by others in other places? 4. Have studies established that the risk factor precedes the disease? 5. Is the risk factor associated with one disease or many different diseases? 6. Is the new finding coherent with earlier knowledge about the risk factor and the m disease? 7. Are the implications of the observed findings biological sensible? 8. Is there experimental evidence, in humans or animals, in which the disease has m been produced by controlled administration of the risk factor? Enduring Understandings YES Teaching Units Professional Development Workshop

All scientific work is incomplete – whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us the freedom to ignore the knowledge we already have, or to postpone the action that it appears to demand at a given time. Sir Austin Bradford Hill Enduring Understandings YES Teaching Units Professional Development Workshop

Other risks that are created by implementing a risk management strategy. Offsetting Effects Enduring Understandings YES Teaching Units Professional Development Workshop

Handout

YES Teaching Units * *

“In general, exceptional teachers begin with simple generalizations and then move toward both complexity and specificity. They use familiar language before trying to introduce specialized vocabulary.” Ken Bain, What the Best College Teachers Do “In general, exceptional teachers begin with simple generalizations and then move toward both complexity and specificity. They use familiar language before trying to introduce specialized vocabulary.” Ken Bain, What the Best College Teachers Do Enduring Understandings YES Teaching Units Professional Development Workshop

Enduring Understandings 2 and 3

5 “W” Questions What? Who? Where? When? Why?

When investigating a crime, police detectives attempt to answer the 5 “W” questions. Detectives want to know “whodunit” so that they can stop the crime from happening again.

When investigating disease occurrence, epidemiologists attempt to answer the 5 “W” questions. Epidemiologists want to know “whatdunit” so that they can stop or slow down the disease occurrence.

Snow on Cholera The “father” of Epidemiology The “father” of Epidemiology Classic Epidemiologic Investigation, 1854 Classic Epidemiologic Investigation, 1854 At the time, the predominant theory of disease causation was the miasma theory—disease came from bad air At the time, the predominant theory of disease causation was the miasma theory—disease came from bad air

Snow investigation: Which Ws did he know? At 2 Emerson Place, on 3 rd August, the wife of an engineer, aged 30, cholera 2 days, Southwark and Vauxhall. At 2 Emerson Place, on 3 rd August, the wife of an engineer, aged 30, cholera 2 days, Southwark and Vauxhall. At 34 Charlotte Street, on 29 th July, a stockmaker, aged 29, cholera 18 hours, Lambeth. At 34 Charlotte Street, on 29 th July, a stockmaker, aged 29, cholera 18 hours, Lambeth.

http://www.ph.ucla.edu/epi/sn ow/outbreak/outbreakUNC.ht ml

Source: Health US 2007

Transatlantic slave trade Inhumane conditions on slave ships Inhumane conditions on slave ships Discussion of mortality onboard Discussion of mortality onboard Activity designed to get them to consider the descriptive epidemiology of slave ship mortality Activity designed to get them to consider the descriptive epidemiology of slave ship mortality Person, place and time factors considered: Person, place and time factors considered:  Gender  Country of origin  Length of voyage

5 “W” Questions What? Health condition: disease, wellness, injury, disability Who? Person: age, gender, race/ethnicity, religion, diet, behaviors Where? Place: rurality, country, city When? Time: annual cycles, long-term trends, time of day Why? 1. Generate hypotheses 2. Analytic epidemiology

Remember that epidemiology is “the study of the distribution and determinants of health- related states or events in specified populations and the application of this study to the control of health problems”.  Descriptive epidemiology  Describe the distribution of a health condition  Generate hypotheses about determinants of disease  Analytic epidemiology  Test hypotheses about determinants of disease

Surveillance “…the ongoing systematic collection, analysis and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control” Thacker & Berkelman, 1988

Purpose of Surveillance Estimate magnitude of the problem Estimate magnitude of the problem Determine geographic distribution of illness Determine geographic distribution of illness Portray the natural history of a disease Portray the natural history of a disease Detect epidemics/define a problem Detect epidemics/define a problem Generate hypotheses, stimulate research Generate hypotheses, stimulate research Evaluate control measures Evaluate control measures Monitor changes in infectious agents Monitor changes in infectious agents Detect changes in health practices Detect changes in health practices Facilitate planning Facilitate planning Source: Slide from CDC Public Health Surveillance http://www.cdc.gov/ncphi/disss/nndss/phs/overview.htm

