Uses of Epidemiology

J N Morris

Int J Epidemiol. 2007;36(6):1165-1172.

Community Diagnosis

Epidemiology provides the facts about community health; it describes the nature and relative size of the problems to be dealt with, and 'maps' are produced of such scales as are required or possible. Results are sometimes surprisingat any rate in contrast with the type of problem of which there is general awareness and concern in the public health movement. Over 10% of sickness absence in male industrial workers in 1951 was ascribed to 'bronchitis' (16 million days). 'Psychological' disorders accounted for >13 million days; gastric and duodenal ailments for over 11 million, 'rheumatism and arthritis' for over 11 million.^[3]

Usually, however, we are concerned with the distribution of phenomena, and not merely their totals. Such distributions are firstly in terms of age and sex (race or colour, where applicable), economic status and so on. Table 1 is an example of a social-economic distribution in relation to primagravidae in Aberdeen. It shows some interesting similarities, as in nutrition, and the remarkable differences that still remain between the social classes in 'capital' goods like housing and education (in these early days of the Welfare State). There is a wide range of reproductive performance in this relatively homogeneous town. Such demonstration of inequalities between groups is a standard function of epidemiology, and it can be put to many usesfor example, in the same field as Table 1 to identify 'vulnerable groups' meriting special attention by health services (Figure 2 ).

(Enlarge Image)

Three groups with particularly high foetal and infant mortality rates, England and Wales, 19498

1 2 3 4 5 6 7 8 9

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Read in opening a discussion at the Section of Preventive Medicine and Infectious Diseases at the Annual Meeting of the British Medical Association, Glasgow, 1954, and since expanded. First published BMJ 1955;2:395-401. Reprinted with permission.

Cite this: Uses of Epidemiology - Medscape - Dec 01, 2007.

First Reproductive 'Cycle' in a Scottish City ^[2,4,5,6,7]
	Social class of husband
Findings in married women	I and II	III	IV and V
Physique of women-height
5 ft 1 in. (155 cm) or smaller (%)	12	24	28
Intelligence
Above average on matrix test (%)	80	42	26
Education
Leaving school over minimum age (%)	56	14	3
Housing
Living >2 per room (%)	2	7	15
Family Budget^a,b
Average weekly income (after compulsory deductions)	150s	129s	119s
Nutrition^a
Calcium intake (mg/day)	1219	1071	868
Animal protein intake (g/day)	48.6	44.0	40.4
Reproduction
Under-20 years old (%)	2	11	17
30 years old or over (%)	22	10	7
Pre-nuptial conception (%)	15	24	37
Babies 5 1/2 lb (2.5 kg) or less at birth (%)	4	8	10
Child Care
Fully breastfeeding at 3 months^a (%)	60	37	29
'Potting' regularly at end of first month (%)	72	49	28

This Table deals with local married primigravidae 'booked' for the Aberdeen Maternity Hospital, 1948-52; and includes 85-90% of all who were eligible. Data are for periods varying from 1 year (818 cases) to 5 years (4365 cases). Social classes I and II include the professions and business; class III are the skilled workers; IV and V, the semi-skilled and unskilled workers. Items^a are for samples of the total ^bclerical workers in social class III are included with classes I and II for family budget only. For other reasons, also, the sample of classes I and II for Budgets was not altogether satisfactory.

First Reproductive 'Cycle' in a Scottish City ^[2,4,5,6,7]
	Social class of husband
Findings in married women	I and II	III	IV and V
Physique of women-height
5 ft 1 in. (155 cm) or smaller (%)	12	24	28
Intelligence
Above average on matrix test (%)	80	42	26
Education
Leaving school over minimum age (%)	56	14	3
Housing
Living >2 per room (%)	2	7	15
Family Budget^a,b
Average weekly income (after compulsory deductions)	150s	129s	119s
Nutrition^a
Calcium intake (mg/day)	1219	1071	868
Animal protein intake (g/day)	48.6	44.0	40.4
Reproduction
Under-20 years old (%)	2	11	17
30 years old or over (%)	22	10	7
Pre-nuptial conception (%)	15	24	37
Babies 5 1/2 lb (2.5 kg) or less at birth (%)	4	8	10
Child Care
Fully breastfeeding at 3 months^a (%)	60	37	29
'Potting' regularly at end of first month (%)	72	49	28

Working of Health Services: A: Treatment of Minor Ailments by School Health Service ^[15] Before and After the National Health Service
Year	No. of pupils	No. of defects treated at school clinics
1947	5 034 275	1 190 754
1952-53	6 088 000	1 154 467

Working of Health Services: A: Treatment of Minor Ailments by School Health Service ^[15] Before and After the National Health Service
Year	No. of pupils	No. of defects treated at school clinics
1947	5 034 275	1 190 754
1952-53	6 088 000	1 154 467

*Serious*' *Clinical Medicine in a General Practice* ^[2,16] During 1 Year, 1949-50
Age	Frequency of serious problems per 100 persons	Proportion these formed of all the doctor's work with age group (%)
0-14	22	20
15-44	23	34
45-64	41	55
65+	83	76
All ages	32	43

*Functions of Occupational Health Service, 1951*., ^[17] Analysis of Sample Attendances at 12 Industrial Medical Officers' Clinics
No. of attendances in year	1952
Proportion for 'occupational reasons'	79%
Proportion for 'non-occupational reasons'	21%

Impact of a New Therapy., ^[18,19] Death Rates per Million From Diabetes at 20-35 Years of Age, Males
Social class	1921-23	1930-
I and II	64	26
III	50	25
IV and V	46	35

First Reproductive 'Cycle' in a Scottish City ^[2,4,5,6,7]
	Social class of husband
Findings in married women	I and II	III	IV and V
Physique of women-height
5 ft 1 in. (155 cm) or smaller (%)	12	24	28
Intelligence
Above average on matrix test (%)	80	42	26
Education
Leaving school over minimum age (%)	56	14	3
Housing
Living >2 per room (%)	2	7	15
Family Budget^a,b
Average weekly income (after compulsory deductions)	150s	129s	119s
Nutrition^a
Calcium intake (mg/day)	1219	1071	868
Animal protein intake (g/day)	48.6	44.0	40.4
Reproduction
Under-20 years old (%)	2	11	17
30 years old or over (%)	22	10	7
Pre-nuptial conception (%)	15	24	37
Babies 5 1/2 lb (2.5 kg) or less at birth (%)	4	8	10
Child Care
Fully breastfeeding at 3 months^a (%)	60	37	29
'Potting' regularly at end of first month (%)	72	49	28

Coronary and Cerebrovascular Disease Among Medical Practitioners. ^[22,27] Number of 'First Attacks', 1947-50 (Men Aged 40-64)
	General practitioners	Other doctors
Coronary heart disease	82	33
Cerebrovascular disease	14	13
Man-years of observation	10 800	8620

Coronary and Cerebrovascular Disease Among Medical Practitioners. ^[22,27] Number of 'First Attacks', 1947-50 (Men Aged 40-64)
	General practitioners	Other doctors
Coronary heart disease	82	33
Cerebrovascular disease	14	13
Man-years of observation	10 800	8620

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