Box 1.1 Epidemiology is…
‘The science of epidemics’ (Concise Oxford Dictionary, 1964)
‘The science of the occurrence of illness’ (Miettinen, 1978)
‘The study of the distribution and determinants of disease in humans’ (MacMahon and Pugh, 1970)
‘The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems’ (Porta, 2008)
So what is epidemiology anyway? As shown in Box 1.1, the Concise Oxford Dictionary (1964) defined it accurately, but not very helpfully, as ‘the science of epidemics’. In 1970, MacMahon and Pugh came up with something a bit more concrete: ‘the study of the distribution and determinants of disease’. Their definition succinctly identifies the two core strands of traditional epidemiology: who is developing disease (and where and when), and why are they developing it? The final definition, from the Dictionary of Epidemiology (Porta, 2008) takes it two steps further by broadening the scope to include health in general, not just disease, as well as highlighting the direct role of epidemiology in disease control.
Epidemiology, therefore, is about measuring health, identifying the causes of ill-health and intervening to improve health; but what do we mean by ‘health’? Back in 1948, the World Health Organization (WHO, 1948) defined it as ‘…a state of physical, mental and social well-being’. Now, while this view is clearly what we hope for as individuals, the inclusion of ‘mental and social well-being’ would until recently have induced despair in epidemiologists.
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