Assignment Code: BANS 184/ASST/TMA/2021-22

Course Code: BANS-184

Assignment Name: Public Health and Epidemiology

Year: 2021-22

Verification Status: Verified by Professor

There are two Sections in the Assignment. You have to answer all questions in all the Sections.

Assignment – I

Answer the following in about 500 words each. 20X2= 40

Q a) What is Public Health? Briefly discuss its importance in the management of COVID 19

Ans) The term "public health" is made up of two words: "public" and "health." The term "public" has a wide range of meanings and implications, including "community," "civic," "municipal," "free," "open," and "unrestricted." The term "public" can also refer to something that is "not private." When we consider the other term, "Health," we find that it is one of the most difficult to define. Because health is such a multifaceted term, it can mean different things to different people. It is defined as "a feeling of "wholeness" and a happy frame of mind," "freedom from any sickness or disease," "harmonious functioning of all body systems," "a feeling of "wholeness" and a happy frame of mind," and so on.

Epidemiology, biostatistics, vaccinology and immunology, programme planning and evaluation, policy and health care administration, and others are all areas of competence in the School of Public Health.

 The public health approach involves: 1) defining and measuring the problem, 2) determining the cause or risk factors for the problem, 3) determining how to prevent or ameliorate the problem, and 4) implementing effective strategies on a larger scale and evaluating the impact.

The public health method begins with a problem and concludes with an action or reaction. The framework in which people and communities can be safe and healthy is shaped by public health. To begin, it employs a population-based strategy, in which individuals or a wider community are designated as the "target/audience." Active surveillance is a method of monitoring communities for disease and health-related phenomena. During the Covid-19 epidemic, for example, active surveillance was used with the support of the health-care system and community networks. Medical policing is sometimes employed as a method of restricting individual rights in order to keep the population healthy. Medical policing is one type of medical policing. Tobacco smoking is prohibited in public places by law. Public health fights for equity for everyone and reaches out to vulnerable communities using a social justice approach.

As the prospect of a successful vaccination becomes more of a reality, the conversation around COVID-19 has altered. However, public health experts warn that the introduction of a vaccination does not imply that other critical public health initiatives should be ignored. Wearing a mask, keeping a safe distance, and maintaining excellent hand hygiene will all be important in limiting the transmission of COVID-19.

Community health centres play an essential role in rural and isolated locations, and they are one of the most comprehensive health-care systems available to rural residents. Community health centres now serve one out of every six rural individuals (19), making them an important part of the COVID-19 response plan in rural areas. Health centres are in a unique position to respond to COVID-19 because they are located in practically every town across the United States. They may be able to assist in increasing community access to COVID-19 testing.

As a result, in the practise of public health, a multidisciplinary/interdisciplinary understanding of health and disease is critical. Recent public health measures to address the covid-19 epidemic highlight the significance of understanding the interconnections among different underlying factors that drive health and disease.

Q b) Define environmental health. Discuss the effects of Biological, Chemical and Physical agents in water on human health.

Ans) The term "environmental health" refers to a combination of two major concepts: environment and health. The environment refers to everything that surrounds us, whereas health is the effect of environmental influences on us. Everything in our environment, including air, water, and soil, has an impact on our physical, mental, and social health.

The World Health Organization (WHO) issued the contemporary definition of health in 1948, and it has remained unchanged since then. The World Health Organization defines health as a state of complete physical, mental, and social well-being. This definition adopts a holistic perspective, which means it considers all aspects of health, including physical, mental, and social, as required for good health.

