FOUNDATION OF PUBLIC HEALTH EPIDEMIOLOGY.

FOUNDATIONS OF PUBLIC HEALTH EPIDEMIOLOGY 1
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Introduction
Epidemiology is the strategy used to investigate the causes of health outcomes as well as the
presence or absence of disease and control of illness in an area. Epidemiology as a branch in the
medical field that seeks to find out why diseases occur in certain areas in varied groups of
people. The major role of epidemiology is to understand the source of disease and deduce ways
to fight the incidence. This essay will look intently into depression being one of the most
condition affecting numerous people irrespective of age and economic status in Australia. The
essay will explain what depression entails, epidemiological description, contributing factors of
depression, and public health strategies that target the contributing factors of depression.
Epidemiological description of depression
Depression refers to a mood disease that negatively interferes with how a person feels, manner of
thinking and how somebody acts. Also, it is associated with a persistent feeling of sadness, loss
of interest as well as affecting the normal daily functioning of an individual. Other areas
interfered with this type of mental illness is sleep and eating. There are various kinds of
depression depending on the severity of diseases which include (Mody, 2019):
Major depression
Major depression can be referred to as unipolar depression or medical depression and it is
categorized by a decrease in mood, lack of interest as well as happiness in usual activities. This
symptom is experienced in almost every day and stay for at least two weeks. This depression is
known to affect negatively every aspect of the life of an individual that is social relationships and
work.

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Psychotic depression
Individuals with psychotic depression tend to lose touch with actuality and experience psychosis.
The psychosis experience involves hallucinations where the person starts to hear and see things
that are not present. For instance, the persons feel that someone is watching or following them
and believing that they are unworthy as well as evil. Individual also becomes paranoid and thinks
that other people are against them or that they are the ones responsible for bad events happening
around them including the illness (Cohen, and DeRubeis, 2018).
Manic depression
Manic depression is also called bipolar disorder since an individual experiences seasons of mania
and seasons of depression, with periods of normal mood in between. Some of the symptoms of
this depression involve a feeling of great, little need for sleep, irritable, talking quickly, feeling
great, and having difficulty concentrating on a task. Also, feeling frustrated, bearing thoughts of
racing and having a lot of energy. Manic depression is mostly associated with family history and
conflict and stress can stimulate episodes for individuals with this state.
Antenatal and postnatal depression
Most common in women when they are expectant and even in the year following childbirth. The
period is known as perinatal and depression at this time is due to a combination of issues. Studies
show that several women experience “baby blues” a state that commonly as a result of hormonal
alterations and affects about 80 per cent of women. Perinatal depression is long lasting and can
end up affecting even the relationship between the mother and child (Anderson, 2018).
Other kinds of depression are melancholia, cyclothymic disorder, and seasonal affective disorder
that involves mood abnormality that has a seasonal pattern. However, depression disorders are

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treatable and effective medications are available, especially when a person seeks treatment
earlier.
Depression morbidity in Australia
According to the National Health Survey around one out of eleven people (8.9%) reported
having depression or feeling of depression in the year 2014-2015 (McGiffin, Galatzer-Levy, and
Bonanno, 2019). The number of females identified with depression or feelings of depression was
at a figure than males where females had 10.4% compared with 7.4% for males (McGiffin,
Galatzer-Levy, and Bonanno, 2019).
The frequency of individuals identified with depression or feelings of depression maximized
until around 55-64 years old is 13.7%. In every set of age group, females reported a larger
number of depression likened to their male counterparts. Over one million adults diagnosed to
have depression in Australia every year that is 6% of all Australian adult. Worldwide, over 300
million people affected with depression illness as shown by the world health organization (Akil
et al, 2018).
Depression mortality in Australia
In the year 2017, about 80.0 % of death due to self-harm occurred and 43.0% was as a result of
depression as one of the mood disorders. Research shows that worldwide, about 800 000
individuals die as a result of depression through suicide, and most affected are individuals
between the ages of 15-29 years old. Even though there is a treatment for depression, less than
half of people affected in several countries access medication and less than 10 per cent are able
to receive such medication.

