P.Mean >> Category >> Epidemiology (created 2007-12-05).

These pages describe the practice of epidemiology. Also see Measuring benefit and risk and Research designs. Articles are arranged by date with the most recent entries at the top. You can find outside resources at the bottom of this page.


2. What is socioeconomic status? (May/June 2010)

1. P.Mean: What is a good surrogate measure for socioeconomic status (created 2010-05-03). I received a question, indirectly, about what might be a good surrogate measure for socioeconomic status (SES). That raises two questions, actually. What is SES, and how can we tell if a surrogate is a good surrogate for SES.

Creative Commons License All of the material above this paragraph is licensed under a Creative Commons Attribution 3.0 United States License. You can use any of the material above if you mention my name, Steve Simon, and include a link to this page.

Outside resources:

Journal article: Beaglehole R, Magnus P. The Search for New Risk Factors for Coronary Heart Disease: Occupational Therapy for Epidemiologists. Int J Epidemiology 2002: 31(6); 1117-22. Abstract: The identification of the proximal causes of coronary heart disease (CHD) during the second half of the 20th century contributed to the prevention of premature CHD and the extension of life expectancy in middle-aged and older people in many wealthy countries. These major CHD risk factors-high blood cholesterol, high blood pressure, cigarette smoking and physical inactivity-satisfy public health criteria of causality. Strong epidemiological evidence suggests that they explain at least 75% of new cases of CHD. However, the search for 'new' or 'emerging' CHD risk factors continues, partly justified by a myth that minimizes the contribution of the major risk factors. The public health criteria of causality were applied to the following proposed new risk factors: thrombotic factors and serum homocysteine levels; infectious agents; early life exposures including prenatal factors; genetic influences; oestrogen deficiency; and the role of the psychosocial environment. None of these factors are as important as the established risk factors for epidemic CHD and their potential contribution for improving population health is limited or unclear. Research into unexplained variations in the occurrence of CHD and into life course influences and socioeconomic inequalities may provide extra leads to effective public health action. Especially important is research on the upstream social and economic determinants of CHD and its major risk factors, on the spread of the CHD epidemic to poorer populations, and into prevention policy and programme effectiveness. Available evidence supports the feasibility and effectiveness of population-wide prevention directed towards increasing the proportion of people at low risk of CHD. The vast majority of the public health effort should be directed to this approach rather than to the high risk individual approach. There is still a major gap between knowledge and action in preventing the CHD epidemics. Available at http://www.ncbi.nlm.nih.gov/pubmed/12540704.

Journal article: Bhopal R. Seven mistakes and potential solutions in epidemiology, including a call for a World Council of Epidemiology and Causality. Emerging Themes in Epidemiology. 2009;6(1):6. Abstract: "All sciences make mistakes, and epidemiology is no exception. I have chosen 7 illustrative mistakes and derived 7 solutions to avoid them. The mistakes (Roman numerals denoting solutions) are: 1. Failing to provide the context and definitions of study populations. (I Describe the study population in detail.). 2. Insufficient attention to evaluation of error. (II Don't pretend error does not exist.). 3. Not demonstrating comparisons are like-for-like. (III Start with detailed comparisons of groups.). 4. Either overstatement or understatement of the case for causality. (IV Never say this design cannot contribute to causality or imply causality is ensured by your design.). 5. Not providing both absolute and relative summary measures. (V Give numbers, rates and comparative measures, and adjust summary measures such as odds ratios appropriately.). 6. In intervention studies not demonstrating general health benefits. (VI Ensure general benefits (mortality/morbidity) before recommending application of cause-specific findings.). 7. Failure to utilise study data to benefit populations. (VII Establish a World Council on Epidemiology to help infer causality from associations and apply the work internationally.). Analysis of these and other common mistakes is needed to benefit from the increasing discovery of associations that will be multiplying as data mining, linkage, and large-scale scale epidemiology become commonplace." [Accessed December 10, 2009]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20003195.

Journal article: Bhopal R. Which book? A comparative review of 25 introductory epidemiology textbooks. Journal of Epidemiology and Community Health 1997: 51(6); 612-22. Excerpt: This reviewe is primarily to help students and teachers to find the first textbook for the keen postgraduate or undergraduate. Available at http://www.ncbi.nlm.nih.gov/pubmed/9519123.

Journal article: Coggon D, Rose G, Barker DJP. Epidemiology for the Uninitiated. Excerpt: "Epidemiology is the study of how often diseases occur in different groups of people and why. Epidemiological information is used to plan and evaluate strategies to prevent illness and as a guide to the management of patients in whom disease has already developed." Accessed on 2013-10-23. Available at http://www.bmj.com/about-bmj/resources-readers/publications/epidemiology-uninitiated.

