Social and Behavioral Epidemiology

The choice of behavioral factors that affect how we live

–These choices often are a function of social influences

–Personal behavior is associated with many chronic diseases

–The impact of the factors is not fully recognized

• Stress is “…a physical,
• chemical, or emotional factor that causes bodily or mental tension and may be a
• factor in disease causation.”

Examples of conditions studied as outcomes of stress:

–Cardiovascular disease

–Posttraumatic stress disorder

–Work-related anxiety and neurotic disorders

• Stressors (sources of stress) that arise from happenings such as job loss, financial problems, and
• death of a close family member

Types of events:

–Positive and negative life events

–Chronic strains

Negative life events are those associated with adverse life circumstances

Examples: being fired from work or being arrested and incarcerated

Positive life events

• Examples:
• graduation from school, marriage, and birth of a new child

Life events that are sustained over a long period of time

“…an anxiety disorder that some people develop after seeing or living through an event that caused or threatened serious harm or death….”

• Flashbacks or bad dreams
• Emotional numbness
• Intense guilt or worry
• Angry outbursts
• Feeling ‘on edge’
• Avoiding thoughts and situations that remind them [people] of the trauma”

Refers to help received from other people when one is under stress

• Friends, relatives, and significant others often are able to
• provide material and emotional support during times of stress

Techniques for managing or removing sources of stress

Effective coping skills help mitigate the effects of stress

• Women: more than one drink per day on average
• Men: more than two drinks per day on average

• Women: more than three drinks during a single occasion
• Men: more than four drinks during a single occasion

• More than one-tenth of alcohol consumed in the U.S. is by persons under age 21
• 90% of this consumption takes place as binge drinking
• Among high school students, more than 30% of males and 25% of females engaged in binge drinking (2005)
• In 2005, 19.5% of full-time college students and 13.0% of part-time college students were heavy drinkers

• Illicit drugs included:
• Marijuana
• -The most commonly used illicit drug among persons aged 12 orolder (2006)
• Methamphetamines
• Heroin

• Methamphetamines are highly addictive substances
• Use may result in:
• -Rise in body temperature
• -Psychotic symptoms
• -Crank bug
• -Meth mouth

A condition that contributes to decay and loss of teeth

Attributed to

–Reduced output of saliva

–Increased sugar consumption

–Neglect of personal hygiene

• In U.S., 1.4 million persons aged 12 or older reported past year use (2004)
• Among U.S. high school students, the lifetime use of methamphetamines was 4.4% (2007)

• Overweight and obesity are increasing in prevalence in the United States
• Being overweight or obese impacts the quality of one’s life and increases the risk of chronic diseases
• Sedentary lifestyle and consumption of high-calorie foods are associated with overweight and obesity

• A measure of overweight and obesity that takes into account both a person’s weight and height
• Defined as body weight in kilograms divided by height in meters squared
• Overweight: BMI ≥ 25 and ≤ 29.9
• Obesity: BMI ≥ 30.

• One of the important applications of epidemiology
• Mental disorders have characteristic distributions according to the categories of person, place, and
• time

• Studies the occurrence of mental disorders in the population
• –Variables include age, sex, and social class
• –The discipline measures the frequency of occurrence of mental disorders and factors related to their etiology

• DSM-IV-TR (2000)
• -Manual used for the classification of psychiatric disorders

• Anxiety disorders
• Mood disorders
• –Major depressive episode
• –Dysthymia
• –Bipolar disorder
• Impulse-control disorders
• Substance use disorders
• More than 25% of U.S. population is afflicted with a mental disorder during a given year

Defined as the co-occurrence of two or more mental disorders

–For example, major depression and substance use disorder

• Autism (autism spectrum disorder-ASD) is a condition that impairs functioning in the social, communication, and behavioral domains
• Generally appears by 3 years of age
• Manifested by difficulties in:
• –Cognitive functioning
• –Learning
• –Processing sensory information
• Prevalence in U.S. about 4.5 to 9.9 per 1,000 children

• Social factors and lifestyle
• practices (which are modifiable) play a significant role in health
• Tobacco use, excessive alcohol consumption
• Substance abuse
• Sedentary habits
• Stress
• Mental disorders are an important topic for epidemiologic studies
• –High prevalence of mental disorders
• Contributions of psychiatric epidemiology