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Hindrances to the access to depression treatment include lack of qualified health practitioners,
lack of resources necessary to deal with the disorder as well as community isolation linked with
mental illness. This leads to an increased mortality rate due to depression.
Other hindrances to access to efficient medical care is erroneous examination. All nations
irrespective of the economic status, individuals with depression are not correctly diagnosed while
others who may not be suffering the illness are not correctly diagnosed and given
antidepressants.
Disability caused by depression
Disability is the second world leading cause of disability that lays a huge burden globally.
Research reveals that most of the poorer countries have higher chances of having individuals
who have a disability as a result of depression. Studies have revealed that nobody is immune to
depression even though it mostly affects women than males. Depression is taken to one of the
psychiatric disability and is handled under the Americans with disability act (Tackman et al,
2019).
Depression is the most serious cause of disability in Australia and where we find that one in
seven Australians at some points in life. Depression as one of the mental health problem affects
negatively so many Australians, whereby we find most of them are not able to work in a normal
manner as compared to the previous working state. Other areas where we experience the
disability among the Australians is the inability to manage simple task like family roles. Most of
the families with one of the family member or parent experience a lot of difficulties especially
basic needs. For the children they may not be able to acquire quality education or they may not
access it at all.

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Additional problems associated with depression are family conflicts and fights mostly when the
person affected is the mother of the family. The rate of the women affected is higher than the
men, meaning that families are the most affected in the society of Australia. Individuals which
Contributing factors of depression
Depression comes from a composite interface of biological, communal and mental issues.
Individuals who have undergone difficult and hostile lifetime situations like bereavement,
unemployment, as well as psychological trauma have higher chances of developing depression.
Depression is likely to cause other health problems due to increased stress and dysfunction,
which makes individuals life condition worsen and even depression itself. Research shows that
there are interrelationships amongst depression and bodily health, for instance, cardiac disease is
able to result in depression and vice versa (Cunningham et al, 2019).
Depression has numerous distinct symptoms and will affect everyone in different ways. Some of
them are anxiety, feeling worthless or guilty, feeling extremely tearful and sad. Also, impaired
thinking or concentration, loss of appetite accompanied with weight loss, physical aches and
pains, disturbances to usual sleep patterns, loss of sexual interest, feeling emotionally flat or
numb and loss of pleasure in activities.
Depression can be treated depending on the extent to which it has affected an individual that is
reasonable and stark depression. Health practitioners can offer mental cures like cognitive
behavioural therapy (CBT), behavioural therapy through activation, and interactive
psychoanalysis (IPA). Additionally, an antidepressant prescription can be administered whereby
the use of selective serotonin reuptake inhibitors (SSRIs) practised (Wray et al, 2018).

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Another method of administering antidepressant is by tricyclic antidepressant (TCAs). However,
health practitioners should bear in cognizance the most likely effects linked with antidepressant
medication. Varied mental cure protocols for deliberation involves separate and or cluster one on
one mental cures offered by the health specialists as well as supervised lay therapists.
Psychological treatments are considered to be the most operative for slight depression, while
antidepressant can be an effective method of treatment for moderate to severe depression.
However, they should not be utilized for the treatment of depression in children and are not the
preferred for treating the teenagers, amongst whom they are supposed to be utilized with more
care (Chukhraev et al, 2018).
There exist a number of causes of depression which will be outlined, but three of them will be
discussed in details. They include serious illness, genetics, substance abuse, death or loss, certain
medication, conflicts, personal problems and abuse. The highlighted causes they can either lead
to depression directly or rise the fortuitous of depression. The contributing factors of depression
looked at in this case are:
Genetics factor
A family past of depression can maximize the danger of getting depression. Researchers have
attempted to conclude that depression is a complicated character, meaning that there are feasible
several distinct genes that each exert small effects, rather than one gene that leads to disease risk
or increasing individuals prone to suffering depression. The genetics of depression disorder like
is the same with many psychiatric diseases, are not as simple or straight forward as in purely
other genetic diseases like cystic fibrosis and Huntington’s chorea (De La Cruz et al, 2018).

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Several studies find out the relationship that exists in genetically traits and results from shows
that a genome-wide Meta-analysis of genetic data from greater than two million people has
linked 102 genetics variations and 269 genes with depression, and found a link amongst the
psychiatric illness and several behavioural characteristics (Elder, 2018). A team of researchers
from the University of Edinburgh, reports that their research concerning genetics relationship
with depression brought an insight that can help them come up with the new strategies of
offering treatment.
The result is further proved that depression is partially down to our genetics, as a comment from
the leader in investigation Andrew McIntosh, who is a professor of biology psychiatry holding a
PhD. Genome-wide meta-analysis of depression utilizing anonymized data from 807, 553 people
where 561, 190 acted as controls and 246, 363 as cases in the three great available study sources.
That is UK Biobank as well as the psychiatry Genomics Consortium and the first analyses
identified 102 independent genetic variants that were individually associated with depression
(Asen, 2018).
Depression normally occurs in accompanied with other diseases and the research results show
correlations between depression and 41 other disease traits and behavioural characteristics. They
involve body fat, bipolar disorder, coronary artery, waist-to-hip ratio and schizophrenia.
Although several of the genetic correlations were reported before, a novel association was
noticed for age at menopause as commented by the team of researchers.
The comment and findings indicate a potentially shared genetic architecture between depression
and early female reproduction life. Novel genetic relations was also noticed between Crohn’s,
and depression as well as beginning to smoke at an early age. According to the statistical method
of Mendelian randomization to examine causation between these associations. The team of

