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The term applied epidemiology has been defined according to five core purposes: (1) the synthesis of the results of etiologic studies as input to practiceoriented policies; (2) the description of disease and risk-factor patterns as information used to set priorities; (3) the evaluation of public health programs, laws, and policies; (4) the measurement of the patterns and outcomes of public health and health care; and (5) the communication of epidemiologic findings effectively to health professionals and the public.
Many in epidemiology and public health view the linkage between etiologic research and public health intervention as implicit. However, it was observed more than two decades ago that the discipline of epidemiology has become increasingly divorced from activities in the real world that result in the improvement of public health. The concept of applied epidemiology has developed in an attempt to address concerns that epidemiology is not responding adequately to the concerns of public health practitioners. A major challenge for applied epidemiology is to improve overall health status by encouraging and measuring the effects of policy change, economic incentives, and behavioral interventions. There is also a shortage of epidemiologists in public health settings. Making epidemiology more relevant to public health practice will require training programs that provide practicing professionals with at least a basic understanding of epidemiologic methods and ways of accurately interpreting the large body of scientific literature.

Background and Historical Evolution

Epidemiology is often considered the key scientific underpinning of public health practice. The pivotal role of epidemiology was emphasized by the Institute of Medicine in its definition of the substance of public health as ‘organized community efforts aimed at the prevention of disease and promotion of health. It links many disciplines and rests upon the scientific core of epidemiology’ (Committee for the Study of the Future of Public Health, 1988, p. 41).
Since 1927, dozens of definitions of epidemiology have been put forth. A widely accepted version is the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems. Perhaps the most comprehensive definition, and the one most relevant to public health practice, and applied work was crafted by Terris (1992):
Epidemiology is the study of the health of human populations. Its functions are:
  • To discover the agent, host, and environmental factors which affect health, in order to provide the scientific basis for the prevention of disease and injury and the promotion of health.
  • To determine the relative importance of causes of illness, disability, and death, in order to establish priorities for research and action.
  • To identify those sections of the population which have the greatest risk from specific causes of ill health, in order that the indicated action may be directed appropriately.
  • To evaluate the effectiveness of health programs and services in improving the health of the population. (p. 912)
Each of these four functions has a direct application toward improving the overall health of the population. Recognition of epidemiology's role in improving the overall health of the

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