Effects of Biological, Chemical, and Physical Agents in Water on Human Health

In India and many other poor countries, waterborne illnesses are one of the leading causes of illness and disease. Water that is safe and healthful is free of pathogens, chemical contaminants, and has a pleasing taste. However, human activities such as industrial discharge, urbanisation, agricultural sources of pollution, and municipal sewage water degrade the water and make it hazardous to drink.

a) Physical and Chemical Pollutants:

Human activities such as agriculture, industry, and urbanisation produce chemical pollutants. These can be inorganic (nitrites, phosphates, chlorides, fluorides, salts, etc.) or organic (detergents, tar, plastic, pesticides). Detergent solvents, cyanides, heavy metals, minerals, and organic acids, nitrogenous substances, fertilisers, soaps, oil spills, chlorine, bleaching agents, dyes, pigments, sulphides, ammonia, and a wide variety of hazardous and biocidal organic compounds are among these pollutants. Chemical pollutants can harm people not just directly, but also indirectly, by accumulating in aquatic life (such as fish) that is consumed as food.

b) Biological agents can be broadly divided into two types:

Bacteria, viruses, nematodes, worms, and protozoans are pathogenic and nuisance organisms (Slime, mollusc, algae, Asellus, nematodes). Biological waterborne diseases are caused by biological agents/infective agents such as viral (Viral Hepatitis A, Hepatitis E), bacterial (Typhoid, dysentery), protozoal (Amemobiasis), helminthic (Roundworm, Threadworm), or Leptospiral (Weil's sickness). The hosts could be aquatic, such as Cyclops (Guinea worm, fish tape worm). A nice example is malaria-stagnant water and the Mosquito-Plasmodium vivax. Aside from this, numerous biological diseases that cause concern thrive in or near water, such as malaria, filaria, arboviruses, onchocerciasis, and African trypanosomiasis, as well as disease-carrying insects reproducing in or near water.

c) Physical:

Human health problems are caused by changes in temperature, turbidity, colour, and suspended and floating debris in water bodies. These changes may occur as a result of the mixing of waste water and industrial effluents with rivers and ground water, as well as the addition of silt, sand, metal fragments, rubber, wood chips, paper, foam, scum, carcasses, and sewage as a result of numerous human activities.

It is obvious that human health is influenced by a variety of elements, one of which is the environment. Human health and well-being can simply be improved by improving the environment and living conditions. As a result, rather than focusing on curing diseases, government policies, programmes, and activities should focus on improving and cleaning the environment to encourage disease prevention.

Assignment – II

Answer the following in about 250 words each. 10X3=30

Q a) Give an account of globalization and its impact on health.

Ans) Globalization had an impact on trade connections and cross-national movements. This process is made possible by competition and the hunt for new markets, technological advancements, and agreements and cooperation between countries mediated by international organisations (World Trade Organization, World Bank). Globalization is described as the processes that are altering the ways in which people connect across physical, temporal, and cognitive barriers, particularly physical (such as nation-states) and cognitive (such as instantaneous communications) (such as cultural identity). As a result, human civilizations are being redefined in a variety of ways, including economics, politics, culture, technology, and so on.

Achievements in health are a crucial worldwide development aim. Globalization aids in the development of new knowledge and skills, as well as the promotion of policy coherence. This also contributes to global public goods for health, global health funds, and the development of international health standards and laws. However, in a globalised environment, some of the unique concerns that have a direct or indirect impact on health are:

1) Food safety

2) Environmental degradation and its impact on health

3) Access to Drugs

4) Health Care Service Availability

5) Emerging issues like Genetically Modified Food’s impact on health

6) Increasing Lifestyle Disease burden.

Local knowledge, local resources, and traditional knowledge have all suffered as a result of globalisation, with global knowledge and resources exerting hegemony in the power system. One example is the rise in popularity of fast-food franchises such as McDonald's and KFC among teens and urbanites, as opposed to Indian cuisine. Fast food culture has an impact on health and lifestyle problems such as PCOD and obesity, which are on the rise in this age range.

Q b) Briefly discuss the role of Non-Governmental Organisations (NGO’s) in health sector of India.

Ans) Non-Governmental Organizations (NGOs) serve a critical role in reaching out to the most marginalised members of society. Non-governmental organisations (NGOs) have a long history of actively promoting human well-being. NGOs, in particular, serve as vital linkages between the community and the government. They have particular strengths and features that allow them to be effective and active participants in this process. Their programmes, which range from research to community-based projects, address a wide range of human challenges and are frequently pioneering in areas like as health and development.