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researchers discovered that a significant causal effect of neuroticism on depression, revealing
that neuroticism can lead the individual to become depressed (Copeland et al, 2019).
A growing research body of evidence shows that there are relationships between psychiatric
disorders and behavioural. This is evidence using meta-analyzed results in in the current study by
the research team.
Several examinations of the 269 depression- associated genes for interactions with prescribed
drugs in the drug-gene interaction database discovered hundreds of association between 514
drugs and 57 genes. Research points out that drug interaction outcomes suggest that numerous
drugs that could target the genetic elements of depression or which may offer unpredicted profits
or have adverse effects in individuals having the disorder (McGiffin, Galatzer-Levy, and
Bonanno, 2019).
The strengths for the genetic as one of the factors as to why chose to discuss it is because most of
the people have genes that trigger how they react towards life conditions. People are prone to
several attacks due to the genetic composition of the body since response can be varied. Some
people have genes which are so resistance to attack of diseases while others have genes which
are prone to the attack of any diseases.
Public health strategies
Some of the public health strategies to fight genetics as one of the contributing factors of
depression is through offering proper reproductive education. Based on reproductive education,
people are expected to know the best means of reproduction like avoiding inbreeding. Avoidance
of inbreeding encourages the formation of new offspring with combined genes which are at least

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resistance or not so vulnerable compared to when inbreeding could be the case. Outbreeding
could be the best method to deal with the genetic factor (Cuijpers, 2019).
Ottawa chatter has five major exploit capacities for health promotion which are strengthening
community action, re-orienting health care services to the protection of sickness and facilitation
of health, the building of sympathetic setting and rising individual abilities and generating
healthy civic programme. In terms of adherence to Ottawa chatter, depression can be minimized
by ensuring that every individual has personal skills that can help in handling difficulty events
and situations that lead to depression. On the side of creating supportive environments, health
practitioners should try to their level best to devise methods of ensuring that people are taught
how to accommodate people with depression (Karp, 2016).
Research should be conducted to discover the best ways of dealing with depression disorder and
more importantly targeting on the best ways to prevent it. All the health care service should be
geared towards prevention of illness and promoting health. The community should be
strengthened by allowing them to understand what the disorder entails so that they can build self-
confidence to face the depression issue. Community need to be involved in achieving a healthy
nation since the health sector alone cannot be able to achieve health promotion alone (Segal, and
Teasdale, 2018).
Fighting depression completely to ensure that there is health equity where people must be
encouraged to control the factors that negatively affect their health. This will help them to reach
the maximum attainable quality of life where people have the best health. Doctors use
mindfulness-based cognitive therapy (MBCT) as a method of preventing depression (Shapero et
al, 2019). Other strategies for preventing depression include finding ways to deal with stress and

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improving self-esteem. Sleeping for enough hours and eating well accompanied by exercising
regularly also assist in avoiding risks of depression.
In conclusion, every individual can suffer depression but the best ideas are to ensure that people
have skills on how to prevent it. The easy has discussed the best epidemiology of depression in a
statistical manner both in Australia and globally evaluating the extent to which depression has
occurred. Several types of depression like bipolar depression, major depression, psychotic
depression and few others have been discussed to understand different levels of depression.
Additionally, methods of treating depression and contributing factors of depression are
highlighted in the easy and detailed discussion on genetic as one of the contributing factors of
depression. Strategies of promoting health according to Ottawa chapter are discussed and some
of the best activities that can aid in reducing depression rather than finding treatment.
Recommendation for more research to be done based on depression to find out the best ways of
eradicating it and also on how skills can be passed to the people to enable them to avoid or
handle depression.

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Anderson, D., 2018. Depression, dust bowl, demography, and drought: the colonial state and soil
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Copeland, W.E., Worthman, C., Shanahan, L., Costello, E.J. and Angold, A., 2019. Early
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