Uses of Epidemiology

J N Morris

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

Identification of Syndromes

This use again relates directly to clinical medicine. Broad descriptive clinical and pathological categories often include very different elements. Their different statistical distribution, and their different behaviour among the population, may make it possible to distinguish such elements from each other, and thus help to identify characteristic syndromes. Consider the mortality from 'peptic ulcer' in 1921-23 (Figure 6 ). Clearly there were at least two conditions to be studiedconditions with possibly different causes. My own main interest in this field is in trying to disentangle coronary heart disease form coronary atheroma, by study of their different distributions in the population today, and their different histories in the past 40 years.^[26]

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Social class differences in ‘peptic ulcer´ mortality in Males, England and Wales, 19212318

Table 3 illustrates again from cardiovascular disease. The common lumping together of coronary and cerebrovascular lesions as 'atherosclerosis' is not very strongly justified in clinical or pathological terms. Nor do the two conditions always behave similarly epidemiologically: the recent vital statistics are quite different; and this small experience among doctors ( Table 3 ) is interesting. The natural history of conditions as group phenomena may thus help to define syndromes. The vast unknown field of chronic chest diseasemiddle-aged men with respiratory symptomstoday offers particular opportunities for this application of the epidemiological method.(The reverse is also truethat the epidemiological method may help to show or to confirm that apparently disparate phenomena are connected, by drawing attention to their related behaviour in the populationfor example, malformation and rubella, rheumatic fever and streptococcal infection, zoster and chicken pox. However, I cannot think of any satisfactory illustrations from the non-infectious diseases.)

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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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Uses of Epidemiology

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