Choosing a future for epidemiology .1. Eras and paradigms

被引:356
|
作者
Susser, M [1 ]
Susser, E [1 ]
机构
[1] COLUMBIA UNIV COLL PHYS & SURG,NEW YORK STATE PSYCHIAT INST,NEW YORK,NY 10032
关键词
D O I
10.2105/AJPH.86.5.668
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
To inform choices about the future of epidemiology, the present condition of epidemiology is examined, in terms of its evolution through three eras, each demarcated by its own paradigm: (1) the era of sanitary statistics with its paradigm, miasma; (2) the era of infectious disease epidemiology with its paradigm, the germ theory; and (3) the era of chronic disease epidemiology with its paradigm, the black box The historical context in which these eras arose is briefly described. In each era, the public health was at the center of the concerns of the founders and early protagonists of the prevailing paradigm. Around this intellectual development we weave a further theme. We argue that in the present era, the public health has become less central a concern. At the same time, in epidemiology today the dominant black box paradigm is of declining utility and is likely soon to be superseded.
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页码:668 / 673
页数:6
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