School of Community Health & Policy PUBH 500 EPIDEMIOLOGY ASSIGNMENT 6.0 Comparison of Disease Frequency & Adjustment (35 points) The table below shows the number of cancers occurred in people exposed and those unexposed to a certain exposure. Follow up was five years. Find the cumulative incidence in the exposed and unexposed. DiseaseNo DiseaseExposed1001900Unexposed1007900 What is the cumulative incidence in the exposed group? [1 point]What is the cumulative incidence in the unexposed group? [1 point]What is the excess risk of disease in the exposed group? [2 point]What is the relative association between the exposure and the disease? [2 points] The table below shows the relationship between body mass index (in Kg/m2) and prevalence of diabetes for these 2000 men. Body mass indexTotalWith diabetesPrevalence of diabetesPrevalence Ratio< 18.00502 18.00 – 24.99120084 1.00 (Ref)25.00 – 29.99500105 30.00 – 39.9920070 >= 405042 Find prevalence of diabetes for each body mass index group, calculate the prevalence ratios, and interpret each prevalence ratio in a sentence. [6 points] Based on these results, name some factors that are associated with higher risk of diabetes. [3 points] Los Bajos and San Lucas are two small communities. The overall death rates are similar in both communities, but the age distributions among both populations are quite different. Use the direct method to age adjust the death rates in the two populations. The standard population should be derived from a combination of the two populations. To help guide you through the calculations, fill in all of the highlighted cells in the tables. Los BajosSan LucasAgePopulationNo.deathsAge-specific ratePopulationNo. deathsAge-specific rate15-191,20025 1,50023 20-243,50050 4,500200 25-2990010 2,00020 All ages5,60085 8,000243 The crude mortality rate in Los Bajos is _________per 1,000 [1 point]The crude mortality rate in San Lucas is ______ per 1,000 [1 point]The age-specific mortality rate for age 15-19 years in Los Bajos is _______ per 1,000 [1 point]The age-specific mortality rate for age 25-29 years in San Lucas is _________ per 1,000 [1 point] Step 1: Derived Combined Standard Population AgeLos BajosSan LucasCombined Standard Population15-191,2001,500 20-243,5004,500 25-299002000 All ages5,6008,000 Calculate the standard population for each age group. [2 points] Step 2: Now apply the age-specific rates of Los Bajos and San Lucas to the standard population in each age group, in order to derive the expected number of deaths. Use the table below to fill in the expected deaths for each age category [4 points] Los BajosSan LucasAgeStandard PopulationAge-specific rateExpected deathsStandard PopulationAge-specific rateExpected deaths15-19 20-24 25-29 All ages Step 3: Calculate the adjusted rates and the ratio of the adjusted rates for the two populations. What is the age adjusted mortality rate for Los Bajos? [2 points]What is the age adjusted mortality rate for San Lucas? [2 points]What is the ratio of the adjusted rates for Los Bajos vs. San Lucas? [2 points]What is the ratio of the crude rates for Los Bajos vs. San Lucas? [2 points] Step 4: Compare the ratio of the adjusted rates to the crude rates. Compare the ratio of the adjusted rates to the crude rates. [2 points] R Adjusted/ R Crude =

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