Demographic And Epidemiological Assessment

Week 2: Demographic and Epidemiological Assessment No unread replies.No replies. For this discussion, you will collect assessment data about your city or county. This post will include information about demographics (general characteristics) and epidemiological data (disease or health behavior rates) of your community.Demographic data: Go online to the U.S. Census Bureau at (Links to an external site.)Links to an external site..Demographic And Epidemiological Assessment Obtain a range information about the demographic characteristics of the population for your city or county of residence. You may have to look at county data if your city is not listed. Discuss demographic data about age, ethnicity, poverty levels, housing, and education.Epidemiological data: Go to your city or county health department website (search the Internet) or County Health Rankings ( (Links to an external site.)Links to an external site.) and report epidemiological data about your area.Identify several priority health concerns for your area.The Instructions on Finding Demographic Data on the U.S. Census Website (Links to an external site.)Links to an external site. will assist you in using this website as a resource.Nies, M. A., & McEwen, M. (2015). Community/Public health nursing: Promoting the health of populations(6th ed.). St. Louis, MO: Saunders/Elsevier.       Demographic And Epidemiological Assessment

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In analyzing “disability” or “functional impairment” among subgroups of the U.S. population, the elderly and oldest-old populations require special attention. Special attention is necessary both because, the elderly represent by far the largest numbers of disabled persons, but perhaps more critically, they are the population group for which defining disability and functional impairment is most difficult. This is because, until relatively recently, both popular concepts and the scientific literature have tended to viewed functional loss as a necessary and nearly universal correlate of the aging process.

More recent research on aging has challenged the inevitability of the linkage of severe functional loss and impairment with age. A number of new studies have shown that the age rate of decline of physiological parameters and function with age found in prior studies was, in part, a product of flaws in the design of many of those studies (e.g., Lakatta, 1985). Specifically, in many of the older studies “representative” samples of elderly were selected. Since the prevalence of chronic disease, both manifest and latent, tends to increase with age, a large part of the functional loss with age in the older studies reflected the effects of an increasing prevalence of chronic disease on function–not the “natural concomitants” of aging itself.

Many newer studies are specifically designed to unconfound the effects of chronic disease and aging by carefully screening for the presence of both latent and manifest disease (e.g., Lakatta, 1985). These studies show that many physiological functions can be preserved to greater age’s than previously thought.Demographic And Epidemiological Assessment Other studies have shown that there is great individual variation in the trajectory of functional loss with age which depends upon the type of chronic disease affecting the individual. These studies of the so-called “terminal drop” show that the rate of physical and cognitive functional decline before death at advanced is often quite rapid producing, in some groups of elderly individuals, very short periods of impairment (e.g., Manton, Siegler and Woodbury, 1986). In addition other studies have shown that many mechanisms emerge at later ages which compensate for specific types of functional loss, and that there is a much greater potential for rehabilitation and regaining function at advanced ages than previously supposed (World Health Organization, 1982). In sum, the current scientific evidence suggests that though there is certainly a strong correlation of functional loss with age, function can (by appropriate early preventive actions) be preserved to more advanced ages and at higher levels than was previously believed, that individuals show considerable variability in the rate at which functional losses occur, and that interventions can help improve functional status at later ages for many individuals.

This evidence suggests that the past acceptance as “natural” of age-related loss of function and disability among the elderly has been counterproducrive–a type of self-fulfilling prophecy–and that a more active statice should be adopted to attempting to preserve function at later ages. This stance must be reflected in changes both in the medical and institutional response to disability and chronic disease among the elderly and in the self-concepts accepted by many elderly themselves.Demographic And Epidemiological Assessment

The evidence also suggests the need for more active research into the lifestyle and other risk factors of functional loss (e.g., Manton, 1989). Specifically, much of the past epidemiological investigation of chronic disease risk factors has focused upon the identification and control of risk factors for acute lethal conditions–especially those affecting middle-aged males. Because of this research emphasis medical science has been reasonably successful in identifying risk factors (e.g., blood pressure, serum cholesterol, smoking, obesity) for lethal conditions like coronary heart disease, stroke, and cancer. In addition to identifying the risk factors for these diseases, considerable progress has occurred in the development of medical and pharmacological technologies to control those factors. For example, there are now four major classes of anti-hypertensive agents (i.e., diuretics, beta blockers, ACE inhibitors, calcium channel blockers) which can be used singly, or in specific combinations, for different types of hypertension. By responding to very specific features of the disease mechanisms in different groups, these different classes of drugs have resulted in greater degrees of risk factor control with less adverse side effects.

More recently, the potential efficacy of treatment, control and prevention of these acute disease processes and their risk factors at advanced ages, has been demonstrated.Demographic And Epidemiological Assessment For example, while early analyses of the effects of controlling the standard heart disease risk factors suggested little benefit at advanced aces (e.g., Kannel and Gordon, 1980) recent studies which controlled for the general rise of mortality with acre show that many of these factors continue to be as important (or more so) at advanced ages. Studies of a large group of persons with relatively healthy lifestyles (i.e., non-smokers and light drinkers) show significantly higher life expectancy at age 65 (Lew and Garfinkel, 1984). Even after adjusting for other risk factors like smoking, parental longevity and blood pressure, the benefits of physical activity have been demonstrated in significantly enhanced life expectancy up to at least age 80 (Paffenbarger et al., 1986). These recent epidemiological findings have caused the revision of clinical principles about treating persons at more advanced acres and led to the development of randomized controlled intervention trials for such conditions as isolated systolic hypertension (i.e., the SHEPS project).

Because of their characteristic natural history acute, lethal conditions, however, do not generate the largest amount of disability in the elderly population. This can be understood by examining Figure 1, where we present a modification of a World Health Organization (1984) life table model of the impact of chronic disease on disability and mortality of the elderly.Demographic And Epidemiological Assessment


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