movie review

WatchAnd the Band Played On (1983). This is an excellent documentary of the AIDS epidemic and the epidemiologic investigation that ensued.

This film can be found at local video stores, the public library, or ask that the video store order it for viewing. If you have access to NetFlix, you can also find it there.

Case Study Guide

And the Band Played On

The investigation of this “emerging disease” took on major proportions. The teams’ goal was to contain it. To do this, all health professionals must investigate the distributionand the determinants of the health events.

As the investigation begins: What is the disease?

Who is affected?

Where are they?

When do events occur?

How does it occur?

Why are some affected more than others?

The goal of epidemiology is to understand causal factors so we can devise interventions to prevent adverse effects. The elements of the epidemiologic triangle are: agent, host, and environment. Throughout the disease investigation the team tried to discover the agent, host, environmental factors. What are the factors?

Outset Final

Causal relationships are more complex than the epidemiologic triangle. Today we speak of web of causality. What factors are interacting to increase or decrease the risk of this disease?
  1. The “natural history of disease” is the course of the disease process from onset to resolution. As you view the natural progression of this disease, what interventions where suggested at the three levels of prevention?

Primary

Secondary

Tertiary

There are three major categories of data collection in epidemiological investigations. What methods did this team use? Give examples.
  1. Was this outbreak an epidemic? Why? Justify your answer. What population was at risk of contracting GRID, HTLV, AIDS?

Why?

What was the “Butcher Bill”? How does it relate to measures of morbidity and mortality? How does it relate to prevalence, incidence, and attack rates?

Descriptive epidemiology describes the distribution of disease, death, and other health outcomes in the population, ie. person, place and time. In this disease investigation define the who, when, and where.

Analytic epidemiology searches for the determinants of the patterns observed. What factors, characteristics, exposures, or behaviors played a part in this disease investigation.

Can you determine the epidemiologic study design in this investigation?

There are numerous issues that lead to the epidemic, AIDS. Dr. Darrow said, “This didn’t have to happen! We could have stopped it.” What are the issues that lead to that conclusion?

Cultural:

Ethical:

Political

Economic

Policy

Other (international)

Who are the invisible health providers in this documentary?