Traditional epidemiology, modern epidemiology, and public health
PEARCE, Niel . Traditional epidemiology, modern epidemiology, and public health. AMERICAN JOURNAL OF PUBLIC HEALTH. , v. 86, n. 5, p.678-683, may 1996.
There have been significant developments in epidemiologic methodoly during the past century, including changes in basic concepts, methos of data analysis, and methods of exposure measurement. However, the rise of modern epidemiology have been a mixed blessing, and the new paradigm has major short-comings, both in public health and in scientfic terms. The chagenges in the paradigm have not been neutral bu have rather helped chage - and have reflected changes in - the way in wich epidemiologists think about health and disease. The key issue has been the shift in the level of analysis from the population to the individual. Epidemiology has largely ceased to funcition as part of a multidisciplinary approach to understanding the causation of disease in populations and has become a set of generic methods for measuring associations of exposure and disease in individuals. This reductionit approach focuses on the individual, blames the victim, and produces interventions that can be harmful. We seem to be using more and more advanced technology to study more and more trivial issues, while the major causes of dsiease are ignored. Epidemiology must reintegrate itself into public health and must rediscover the population perspective.