Epidemiología de campo y epidemiología social

Abstract

Comparing field epidemiology and social epidemiology, we pretend to think about the no explicit images and meanings operating in both necessary convergent fields, about the obstacles present in epidemiological practice to fulfil its social function and about the necessity of changing epistemological, methodological and practice grounds, beginning with field epidemiologists teaching programmes. Field epidemiology would tend to act in an absent theoretical frame. On the other hand, social epidemiology would tend to prioritize theoretical developments (thinking and research about social determinants) without correspondent action, because of the limits to change public policies. Other differences are found at intervention level (micro-macrospace), its aim (outbreak control vs. inequalities control) and the way to communicate with society. They are similar in the methodological concern, the predominance of orientation based on positivism and framed through statistic methods, but in process of epistemological opening, the stress experienced between the alternative relationship to a virtual world of data bases or to the real society, their peripherical situation in relation of the political, social, institutional and professional system and the tendency to professional frustration. Finally, we ask ten questions to the field epidemiologists related with their present practice, in order to consider if they are developing social epidemiology, and propose some changes in epidemiologist teaching and practice.

Entornos y actividad física en enfermedades crónicas: Más allá de factores asociados

“…Uno de estos modelos es la epidemiología social. Aunque se conocen dos corrientes claramente definidas (Anglosajona y Latinoamericana), "la epidemiología social busca ampliar el alcance de la investigación para incluir variables y conceptos extraídos de una teoría en efecto, articulando marcos sociológicos a la investigación epidemiológica" (68) .…”

Salud de la población desde la perspectiva de los determinantes sociales en salud

“…La epidemiología social es la rama de la epidemiología encargada de estudiar la distribución social y los factores sociales determinantes de la salud, (16,17), así como de brindar información sobre políticas públicas y su efecto en las desigualdades presentes en el sector de la salud. La perspectiva de la epidemiología social reconoce cómo la posición social determina la salud por medio de factores intermedios.…”

“…Por lo tanto, al querer plantear un nuevo concepto de salud de la población se necesita tener la perspectiva de la epidemiología social, ya que tiene en cuenta como enfoque principal las variables sociales (ingreso, educación, ocupación, clase social, sexo, raza) y su distribución diferencial en un grupo social, en contraposición con la epidemiología moderna, la cual sólo tiene en cuenta los factores de riesgo individuales (16).…”

Clinical Epidemiology and Its Relevance for Public Health in Developing Countries

“…The current medical approach must contemplate the application of clinical epidemiology in the health establishments, patients; in general, epidemiologic research with its analytical designs and clinical trials allow the progress in treatments and managements, as well as defining the quality of auxiliary exams ever more sophisticated by means of the test of tests design and its cost-benefit approach [1,2] On the other hand, the field epidemiology is applied through descriptive studies of the population's health situation with their analytical approaches to the Situational Health Analysis (SHA), the study of epidemic outbreaks and evaluation of the respective answer of the community interventions [3,4]. This way, it allows carrying out an integral management of the epidemiology, both communal and individual, which will finally result in preventive medicine and public health Clinical epidemiology has its application peak in the solution of treatment and management of diseases, contributing the identification of risk factors to certain illnesses and being to date the fundamental part of Evidence Based Medicine, and for that it becomes important the teaching of clinical epidemiology, for it will aid in the education of professionals with judicious capacity and rational use of the best alternatives in diagnostic and treatment, by means of a critical evaluation of the literature [5], as well as helping to stimulate the training of researchers, because it's implied that the execution of the clinical epidemiology will lead to the development of research [6].…”

“…It is discussed that field epidemiology would tend to action without a theoretical framework. This tendency would be based on its most direct reference: the Epidemic Intelligence Service (EIS) of the Center for Disease Control and Prevention (CDC) from the USA government, administrative body of military origin related to the intelligence service, which gives them a more attractive image than a function, closer to a secret agent directed towards the action, the protection of a community against a germ invasion, the avoidance of social alarm and insecurity on the population [4]. Field epidemiology executes its intervention on a daily basis in micro spaces, generally institutional: schools, restaurants, elderly residencies, hospitals whose services can present outbreaks, and uses conventional methods [15].…”