Epidemiologia e Sa�de P�blica

Briz, Teodoro
July 2009
Revista Portuguesa de Sa�de P�blica / Portuguese Journal of ;2009 Special Issue 25 anos, p31
Academic Journal
The aim of the author is to explicit the origin, the rationale, the mnature and the prospects of the relationship between Epidemiology and Public health, through an historic approach. The two entities have been defining and making sense together, by achieving successes, but also with much controversy, since millennia ago, until mid XIX century. A combination of circumstances provided them the opportunity for an explosion of growth and definition, then, alongside several other disciplines. From the ancient biblical report on how good food explains good health, up to the scientific appreciation of both social and economical constraints to health by Marmot and Rose, passing through �miasma� causing disease and through displacing from individual health risk to population risk - with the inherent implications of that important innovation -, this route allows the identification of the foundations of such remarkable symbiosis, the explanation of current status, to see its evolution and find in it the meaning of today's heritage and what it promises. Some discrepancies on the name of its methods, as well as the continuing discussion about its true nature and future orientation, attest Epidemiology's youth as a scientific discipline. Meanwhile, Public Health strives to keep its integrating essence, while other disciplines increasingly contribute so that it achieves its objectives; it is challenged by large scale population exposure to disease factors, sometimes with a minimum intensity, and by new diseases emerging in the population or by old ones getting amplified, often not respecting regions boundaries. The history of such a symbiosis shows that knowing the way a disease is generated allows to control it in the population, or even to avoid it, and that the number of problems that the two disciplines are able to clarify and solve together in synergy is considerable. Therefore, Epidemiology offers Public Health explanations (eyes, intelligence and language) for populations's health problems - allowing that the latter knows on what to act -, scenarios on how problems may tend to evolve - allowing decision-makers to make their choices as a function of different assumptions, on how to act - and judgement capabilities on the results of already undertaken actions, accompanied by the raising of conscience level, understanding and intervention of what is going on by both professionals and the population - knowledge transfer. It is easy to anticipate that the relationship between both disciplines will develop towards increasing complexity and demand from Public Health to Epidemiology, and that this one will have to correspond in usefulness. And the latter, while continuing its subspecialisation and sophistication either in its methods, or in its approaches to specific factor categories, will need to progress in managing its consistency as an integrated body of knowledge having methodological peculiarities, similarly to Public Health.�


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