Why Groups Matter: Social Epidemiology

The very first epidemiologists considered the social forces behind health. For instance, they understood that if you were poor, you were more likely to be exposed to diseases like cholera. But the dawn of germ theory in the 1820s pulled epidemiologists to the microscope and away from looking at how social context affects individual health.

In the past decade, a growing number of epidemiologists have called for a return to considering how social interactions--norms, laws, institutions, conventions, and conditions--affect the health of populations. With a new book, Methods in Social Epidemiology, SPH associate professor J. Michael Oakes offers a resource for those interested in this emerging field.

Oakes and co-editor Jay Kaufman, University of North Carolina at Chapel Hill, recruited original work from all-star experts in the field. The collection marks the first methods book on social epidemiology. It's a greatly needed resource, says Oakes.

"People working in this new field haven't paid enough attention to scientific rigor and to the challenges that social scientists have struggled with for a century," he says. "These issues have been largely ignored."

At the surface, it may seem obvious to say that socioeconomic position affects health. But scientifically analyzing the issue brings complex challenges. How does one measure race, poverty, or segregation? How does one statistically compare the differences among neighborhoods? How does one account for differences that affect health?

Social epidemiology aims for a more comprehensive approach than the traditional "genes and germs" framework, says Oakes. He calls on a famous fictional castaway to illustrate his point.

"Epidemiologists have seen people's health as the result of mother nature, island weather, and bacteria--but not other people," he says. "This isn't what the original epidemiologists or current social epidemiologists think. We're trying to get past the epidemiology of Robinson Crusoe."