Applied epidemiology for the 21st Century

Critics argue that the modern epidemiologist seems more concerned with intricately modelling complex relationships among risk factors than understanding their origins and their implications for public health. Indeed, some contend that epidemiology has reached its limits as a discipline. To address such concerns, alternatives have been proposed that integrate biological, analytical, and social approaches to epidemiological practice and training.

The published literature was reviewed to examine critical issues in current epidemiological practice and training. In addition, we reviewed records of training programmes in applied epidemiology established in 20 countries.

We describe an existing approach to preparing epidemiologists for the emerging challenges of public health in which epidemiological research and practice are applied toward the end of improving public health and health care. Training in applied epidemiology is based on a philosophy of 'learning while doing'. Under the supervision of an experienced epidemiologist, trainees conduct field investigations, analyse large data bases, evaluate surveillance systems, publish and present scientific research, and respond to public enquiries. More than 3000 people have received intensive formal training over the past 50 years in programmes in more than 20 countries; most graduates continued to use the tools of applied epidemiology in their work.

Training in applied epidemiology anchors the discipline in population-based, relevant public health practice.