Foreign finances, government grants, corporate social responsibility funds, NGOs' own fund-generating resources, and other philanthropic/individual charitable gifts are all sources of funding for NGOs. NGOs have acquired prominence in a wide range of social activities, including health care, despite the nature and focus of their operations changing throughout time. The World Health Organization has praised NGOs for gaining greater recognition as a supplement to government programmes and for providing an effective people's voice in terms of healthcare needs and expectations.

Functions of NGOs in the Health System

The primary focus of NGOs in the health sector can be listed as follows:

1. Establishing health care institutions;

2. Fulfilling health and social needs of groups like women, elderly and

3. vulnerable local communities;

4. Dealing with specific health issues such as AIDS, alcoholism;

5. Promoting Health Rights;

6. Performing preventive health programmes; and

7. Managing health finance/ funding and administration.

Some NGOs are concerned with global health issues and operate on a worldwide scale. In India, some NGOs play a vital role in providing health care during emergencies and natural catastrophes.

Q c) What is epidemiology? Discuss randomized studies.

Ans) Epidemiology is defined as “the study of the distribution and determinants of health- related states or events in specified populations, and the application of this study to the prevention and control of health problems.”

Randomized Studies

Randomized studies are classified into randomized clinical trials, field trials and community trials.

1. Randomized Clinical Studies (Trials)

The efficacy of pharmaceuticals, new therapies, and new equipment is studied in randomised clinical trials. This research design is effective for examining the impact of a single intervention on a variety of outcomes. Hospitals and contract research groups conduct randomised clinical trials. The subjects are assigned to one of two groups: treatment or control. Simple block, stratified, covariate adaptive randomization processes and online software tools can be used to perform this randomised.

2. Field Trials

This type of experiment takes place in the real world, in the general community, and involves healthy individuals or groups. In this study design, the effect of intervention on numerous outcomes can be investigated. Randomization is the best option but putting it into practise in field trials (FTs) is difficult. To lower the risk of acquiring disease, risk factors/exposures or procedures are adjusted, terminated, or discontinued in FTs.

3. Community Trials

Communities serve as the trial's unit. Some communities in the chosen communities are subjected to exposure, while others are not. Community trials (CTs) are conducted for conditions including coronary artery disease that are influenced by socioeconomic status (CAD). In order to prevent the disease from developing, a risk factor, exposure, or behaviour is interrupted in individuals who have it. CT scans look at a single or a number of risk factors.

Answer the following in about 150 words each. 5X6=30

Q a) Gender and Health

Ans) Gender refers to men and women's socially (and culturally) defined roles and duties. Gender roles are formed as a result of socialisation in various social institutions. Gender inequality is discrimination based on a person's sex in terms of resource allocation, benefits, and service access.

Gender equality refers to the absence of discrimination in opportunities, resource allocation or rewards, or access to services based on a person's sex. Gender equality refers to the distribution of advantages and duties between men and women that is fair and just, and it frequently necessitates women-specific projects and programmes to address existing disparities.

In many nations, women consistently fail to attain or exercise certain basic human rights that males take for granted. The majority of the time, women's health and difficulties associated with it have an impact on mortality, morbidity, and disability rates.

The fundamental critique of women empowerment plans, according to a WHO Technical Paper on gender and health, is that they continue to characterise women as the problem, who require welfare and special attention if their conditions are to improve.

Q b) Vaccination

Ans) Vaccination is another medical technique that has had an impact on people's health. Edward Jenner, an English country doctor, demonstrated smallpox vaccine in 1796. Jenner induced immunity against smallpox through exposure to a harmless related disease, cowpox, based on his experience in inoculation and related works. Jenner reasoned that a case of cowpox gave him immunity to smallpox since he knew milkmaids never had smallpox. Jenner injected pus from a cowpox-infected milkmaid named Sarah Nelmes into the arm of his gardener's son, James Phipps. When Jenner exposed the boy to smallpox a few days later, he was discovered to be immune. Jenner named his innovative procedure after the Latin word for cow, vaccination (vacca).

