Norwegian social epidemiology during 200 years
Journal article, Peer reviewed
Published version
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http://hdl.handle.net/11250/2630972Utgivelsesdato
2015Metadata
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Originalversjon
Norsk Epidemiologi. 2015, 25 (1-2), 99-106.Sammendrag
Social epidemiology has been defined as The branch of epidemiology that studies the social distribution andsocial determinants of states of health (1). Whereastraditional epidemiology is primarily concerned with health related factors at the individual level, social epidemiology is more concerned with the health conditions between social groups in the population or between populations. Thus, social epidemiology is highly relevant for public health and health policy (S. Westin, this issue), while epidemiology, concerned more with individual risk or resilience is most relevant for treatment of specific diseases within the health services. The epidemiologist Geoffrey Rose (1926-1993) was instrumental in emphasizing the difference between the determinants of individual cases and the determinants of incidence rates, thereby shifting the focus from individuals to populations (2). George Davey Smith recently highlighted main challenges with the individual focus, personalized medicine, and the desire to predict individual destinies – randomness and individual life's coincidences (3). However, when comparing groups of populations or entire populations in social epidemiology, average health can be predicted in a more expected manner based on information on the socioeconomic conditions people are living under; the social determinants of health. Social epidemiology attained its name in English in 1950 and is by its definition truly cross-disciplinary, encompassing both the medical, behavioural as well as the social sciences. In recent years, social epidemiologists have been much occupied with the socioeconomic gradient in health, extending from top to bottom of the social hierarchy, and showed that it is not a poverty threshold that separates those with poor versus good health (4). In addition, research has shown that poor people living in poor neighborhoods are likely to have poorer health than equally poor people living in more affluent neighborhoods (5,6). But are these observations in fact new? Or is it that researchers once again have been willing to engage with questions initially raised during the formative days of epidemiology as a discipline, in the early 19th century (7)?