Comparing Health Events in Populations: A Framework for Analysis

Eric Delmelle
September 2 and September 5 2025

Introduction

  • Definition of Health Events: Disease outbreaks, chronic conditions, injuries, and health behaviors.
  • Importance of Comparisons: Understanding disparities, identifying risk factors, guiding public health interventions.
  • Key Concepts: Population health, epidemiology, and biostatistics.

Objectives of Population Health

Four Key Objectives:

  1. Describe: Understand population-level health outcomes.
  2. Explain: Identify determinants and drivers of health outcomes.
  3. Predict: Anticipate future health trends and patterns.
  4. Control: Implement interventions to improve outcomes.

Historical Context

Key Figures:

  • John Snow: Cholera outbreak mapping.
  • Ignaz Semmelweis: Importance of handwashing.
  • Joseph Goldberger: Nutritional causes of pellagra.

Type of Comparisons

Time-Based

Key Metrics:

  • Incidence: New cases over time.
  • Prevalence: Existing cases at a given time.

Place-Based

Example:

  • Urban vs. Rural Heart Disease Mortality:
    • Urban: 50 per 100,000.
    • Rural: 75 per 100,000.

Group-Based

Example:

  • Health disparities by race, age, and income.

Event-Based

Key Concept:

  • Natural experiments: Before vs. after policy changes or interventions.

Additional Event-Based Example

Measures of Comparison

Key Metrics:

  • Age-Standardized Rates: Adjusted to eliminate age structure differences.
  • Attributable Risk: Measures the impact of specific risk factors on outcomes.

Levels of Analysis

Frameworks:

  • Individual-Level: Biostatistical and clinical trials.
  • Population-Level: Geographic and demographic patterns.

Determinants of Health

Categories:

  1. Social and Economic Factors
  2. Environmental Conditions
  3. Behavioral and Genetic Influences

Challenges in Comparisons

Key Challenges:

  • Data Quality: Inaccuracies or incomplete datasets.
  • Ethical Considerations: Privacy and fair comparisons.

Population vs. Community Health Assessments

Key Differences:

  • Community Health Assessments:
    • Focus on local needs/resources.
    • Qualitative methods (e.g., interviews).
  • Population Health Assessments:
    • Broad, systemic focus.
    • Quantitative data (e.g., chronic disease rates).

Population vs. Community Health Assessments

Example:

  • Community: Identifying food deserts.
  • Population: Obesity prevalence across counties.

Policy Implications

Using Comparisons to Drive Change:

  1. Set Priorities: Identify at-risk groups (e.g., elderly, low-income communities).
  2. Develop Interventions: Targeted programs (e.g., tobacco cessation).
  3. Advocate for Policy Change: Use data for systemic reforms.

Policy Implications

Visual:

Interactive Example

Dataset Example:

Population Cases Rate (per 100,000)
Urban 200 50
Rural 300 75

Prompt:

  • “What does this suggest about resource allocation?”

Recap and Transition

Key Takeaways:

  • Importance of describing, explaining, predicting, and controlling health events.
  • Tools and methods to compare health outcomes.
  • Practical implications for population health strategies.

Next:

  • Group activity: Apply concepts to a real-world health disparity.

Group Activity: Population Health Comparison

Objective:

Apply Chapter 1 metrics to analyze health disparities.

Instructions:

  1. Form groups of 5 (see groupe in 2 slides).

Instructions:

  1. Analyze the provided dataset on coursesite
    • Calculate rates (e.g., incidence, prevalence).
    • Identify disparities (e.g., geographic, demographic).
    • Propose targeted interventions.
  2. Prepare to present findings in 3 minutes.

Group Assignments and Analysis Instructions

  • Group John Snow (5): Dhyana Abeysinghe; Nora Albright; Jaimie Alva; Carrie Rothman; Mikaela Villajoaquin
  • Group Pasteur (5): Cameron Driscoll; Kendall-Marie Fitzgerald; Mia Freeman; Alex Sawh; Juliea Zhao
  • Group Nightingale (5): Maria Garcia Rodriguez; Sarah Haque; Daniel Hughes; Emily Snyder; Keira Conway
  • Group Gupta (5): Anna Jones; Nora Kerrigan; Phillip Kim; Alana Thomforde; Herve Sanon
  • Group Fauci (6): Mariana King; Esther Lee; Nicole Mejias; Aili Tutschek; Christos Vlanti; Maya Bjorneby
  • Group Wakefield (5):Samantha Pfeffer; Harnek Purewal; Mary Reed; Bibian Verdugo; Mackenzie Barlow

Analysis Instructions

  • Analyze the provided dataset on coursesite:
    • Calculate rates (e.g., incidence, prevalence).
    • Identify disparities (e.g., geographic, demographic).
    • Propose targeted interventions.
  • Presentation Guidelines:
    • Prepare findings for a 3-minute presentation.
    • Include key calculations, identified disparities, and proposed interventions.