Epidemiology: Grappling with the Concept

Public health as a segment of healthcare naturally is healthcare in the public domain, as distinct from healthcare outside of society’s purview; and the care naturally is paramedical care together with medical care – hence the term ‘health,’ rather than ‘medicine,’ in ‘public health.’ Medicine encompasses community medicine in addition to clinical medicine. This segment of medicine inherently is public-health medicine, whereas clinical medicine falls under public health only to the extent that national health insurance has been introduced. Community medicine used to be focused on epidemics of communicable diseases; and a natural term for this segment of medicine thus was epidemiology. As the concerns in community medicine were extended to encompass endemic occurrence of communicable – and also of non-communicable – illnesses, ‘endemology’ could have been introduced as a term for this extension; but instead, the concept of epidemiology was expanded to community medicine in the thus-expanded meaning of it. Epidemiological research naturally is research to advance (the practice of) community medicine – of epidemiology, that is. This research includes ‘bench’ or ‘basic’ research aimed at the development of vaccines, for example; and it falls under various medical sciences instead of constituting a science unto itself. All of this presumably is natural and quite obviously true in the judgements of beginning students of epidemiological research, but it is here said for the troubling reason that concepts of epidemiology and epidemiological research different from these are endemic in today’s epidemiologic academia. The purpose of this chapter is to help the beginning student to find proper orientation in this academia.