A DISTANT ECHO OF ECO-EPIDEMIOLOGY: A REVIEW

Abstract

Epidemiology is here defined as “the study of distribution, frequency and causes of human diseases, and also the study of threats to health and the practices of public health for the prevention of specific diseases and all risks to health”. Formerly directed to phenomena affecting populations, results of epidemiological investigations have been applied to individuals, especially in what concerns risk, what became known as “the great fallacy”. Another distortion became known as “black-box epidemiology”, the adoption of sanitary and public health measures without a sound knowledge of underlying biological factors in favor of the investigation of the correlates of risk. This led to the theory that diseases could be prevented by altering the environment, without the need for detailed knowledge of pathogenic mechanisms. Finally, Susser and Susser advocated a paradigm for an emergent era of eco-epidemiology, called the “Chinese boxes”, in an allusion to the sets of boxes where each fits inside a larger box. This paper discusses in greater detail the disputes around such concepts and the pitfalls for the application of epidemiological theories to public health.