Hi, and welcome to our first week.

Today, we're going to talk about the background and history of social epidemiology. The main goal of this whole lecture is to help you understand the landscape of what social epidemiology is and isn't. And some key features to help you really feel for what the disciplines all about and what work can be done and why it's hopefully helpful to you. There are four parts to this overall lecture, this first week. The first one is what we're going to talk about soon, which is what is social epidemiology? We're going to have another module or part, on where social epidemiology came from. And I suppose it's worth saying that, I'll find myself routinely saying social epi instead of social epidemiology. That's the shortcut that I typically use. The third part, we're going to talk about this central questions. Now we're going to have a whole week of this. So this'll just be a highlight, but hopefully you can get a feel for what we're doing. Then finally I want to talk about where social epidemiology is headed, strengths and weaknesses. Again to give you a sense of the overall landscape. For this week, this overall lecture, you're going to have three reading assignments. And they're simply hooked up to, hyperlinked or URL to the Coursera website. So, please read those 'cuz, as I mentioned earlier, there'll be a quiz that incorporates, not only the lectures, but these readings as well. Okay, so let's get into it. The first part of this overall lecture is, what is social epidemiology? Well, to understand that, let's first take a step back and ask, what is epidemiology? [COUGH] Well, epidemiology by definition, is a study of what is upon the people. And we can find this in Wikipedia, or any other major dictionary, and it comes from the Greek. and it's about studying groups of people,[COUGH] . That surprisingly lots of people will say

epidemiology is about the study of epidemics. And that's true, but I want to offer you as a broader sense of the word epidemic. Many people will think that epidemiology is about studying cool, fascinating, scary, diseases, bacteria viruses, such as Ebola. And here in the slide you can see a picture of a worker in a, probably a CDC lab, or something like that, in a secure suit. Epidemiology is certainly about studying. Scary things such as Ebola, epidemics of them, as I said, it's a broader question. So if we just take the case of Ebola, something we see in the news or at least did in a few years back. Scary virus that makes people sick and die rather quickly. If we take it from a social epidemiology perspective we can ask deeper questions or further questions. And that is, hm, someone got infected. How does the next person get infected? Typically through human interaction. And depending on the bug, it's a touch, it's a sneeze, it's being in close proximity. That's all true. And infectious disease epidemiologist study this every day. And they calculate things, such as transmission probability. In social epidemiology, we can ask why are the people around the first person. Why are they there? Do they have to be there? Is there some reason they're in the same workplace, in the same family, same social network? And so social epidemiology includes, if you will, the typical case of an Ebola infection and expands it to ask the next question of, why some and not the others? And then how does the bacteria or virus spread through the social network? Did someone get on a n airplane for a business trip? Travel across the land, travel across an ocean? And then bring that virus or bacteria to someone else, say in Chicago or Bangladesh. These questions are what drives social epidemiology. So in some, while it's absolutely true that epidemiologists study interesting, cool and scary things such as ebola and other viruses, HIV, of course.

What I want to say to you is that epidemiology studies more than this. Things such as auto accidents, smoking. And these things can all be understood partially through the social epidemiology framework. Now, more formally, epidemiology is a science that studies population health. That last part's very important. We want to understand the health of populations. Not a particular person, per say. So, we want to understand the health of a nation, a state, a part, Northern Hemisphere, Southern Hemisphere. And ask questions about why this group is healthy or why are they not healthy? In many textbooks about epidemiology you'll see a definition something like, epidemiology is the study of the distribution and determinants of disease in a population. So, the distribution. How many people are sick? What age group are the people that are sick? Determinants. Why are they sick? What could have prevented them from being sick? And so that's a pretty standard textbook definition. Epidemiology can simply be broken down into two parts. That is the group that studies surveillance, counting up how many people are sick. Are they young, are they old, do they live here, do they live there? This is very important work and many health departments around the world do this. Another part of epidemiology, sometimes it's the same, studies etiology. This is the study of causes. So quite a part, or somewhat separate from studying who's sick, we can ask why they are sick. What caused them to get sick? In here is where the distinctions between subdisciplines of epidemiology become quite illuminated. The traditional or textbook view or paradigm of epidemiology has three principal parts. The agent, the infectious agent, if you want. The environment, this is sort of the biological environment in which someone or some animal lives.

And then the host, and this is the person or animal who gets the disease. And, of course, time is always moving. So we talk about agent-host environment, and epidemiology is typically focused on this, and that's quite appropriate. Push come to shove, however epidemiology is mostly about studying diseases and asking questions about why did someone get the disease. And this is a question of exposure or treatment. We're you exposed to a flu virus. We're you exposed to toxic pollution. Were you exposed to a really excellent education when you were a child. How do these kinds of things yield health of persons, that get aggregated up or grouped together that creates health for populations? So, what is social epidemiology? And we'll come back to this. Social epidemiology is the branch of epidemiology, that considers how social interactions and collective human activities affect health. That's a of words. What does it mean? Well social epidemiology can be said to be the sub-discipline of epidemiology, the population health science that studies how society. Social arrangements such as families, social networks, friendship groups affect health. Laws, policies, social norms, how do these things load the gun if you will, to affect health? We often talk about how societies make us sick. But it's more technically appropriate to talk about. How social systems make us sick and healthy? The word social system is just broader, more technically accurate than society. And it lets us interface with other disciplines, such as sociology, anthropology and economics. So, I'll use the terms society and social system interchangeably. But it's probably worth saying to you that Social system is a more accurate definition. In the end, social epidemiology is in contrast to the fictitious character Robinson Crusoe. You may remember the classic story, where Robinson Crusoe is marooned on an island and he lives by himself to save for his

friend, Friday. But Robinson's health, of course, is determined by his genetics, island weather, typhoons, sunny days. And perhaps some bacteria or other agents on a rock that he might cut his foot on. Many people think this model, this vision of health, is how we're sick or healthy. What's important to recognize, however, and what this course is really about, is that Robinson's health is not affected by other people. But that's not the story for almost all of us. We're all affected by the friends we have. The political systems in which we live. The laws which we abide by or not. Traffic on the highway. Cigarette smoking advertisement. All of these things, society richly and broadly define, this is what really drives our health. It's in contrast to the story, the fictitious story, of Robinson Crusoe. [SOUND]