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Traditional epidemiology, modern epidemiology, and public health

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  • Pearce, N.

Abstract

There have been significant developments in epidemiologic methodology during the past century, including changes in basic concepts, methods of data analysis, and methods of exposure measurement. However, the rise of modem epidemiology has been a mixed blessing, and the new paradigm has major shortcomings, both in public health and in scientific terms. The changes in the paradigm have not been neutral but have rather helped change-and have reflected changes in-the way in which 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 function 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 reductionist 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 disease are ignored. Epidemiology must reintegrate itself into public health and must rediscover the population perspective.

Suggested Citation

  • Pearce, N., 1996. "Traditional epidemiology, modern epidemiology, and public health," American Journal of Public Health, American Public Health Association, vol. 86(5), pages 678-683.
    • Handle: RePEc:aph:ajpbhl:1996:86:5:678-683_2
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    Cited by:

    1. Ronald B. Brown, 2022. "Transdisciplinary model for environmental protection and primordial prevention of disease," Journal of Environmental Studies and Sciences, Springer;Association of Environmental Studies and Sciences, vol. 12(4), pages 898-904, December.
    2. Wei Xun & Aneire Khan & Edwin Michael & Paolo Vineis, 2010. "Climate change epidemiology: methodological challenges," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(2), pages 85-96, April.
    3. Elisabeth Marks & Margaret Cargo & Mark Daniel, 2007. "Constructing A Health And Social Indicator Framework For Indigenous Community Health Research," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 82(1), pages 93-110, May.
    4. Zimmerman, Frederick J., 2013. "Habit, custom, and power: A multi-level theory of population health," Social Science & Medicine, Elsevier, vol. 80(C), pages 47-56.
    5. van Herten, Loes M. & Gunning-Schepers, Louise J., 2000. "Targets as a tool in health policy: Part I: lessons learned," Health Policy, Elsevier, vol. 53(1), pages 1-11, August.
    6. Ritu Priya & Amitabha Sarkar & Sayan Das & Rakhal Gaitonde & Prachinkumar Ghodajkar & Mohit P. Gandhi, 2023. "Questioning global health in the times of COVID-19: Re-imagining primary health care through the lens of politics of knowledge," Palgrave Communications, Palgrave Macmillan, vol. 10(1), pages 1-11, December.
    7. Mark Daniel & Margaret Cargo & Elisabeth Marks & Catherine Paquet & David Simmons & Margaret Williams & Kevin Rowley & Kerin O’Dea, 2009. "Rating Health and Social Indicators for Use with Indigenous Communities: A Tool for Balancing Cultural and Scientific Utility," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 94(2), pages 241-256, November.
    8. Blakely, Tony & Tobias, Martin & Robson, Bridget & Ajwani, Shilpi & Bonné, Martin & Woodward, Alistair, 2005. "Widening ethnic mortality disparities in New Zealand 1981-99," Social Science & Medicine, Elsevier, vol. 61(10), pages 2233-2251, November.
    9. Roberts, Eric T. & Matthews, Derrick D., 2012. "HIV and chemoprophylaxis, the importance of considering social structures alongside biomedical and behavioral intervention," Social Science & Medicine, Elsevier, vol. 75(9), pages 1555-1561.
    10. Francesco Forastiere, 2010. "Climate change and health: a challenge for epidemiology and public health," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(2), pages 83-84, April.
    11. Kate Clancy, 1997. "1996 Presidential address to the Agriculture, Food, and Human Values Society," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 14(2), pages 111-114, June.
    12. João Delgado & Simon Pollard & Emma Snary & Edgar Black & George Prpich & Phil Longhurst, 2013. "A Systems Approach to the Policy‐Level Risk Assessment of Exotic Animal Diseases: Network Model and Application to Classical Swine Fever," Risk Analysis, John Wiley & Sons, vol. 33(8), pages 1454-1472, August.
    13. Lucia Fazzo & Marco De Santis & Eleonora Beccaloni & Federica Scaini & Ivano Iavarone & Pietro Comba & Domenico Airoma, 2020. "A Geographic Information System-Based Indicator of Waste Risk to Investigate the Health Impact of Landfills and Uncontrolled Dumping Sites," IJERPH, MDPI, vol. 17(16), pages 1-17, August.
    14. Melissa Chinchilla & Mariana C. Arcaya, 2017. "Using Health Impact Assessment as an Interdisciplinary Teaching Tool," IJERPH, MDPI, vol. 14(7), pages 1-13, July.
    15. Aparna Lal, 2016. "Spatial Modelling Tools to Integrate Public Health and Environmental Science, Illustrated with Infectious Cryptosporidiosis," IJERPH, MDPI, vol. 13(2), pages 1-8, February.
    16. Acolin, Jessica & Fishman, Paul, 2023. "Beyond the biomedical, towards the agentic: A paradigm shift for population health science," Social Science & Medicine, Elsevier, vol. 326(C).

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