Journal article: Gail M. A bibliography and comments on the use of statistical models in epidemiology in the 1980s. Statistics in Medicine 1991: 10; 1819-1885. Abstract "This paper reviews developments in statistical modelling in epidemiology in the 1980's, with emphasis on cohort and case-control studies. The central roles of the logistic and proportional hazard models are highlighted, and it is shown how these models lead to a deeper understanding of classical designs and methods of analysis as well as to efficient new designs and analytical procedures. The important area of model misspecification is discussed, including the problems of omitted latent structure, mis-modelling of available measurements, missing data and errors in measurements. Various designs motivated by the logistic model are illustrated numerically, and designs based on the proportional hazards model are discussed, as are papers on sample size determination. There are brief introductions to the literature on other topics, including attributable risk, disease clustering, family studies and genetics, analysis of disease incidence data, infectious disease, longitudinal data, screening and miscellaneous related topics in statistics. An extensive bibliography is indexed according to the outline of the paper." Abstract only available at http://onlinelibrary.wiley.com/doi/10.1002/sim.4780101204/abstract

Journal article: Kaptchuk TJ. Epidemiology research. Lancet 2002: 360(9328); 259. Excerpt: "Kenneth Schulz and David Grimes' discussion of blinding in randomised trials (Feb 23, p 696)1 is a useful reminder of the scientific importance of this safeguard method. Nonetheless, they might have mentioned that like many experimental devices, blinding could, in some situations, alter the phenomenon that is being studied." Available at http://www.ncbi.nlm.nih.gov/pubmed/12133687.

Journal article: McPherson K. Epidemiology on trial-confessions of an expert witness. Lancet 2002: 360(9337); 889. Excerpt: "A recent case in the UK High Court judged a claim by users of the third-generation oral contraceptive pill (3GOC), who alleged that the drug had caused a venous thromboembolism. I was an expert witness for the claimants, arguing for a scientific consensus." Available at http://www.ncbi.nlm.nih.gov/pubmed/12354468.

Journal article: Smith GD, Ebrahim S. Epidemiology-is it time to call it a day? Int J Epidemiol 2001: 30(1); 1-11. Excerpt: "Viewed through DNA-tinted spectacles, is epidemiology a discipline with a glorious past, but decreasing relevance as description (epidemiological) is replaced by explanation (gene expression)? In 2001 would we be justified in advising a potential researcher committed to making a contribution to population health to enter epidemiology training rather than head straight for the nearest polymerase chain reaction console?" Available at http://ije.oxfordjournals.org/content/30/1/1.full.

Journal article: Smith GD. The uses of 'Uses of epidemiology'. Int J Epidemiol 2001: 30(5); 1146-55. Excerpt: "In 1948—and now as a civilian—Jerry Morris became Director of the Medical Research Council Social Medicine Research Unit. This unit contributed importantly to the development of the methodology and practice of the epidemiology of chronic disease and in 1955 the Director published an article entitled 'Uses of Epidemiology' in the British Medical Journal. This article was expanded into a book which, on publication in 1957, became one of the pioneering texts of 20th century epidemiology." Available at http://ije.oxfordjournals.org/content/30/5/1146.short.

Journal article: Taubes G. Epidemiology faces its limits. Science 1995: 269(5221); 164-9. Excerpt: "The search for sublte links between diet, lifestyle, or environmental factors and disease is an unending source of fear--but often yields little certainty." Available at http://geography.ssc.uwo.ca/faculty/baxter/readings/Taubes_limits_epidemiology_Science_1995.pdf.

Journal article: Tillett H, Carpenter R. Statistical methods applied in microbiology and epidemiology. Epidemiol. Infect. 1991: 107(3); 467-478. Excerpt: "Those who work in any area of public health are exposed to large amounts of data and processed information. Some acquaintance with statistical methods can make that exposure more profitable." Available at http://www.ncbi.nlm.nih.gov/pubmed/1752296.

Quote: Scott Zeger. "Statistical models are sometimes misunderstood in epidemiology. Statistical models for data are never true. The question whether a model is true is irrelevant. A more appropriate question is whether we obtain the correct scientific conclusion if we pretend that the process under study behaves according to a particular statistical model." As quoted at American Journal of Epidemiology 1991, 134 (10), 1062.

Website: Schoenbach VJ. Epidemiology learning materials. Accessed on 2002-11-27. Excerpt: "This web site has been created as a vehicle for disseminating the current version of Understanding the fundamentals of epidemiology - an evolving text and other learning materials developed during 21 years of teaching EPID168, the introductory course for majors in the Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, ideally with refinements and additions to come." http://www.epidemiolog.net/

Website: UNC Center for Public Health Preparedness. FOCUS on Field Epidemiology. Excerpt: "FOCUS on Field Epidemiology is a periodical with a hands-on, practical approach to various topics in field epidemiology. It can be used: for computer-based self-study; as a face-to-face teaching tool for trainers; to add to lunch and learn seminars or in-service trainings" Accessed on 2013-10-23. http://www.sph.unc.edu/nccphp/focus/index.htm.

What now?

Browse other categories at this site

Browse through the most recent entries

Get help