Barry Commoner Center for Health and the Environment, Queens College, City University of New York, New York, NY 11367; email:
Annu Rev Public Health. 2015 Mar 18;36:69-88. doi: 10.1146/annurev-publhealth-031914-122403. Epub 2015 Jan 16.
Before World War II, epidemiology was a small discipline, practiced by a handful of people working mostly in the United Kingdom and in the United States. Today it is practiced by tens of thousands of people on all continents. Between 1945 and 1965, during what is known as its "classical" phase, epidemiology became recognized as a major academic discipline in medicine and public health. On the basis of a review of the historical evidence, this article examines to which extent classical epidemiology has been a golden age of an action-driven, problem-solving science, in which epidemiologists were less concerned with the sophistication of their methods than with the societal consequences of their work. It also discusses whether the paucity of methods stymied or boosted classical epidemiology's ability to convince political and financial agencies about the need to intervene in order to improve the health of the people.
第二次世界大战之前,流行病学是一门规模较小的学科,只有少数人从事这方面的工作,主要分布在英国和美国。如今,它在各大洲都有数以万计的人在从事。在被称为“经典”阶段的 1945 年至 1965 年间,流行病学被公认为医学和公共卫生领域的一门主要学术学科。本文通过对历史证据的回顾,探讨了经典流行病学在多大程度上是一个行动驱动、解决问题的科学的黄金时代,在这个时代,流行病学家不太关注方法的复杂性,而更关注他们工作的社会后果。本文还讨论了方法的匮乏是否阻碍或促进了经典流行病学使政治和金融机构相信有必要进行干预以改善人民健康的能力。