Surveillance Events Outcomes: STDs, lead poisoning, birth defects, cancer, infant mortality, LCDs, motor vehicle fatalities, occupational injuries Outcomes: STDs, lead poisoning, birth defects, cancer, infant mortality, LCDs, motor vehicle fatalities, occupational injuries Risk factors: Smoking, nutrition, screening tests, physical activity Risk factors: Smoking, nutrition, screening tests, physical activity Hazards: Pollutants, toxic chemicals Hazards: Pollutants, toxic chemicals

Sources of Surveillance Data State/Local Health Department State/Local Health Department CDC CDC Birth and Death certificates Birth and Death certificates Laboratories Laboratories Hospital billing databases Hospital billing databases Providers’ offices Providers’ offices

Sources of Surveillance Data Registries Registries  State and national (SEER) cancer  WTC health registry 71k to be followed for 20 years  Nagasaki and Hiroshima being followed since the late 1950s

Nagasaki and Hiroshima Create timeline of key events of WWII Create timeline of key events of WWII Events leading to end of WWII Events leading to end of WWII Short- and long-term consequences of war > morbidity and mortality Short- and long-term consequences of war > morbidity and mortality Surveillance of bomb survivors Surveillance of bomb survivors Introduce surveillance data Introduce surveillance data

Cancer surveillance data (1977-1979) Incidence rate/100,000 Males Males Hiroshima239.6 Nagasaki257.6 All of Japan 209.4 Females Females Hiroshima162.3 Nagasaki175.9 All of Japan 138.5

Which one shows evidence of a relationship between radiation exposure and increased risk of cancer?

Disease rates vs disease counts Adjustment for alternate explanations (city, sex, age) for the radiation-cancer association

YES Teaching Units Professional Development Workshop Enduring Understandings … the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.

Descriptive epidemiology in the classroom Demonstration of a student exercise

Video Review Hiroshima

YES Teaching Units Professional Development Workshop Video Review

“They can then use that ability to think about their own thinking … to grasp how other people might learn. They know what has to come first, and they can distinguish between foundational concepts and elaborations or illustrations of those ideas.” YES Teaching Units Professional Development Workshop Metacognition

“They realize where people are likely to face difficulties developing their own comprehension ….” Metacognition YES Teaching Units Professional Development Workshop

“… and they can use that understanding to simplify and clarify complex topics for others, tell the right story, or raise a powerfully provocative question.” Metacognition YES Teaching Units Professional Development Workshop

Understanding by Design Handout

Reading Health Department - Larry Sunburg YES Teaching Units Professional Development Workshop

At first glance these articles are about _____________________________ but, based on our understanding of epidemiology, we can see that they are about person, place, and time, counting, dividing, and comparing, numerators and denominators, associations, causation, confounding, prevention, and policy. coffee and pancreatic cancer

At first glance these articles are about _____________________________ but, based on our understanding of epidemiology, we can see that they are about person, place, and time, counting, dividing, and comparing, numerators and denominators, associations, causation, confounding, prevention, and policy. a Bausch & Lomb lens solution YES Teaching Units Professional Development Workshop

At first glance these articles are about _____________________________ but, based on our understanding of epidemiology, we can see that they are about person, place, and time, counting, dividing, and comparing, numerators and denominators, associations, causation, confounding, prevention, and policy. E. Coli and spinach

Give people fish, they have food for a day, Teach people how to fish, they have food for a lifetime. YES Teaching Units Professional Development Workshop

To understand something as a specific instance of a more general case … is to have learned not only a specific thing but also a model for understanding other things like it that one may encounter. J. Bruner, The Process of Education, 1960 Understanding will YES Teaching Units Professional Development Workshop

Team 2 Slave Trade Team 1 Casualties of War Teaching the Teaching Units YES Teaching Units Professional Development Workshop

”… they can distinguish between foundational concepts and elaborations or illustrations of those ideas.” YES Teaching Units Professional Development Workshop Post-Workshop Assessment

1.Coherently describe the 12 enduring understandings that are fundamental to epidemiologic thinking. 2.Coherently and thoroughly describe how epidemiologic thinking makes it possible to identify patterns of health and disease in populations and formulate hypotheses to explain those patterns. 3.Teach two YES Teaching Units, from the perspectives of the disciplines of social studies, language arts, science, and mathematics, so that their students develop a comprehensive understanding of enduring understandings 2 and 3. YES Teaching Units Professional Development Workshop Workshop Objectives At the conclusion of the June 12 workshop, participants will be able to:

YES Teaching Units Professional Development Workshop Post-Workshop Assessment Post-Workshop Questionnaire

Thank You Integrating Epidemiology Education into Your Existing Curriculum Reading High School, April 12, 2008 Young Epidemiology Scholars Teaching Units Professional Development Workshop

Enduring Understandings 2 and 3

5 “W” Questions What? Who? Where? When? Why?