Measles, whooping cough, tetanus, rubella, flu, polio, yellow fever, pneumococcal illness, and meningococcal disease have all been considerably reduced as a result of vaccination.

Q c) Random sampling

Ans) In Random Sampling the population members are included in the sample by a random or lottery type mechanism.

The following methods  are of random sampling:

1. Simple Random Sampling

Every unit of the population will have an equal probability of being picked into the sample using this procedure. When the population is homogeneous in terms of age, gender, body mass, level of education, and other criteria, it can be used.

2. Stratified Random Sampling

When the population units are heterogeneous, such as in terms of education, residency, socioeconomic position, and so on, this method is applied. Each group is called a stratum, and to avoid overrepresentation of a few groups, sampling must cover all strata (pleural of stratum).

3. Systematic Sampling

When the population units are already arranged in a series, such as the residential dwellings in a colony, this method is utilised. Systematic sampling picks succeeding homes with a fixed spacing between them, starting with one member at random.

4. Cluster Sampling

Cluster sampling is a simple and quick procedure. Each cluster has a wide range of individuals and so represents the majority of the population's features. The World Health Organization (WHO) recommends this strategy for conducting vaccination surveys.

Q d) Chronic diseases

Ans) Chronic disease is described as a disease that lasts for a long time and progresses slowly. Cardiovascular illnesses, arthritis, obesity, cancer, diabetes, stroke, and chronic obstructive pulmonary disease are examples of chronic diseases.

For chronic diseases, prevention can be done at four levels namely primordial, primary, secondary and tertiary:

The goal of primary prevention is to avoid the emergence of risk factors that lead to the development of chronic diseases. The government has a significant role to play in this sort of prevention, such as developing regulations to promote good eating by raising taxes on junk food; encouraging physical activity by constructing footpaths in highways and educating the public on the benefits of physical activity; and so on.

Secondary prevention aims to halt the progression of disease by detecting it early and intervening effectively. When the disease's natural history is understood and the disease can be recognised quickly and readily, this method of preventive is appropriate.

Tertiary prevention aims to halt the progression or complication of disease in patients by implementing measures to lessen pain, disability, and impairment, as well as promote patients' adjustment to their new circumstances, welfare, and return to work.

Q e. Chi-square (χ2) test

Ans) A chi-square (2) statistic is a test that assesses how well a model matches actual data. A chi-square statistic requires data that is random, raw, mutually exclusive, collected from independent variables, and drawn from a large enough sample. The outcomes of a fair coin flip, for example, meet these conditions.

In hypothesis testing, chi-square tests are frequently utilised. Given the size of the sample and the number of variables in the relationship, the chi-square statistic examines the size of any disparities between the expected and actual results. Degrees of freedom are used in these tests to see if a null hypothesis can be rejected based on the total number of variables and samples in the experiment. The larger the sample size, as with every statistic, the more dependable the results.

Key Points

A chi-square (χ2) statistic is a measure of the difference between the observed and expected frequencies of the outcomes of a set of events or variables.

χ2 depends on the size of the difference between actual and observed values, the degrees of freedom, and the samples size.

χ2 can be used to test whether two variables are related or independent from one another or to test the goodness-of-fit between an observed distribution and a theoretical distribution of frequencies.

Q f) SPSS

Ans) SPSS (Statistical Package for Social Sciences) is a programme that allows you to perform statistical computations and analysis. SPSS is for Statistical Package for the Social Sciences, and it's a programme that's utilised by a variety of scholars to analyse complex statistical data. SPSS is a software suite designed for data management and statistical analysis in the social sciences. It was first released by SPSS Inc. in 1968 and was later purchased by IBM in 2009.

Market researchers, health researchers, survey firms, government bodies, education researchers, marketing organisations, data miners, and others utilise SPSS to handle and analyse survey data collected with an online survey platform like Alchemer. To get the most out of their research and survey projects, most leading research agencies use SPSS to analyse survey data and extract text data.

SPSS also has data management tools that allow researchers to do things like case selection, construct derived data, and reshape files.