Epidemiology and the Public Health Movement

Abstract

This paper discusses the relationship of epidemiology to the public health movement, with specific reference to the recent shift in emphasis to noninfectious diseases. It attempts to answer the question: Why did this change occur first in Great Britain and the United States rather than in continental Europe? The hypothesis is developed that a major inhibiting factor in Europe was the concept that public health is a medical discipline; there were no independent public health centers in which epidemiology, biostatistics and other public health disciplines could collaborate. The London School of Hygiene and Tropical Medicine served as such a center in Great Britain. In the United States, the U.S. Public Health Service played a primary role in the development and transformation of epidemiology, together with a number of outstanding state and local health departments and the 23 multidisciplinary schools of public health. The mutual dependence of epidemiology and the public health movement is emphasized.