Presentations in english
BUCK: We sometimes forget that the term etiological refers not only to causes of disease, but to causation in general; that a well-done investigation of factors affecting the outcome of illness or the prevention of disease uses the same rules of inference as an etiological study of disease causation. I realize it is awkward because etiology in most people’s minds means only disease causation, pure and simple. But in terms of science I think we should be right in the way we classify things.
NAJERA: Perhaps we should start by emphasizing the interrelatedness of the factors that cause disease. Today, everybody talks of multicausation, but if you read the studies, most researchers still search for “a cause,” they still think in terms of a single or a few simple causes of disease. They haven’t really begun to understand disease as a result of the interaction of factors working within a real web. It was Mac- Mahon who first talked of a “web of causation,” but too often this is still interpreted as a complicated but linear chain of causation rather than a complicated interrelationship of many factors. A web really means interrelation. I think we have to emphasize this.
BUCK: The title of this section implies a transition from the “old” to the “new” epidemiology, and I am not exactly sure what we mean by transition. In the first section we discussed early works that represented the old epidemiology. By new do we mean, then, the application of epidemiology to new problems? Perhaps a good beginning for this section would be for us to try and define this transition.
NAJERA: Perhaps we could begin by exploring why, how, when, and where the concept of epidemiology originated. As far as we know, “epidemic” and “endemic” derived from epidemeion and endemeion. Hippocrates used these words at the School of Cos 2400 years ago, as a way of incorporating a community outlook into the understanding of diseases. Their purpose at that time, and their correct etymology, was to differentiate diseases that visit the community-the verb epidemeion meaning “to visit”-from those that reside in it, without the added meaning of an unusual or severe occurrence. We should, therefore, keep this characteristic of “visitor” in mind, because of its usefulness in creating a methodology for studying health problems in the community.
Panamericana de la Salud con el mismo entusiasmo del primer día, y con el compromiso de seguir trabajando día a día, y hora a hora por los más vulnerables de la Región. Uno de los aspectos que mencioné en mi discurso de toma de posesión, es la necesidad de propiciar la equidad de acceso y calidad en los servicios de salud para así contribuir a la reducción de las inequidades en la Región. Una de estas inequidades la representa la persistencia de altas tasas de mortalidad neonatal en los países de la Región, y en el interior de los mismos países.
Research has demonstrated a strong and consistent link between obesity and diabetes.