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. 1999 Aug;89(8):1158–1161. doi: 10.2105/ajph.89.8.1158

Reassessing the role of epidemiology in public health.

D A Savitz 1, C Poole 1, W C Miller 1
PMCID: PMC1508699  PMID: 10432898

Abstract

This commentary examines the scope of epidemiology and delineates the role of epidemiology in relation to public health. Epidemiology is a science; public health is a mission that is implemented through societal action. The implications of this difference are considered, and the sufficiency of epidemiology for guiding public health is evaluated in relation to other scientific disciplines and nonscientific considerations. The authors conclude that epidemiology is not the basic science of public health but one of many contributors to guiding action. The need for public health decisions despite scientific uncertainty and the potential for epidemiologic certainty's failing to provide clear guidance to public health action emphasize the distinctiveness of these endeavors. Criticisms that epidemiology fails to solve major public health problems, such as tobacco use; that it overemphasizes methods; that it fails to meet the needs of public health practitioners; and that it isolates itself from public health ethics are unwarranted. However, epidemiology should focus on addressing issues that directly affect public health decisions and should clearly communicate information about such issues to public health workers. Public health is far more complex than merely applying epidemiology.

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Selected References

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  1. Atwood K., Colditz G. A., Kawachi I. From public health science to prevention policy: placing science in its social and political contexts. Am J Public Health. 1997 Oct;87(10):1603–1606. doi: 10.2105/ajph.87.10.1603. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Colditz G. A. Epidemiology--future directions. Int J Epidemiol. 1997 Aug;26(4):693–697. doi: 10.1093/ije/26.4.693. [DOI] [PubMed] [Google Scholar]
  3. Czeizel A. E., Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992 Dec 24;327(26):1832–1835. doi: 10.1056/NEJM199212243272602. [DOI] [PubMed] [Google Scholar]
  4. Diez-Roux A. V. On genes, individuals, society, and epidemiology. Am J Epidemiol. 1998 Dec 1;148(11):1027–1032. doi: 10.1093/oxfordjournals.aje.a009578. [DOI] [PubMed] [Google Scholar]
  5. Feinstein A. R. Scientific standards in epidemiologic studies of the menace of daily life. Science. 1988 Dec 2;242(4883):1257–1263. doi: 10.1126/science.3057627. [DOI] [PubMed] [Google Scholar]
  6. Foxman B. Epidemiologists and public health policy. J Clin Epidemiol. 1989;42(11):1107–1109. doi: 10.1016/0895-4356(89)90052-8. [DOI] [PubMed] [Google Scholar]
  7. Kelsey J. L., Gammon M. D., John E. M. Reproductive factors and breast cancer. Epidemiol Rev. 1993;15(1):36–47. doi: 10.1093/oxfordjournals.epirev.a036115. [DOI] [PubMed] [Google Scholar]
  8. Krieger N., Zierler S. What explains the public's health?--A call for epidemiologic theory. Epidemiology. 1996 Jan;7(1):107–109. doi: 10.1097/00001648-199601000-00020. [DOI] [PubMed] [Google Scholar]
  9. McMichael A. J. The health of persons, populations, and planets: epidemiology comes full circle. Epidemiology. 1995 Nov;6(6):633–636. [PubMed] [Google Scholar]
  10. Morrison A. B. Public policy on health and scientific evidence--is there a link? J Chronic Dis. 1984;37(8):647–652. doi: 10.1016/0021-9681(84)90115-2. [DOI] [PubMed] [Google Scholar]
  11. Pearce N. Traditional epidemiology, modern epidemiology, and public health. Am J Public Health. 1996 May;86(5):678–683. doi: 10.2105/ajph.86.5.678. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Rothman K. J., Poole C. Science and policy making. Am J Public Health. 1985 Apr;75(4):340–341. doi: 10.2105/ajph.75.4.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Russell L. B. The knowledge base for public health strategies. Am J Public Health. 1997 Oct;87(10):1597–1598. doi: 10.2105/ajph.87.10.1597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Samet J. M., Schnatter R., Gibb H. Epidemiology and risk assessment. Am J Epidemiol. 1998 Nov 15;148(10):929–936. doi: 10.1093/oxfordjournals.aje.a009569. [DOI] [PubMed] [Google Scholar]
  15. Shy C. M. The failure of academic epidemiology: witness for the prosecution. Am J Epidemiol. 1997 Mar 15;145(6):479–487. doi: 10.1093/oxfordjournals.aje.a009133. [DOI] [PubMed] [Google Scholar]
  16. Skrabanek P. The emptiness of the black box. Epidemiology. 1994 Sep;5(5):553–555. [PubMed] [Google Scholar]
  17. Susser M. Epidemiology today: 'a thought-tormented world'. Int J Epidemiol. 1989 Sep;18(3):481–488. doi: 10.1093/ije/18.3.481. [DOI] [PubMed] [Google Scholar]
  18. Susser M., Susser E. Choosing a future for epidemiology: II. From black box to Chinese boxes and eco-epidemiology. Am J Public Health. 1996 May;86(5):674–677. doi: 10.2105/ajph.86.5.674. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Taubes G. Epidemiology faces its limits. Science. 1995 Jul 14;269(5221):164–169. doi: 10.1126/science.7618077. [DOI] [PubMed] [Google Scholar]
  20. Terris M. The changing relationships of epidemiology and society: the Robert Cruikshank lecture. J Public Health Policy. 1985 Mar;6(1):15–36. [PubMed] [Google Scholar]
  21. Wall S. Epidemiology for prevention. Int J Epidemiol. 1995 Aug;24(4):655–664. doi: 10.1093/ije/24.4.655. [DOI] [PubMed] [Google Scholar]
  22. Wegman D. H. The potential impact of epidemiology on the prevention of occupational disease. Am J Public Health. 1992 Jul;82(7):944–954. doi: 10.2105/ajph.82.7.944. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Wilcox A. J. From the Shy trial defense: a leak, or red herring? Epidemiology. 1997 Nov;8(6):684–685. doi: 10.1097/00001648-199711000-00017. [DOI] [PubMed] [Google Scholar]
  24. Wynder E. L. Applied epidemiology. Am J Epidemiol. 1985 Jun;121(6):781–782. doi: 10.1093/oxfordjournals.aje.a114048. [DOI] [PubMed] [Google Scholar]

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