When investigating a crime, police detectives attempt to answer the 5 “W” questions. Detectives want to know “whodunit” so that they can stop the crime from happening again.

When investigating disease occurrence, epidemiologists attempt to answer the 5 “W” questions. Epidemiologists want to know “whatdunit” so that they can stop or slow down the disease occurrence.

Snow on Cholera The “father” of Epidemiology Classic Epidemiologic Investigation, 1854 At the time, the predominant theory of disease causation was the miasma theory—disease came from bad air

Snow investigation At 2 Emerson Place, on 3 rd August, the wife of an engineer, aged 30, cholera 2 days, Southwark and Vauxhall. At 34 Charlotte Street, on 29 th July, a stockmaker, aged 29, cholera 18 hours, Lambeth.

http://www.ph.ucla.edu/epi/sn ow/outbreak/outbreakUNC.ht ml

Activity Each pair of teachers will receive a case study –What patterns do you see? Who? What? Where? When? –Why do you think the patterns appear that way? Example: ADHD

Activity Each pair of teachers will receive a case study –What patterns do you see? Who? What? Where? When? –Why do you think the patterns appear that way? Please take about ten minutes to review the assigned data

Activity –What patterns do you see? Who? What? Where? When? –Why do you think the patterns appear that way?

5 “W” Questions What?Health condition: disease, wellness, injury, disability Who?Person: age, gender, race/ethnicity, religion, diet, behaviors Where?Place: rurality, country, city When?Time: annual cycles, long-term trends, time of day Why?1. Generate hypotheses 2. Analytic epidemiology

Remember that epidemiology is “the study of the distribution and determinants of health- related states or events in specified populations and the application of this study to the control of health problems”. –Descriptive epidemiology Describe the distribution of a health condition Generate hypotheses about determinants of disease –Analytic epidemiology Test hypotheses about determinants of disease

Surveillance “…the ongoing systematic collection, analysis and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those responsible for prevention and control” Thacker & Berkelman, 1988

Purpose of Surveillance Estimate magnitude of the problem Determine geographic distribution of illness Portray the natural history of a disease Detect epidemics/define a problem Generate hypotheses, stimulate research Evaluate control measures Monitor changes in infectious agents Detect changes in health practices Facilitate planning Source: Slide from CDC Public Health Surveillance http://www.cdc.gov/ncphi/disss/nndss/phs/overview.htm

Surveillance Events Outcomes: STDs, lead poisoning, birth defects, cancer, infant mortality, LCDs, motor vehicle fatalities, occupational injuries Risk factors: Smoking, nutrition, screening tests, physical activity Hazards: Pollutants, toxic chemicals

Types of Surveillance Systems Passive surveillance –agency waits to receive case reports Active surveillance –agency contacts to providers, labs, etc.

Sources of Surveillance Data State/Local Health Department CDC Death certificates Birth certificates Fire incident reports Laboratories Hospital billing databases Providers’ offices

YES Teaching Units Professional Development Workshop Enduring Understandings … the big ideas that reside at the heart of a discipline and have lasting value outside the classroom.

Descriptive epidemiology in the classroom Demonstration of a student exercise

YES Teaching Units Professional Development Workshop *

Enduring Epidemiological Understandings YES Teaching Units Professional Development Workshop

Learners “… presented with vast amounts of content knowledge that is not organized into meaningful patterns are likely to forget what they have learned and to be unable to apply the knowledge to new problems or unfamiliar contexts.” National Research Council, Learning and Understanding Learners “… presented with vast amounts of content knowledge that is not organized into meaningful patterns are likely to forget what they have learned and to be unable to apply the knowledge to new problems or unfamiliar contexts.” National Research Council, Learning and Understanding YES Teaching Units Professional Development Workshop

Diane Marie

YES Teaching Units Professional Development Workshop Video Review

YES Teaching Units

Integrating Epidemiology Education into Your Existing Curriculum Reading High School, April 12, 2008 Young Epidemiology Scholars Teaching Units Welcome.

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Integrating Epidemiology Education into Your Existing Curriculum Reading High School, April 12, 2008 Young Epidemiology Scholars Teaching Units Welcome.

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