What is epidemiology? Changing definitions of epidemiology 1978-2017

Abstract

ContextEpidemiology is a discipline which has evolved with the changes taking place in society and the emergence of new diseases and new discipline related to epidemiology. With these evolutions, it is important to understand epidemiology and to analyse the evolution of content of definitions of epidemiology.ObjectivesThe main objective of this paper was to identify new definitions of epidemiology available since 1978. Secondary objectives were to analyse the content of these definitions, to compare them with those used by Lilienfeld and to determine whether changes have taken place over the last forty years.MethodsA review of grey literature and published literature was conducted to find the definitions of epidemiology written between 1978 and 2017.Results102 definitions of epidemiology were retained. They helped to highlight 20 terms and concepts related to epidemiology. Most of them were already used in the definitions used by Lilienfeld. Five terms were present in more than 50% of definitions from the period 1978 to 2017: “population”, “study”, “disease”, “health” and “distribution”. Several developments have occurred: strengthening of the terms “control” and “health” already used, the concept of “disease” was less frequently encountered whereas the concepts “infectious diseases”, “mass phenomenon” are no longer used in definitions from 1978 to 2017.ConclusionThis evolution of content of definition of epidemiology is absent from books on epidemiology. A thematic analysis of definitions of epidemiology could be conducted in order to improve our understanding of changes observed.

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“…Mathilde Frérot and colleagues surveyed the literature from 1978 to 2017 in order to determine the ways that epidemiologists understand their enterprise and how that understanding has changed through time. They examine 102 definitions of ‘epidemiology’ and found that five terms were present in more than 50% of definitions: “population”, “study”, “disease”, “health” and “distribution” (Frérot et al 2018 ). Philosophers of epidemiology have noted that definitions of epidemiology will vary depending on the social and political contexts involved.…”

“…(2006, I-1) and later in the same document: "in epidemiology, the 'patient' is the community"(2006, I-4). SeeFrérot et al (2018) for a careful empirical assessment of the variety of ways that epidemiology has been characterized in recent decades.…”

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“…the social-health situation 6 . Accordingly, epidemiological knowledge is founded upon a practical goal, namely, to contribute with solutions to populations' problems.…”

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“…Other researchers added to this concept the importance to consider the interactions among individuals and the interplay between individuals and the environment [6]. Frérot and collaborators found evolution of the concepts of epidemiology since the end of 70 s of the twentieth century to nowadays, from a disease-centered epidemiology to a study of the distribution and determinants of health-related states or events (that include diseases as just a dimension to study) [7]. Meanwhile, considering this context as an opportunity to go beyond the epidemiological approach of diseases, we face the challenge to develop what Melo calls a postmodern epidemiology, focused on people and their health-disease phenomena, concerning the nursing point of view [8].…”