December 22, 2014
University of Phoenix
Premature babies are considered a vulnerable population. They are at risk for many complications of prematurity such as anemia, hypoglycemia, Cerebral Palsy, retinopathy, and necrotizing enterocolitis (Mayo Clinic, 2014). Necrotizing enterocolitis (NEC) is a devastating condition that occurs in the premature baby’s bowel in which the cells lining the bowel wall are injured (2014). This injury can occur in premature babies after they start feeding. The infant mortality rate for NEC is 12.5 of 100,000 live births (Fitzgibbons, et al, 2009). This paper will define epidemiology and describe the epidemiological triangle as it relates to NEC. Types of epidemiology will also be discussed, cultural considerations of vulnerable populations such as African Americans, and various levels of prevention of NEC will be examined. Necrotizing enterocolitis is a devastating inflammatory bowel disease of the newborn primarily affecting premature babies (Gibbons, et al., 2008). This disease is characterized by ischemic necrosis of the lining of the intestines. Premature babies are at particular risk of developing NEC, and the focus is on reducing exposure to risk factors and implementing interventions that will prevent the disorder such as human milk feeding and the avoidance of hypertonic formulas (2008). Epidemiology is the main science of public health and is portrayed as an assemblage of specialties with a common goal: optimal health for the whole community (Stanhope & Lancaster, 2008). Epidemiologists strive to find the root of diseases and why they affect certain populations. These causes allow public health representatives to assess and evaluate disorders, identify vulnerable populations, plan for changes in treatment, implement evidence-based practice, and evaluate outcomes for better health of vulnerable populations. There are many steps and methods involved in epidemiology such as surveillance, randomized surveys, observational studies, and cohort studies (Stanhope & Lancaster, 2008). Epidemiologists rely on scientific methods, experience, expert judgment, and exceptional knowledge of specific populations or communities in order to follow disease paths. Common steps in the epidemiologic approach include performing an initial observation to confirm outbreaks, disease definition, disease description by time, place, person, the creation of a hypothesis, the conduction of analytical studies, the summarization of findings, and recommendations (2008). In terms of methods related to epidemiology, one of the first issues to address in any epidemiologic study is how to obtain the data. There are three major categories of data sources including routinely collected data such as census data and vital records, data collected for other purposes such as medical and insurance, and original data collected for specific studies (Stanhope & Lancaster, 2012). One method that is used quite frequently by epidemiologists is the morbidity survey which collects data on the health status of a population group. Purposes of morbidity surveys are to determine the frequency of chronic and acute diseases and disability, collect measurements of bodily characteristics, conduct physical examinations and lab tests, and probe other health related characteristics of specific concern to those who sponsor the survey (Friss & Sellers, 2009). The CDC reports 342 deaths per year of necrotizing enterocolitis the newborn (CDC, 2013). Epidemiologists studying the incidence of NEC might use a population-based survey to identify cases of NEC such as the one done in upstate New York in 2002. A survey was done in a well-defined, six county perinatal area. The purpose of the study was to describe the birthweight, gender, and race specific incidence as well as any demographic and clinical correlates in a population of infants born during an eight-year period (Llanos, et...
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