There are many different areas of medicine and health. There are so many, in fact, that many people feel quite overwhelmed with their concentration options if they want to have a career in the health care industry. It is further complicated by the fact that there is a lot of overlap between different fields and degree programs as well. Two areas in which there is a lot of overlap, but where significant differences can be found as well, are public health and epidemiology. So how do these two compare?
Public health is a mixture of many different sciences and skills. The goal of the discipline is to ensure greater health outcomes for communities across the world, but the focus is strongly on preventative measures, rather than curative, which is what you would see in medicine. Public health is an incredibly broad field, making it very difficult to truly define. The result is that the discipline is also poorly understood. There is a link to medical care within various settings in communities, but it may also have to do with preventing epidemics across the world.
The Centers for Disease Control and Prevention (CDC) has attempted to define the field, explaining that all health systems are very complex and involve a multitude of organizations, including hospitals, employers, clinics, churches, schools, and more. To better define this particular field, the CDC has stated that 10 essential services should be provided by all these different systems, and that is what public health professionals should concern themselves with. These are:
- Monitoring the health status of a community as a whole, but also of individuals, identifying problems found within those population groups and trying to solve them
- Investigating and diagnosing health hazards and health problems that affect communities as a whole
- Empowering people to take positive action for their personal health and well-being through education and information
- Creating, mobilizing, and inspiring partnerships across communities and taking action to identify health issues and resolve them
- Creating and developing plans and policies that support both community and individual health efforts
- Enforcing regulations and laws that ensure overall health is protected, keeping populations safe from disease
- Ensuring people, on an individual basis, are able to find the health services that they need, and making sure that health care provision is available across all communities
- Ensuring that the health care workforce as a whole is competent, whether they work for individuals or for entire population groups
- Make evaluations in terms of the quality, accessibility, and effectiveness of community, population, and personal health services in various communities
- Perform research to find innovative solutions and new insights in order to address various health problems
Because of this wide variety of responsibilities, a huge range of different professions and studies can be included in the umbrella term of ‘public health’, and it is also for this reason that students are encouraged to choose specialization options. Epidemiology is a very common specialization, but there are also options such as:
- Biostatistics and informatics
- Community health
- Environmental health
- Global health
- Health policy and management
- Health promotion and communication
- Maternal and child health
- Minority health and health disparities
- Social and behavioral health
Epidemiology is generally seen as a concentration within public health. It is defined as:
- A discipline that is quantitative in nature, using statistics, probability, and sound research methods
- A casual reasoning method in which professionals develop and test their hypotheses in relation to the prevention and occurrence of mortality and morbidity
- A tool that influences actions in public health in order to promote better health outcomes using causal reasoning, science, and common sense at the same time
Epidemiology is derived from the Greek ‘epi’, which means ‘upon or on’, ‘demos’, which means ‘people’, and ‘logos’, which means ‘the study of’. Actually defining epidemiology has proven to be incredibly difficult, however, mainly because the field is so wide. That being said, there are two popular definitions that are used most commonly:
- Epidemiology focuses on studying the determinants and distributions of states or events relating to health in specific populations and on applying the results of this study to put health controls in place.
- Epidemiology focuses on studying how determinants and distribution of disease frequency occur in human populations.
Within those two definitions, you can find a number of common terms that really reflect what the discipline is all about. These are:
- “Study” – epidemiology is based on sound methods of scientific enquiry and is therefore a scientific discipline.
- “Distribution” – epidemiology studies the patterns and frequency of health events that affect populations. These include how many events take place, but also what the risk and rates of diseases are in specific population groups.
- “Determinant” – epidemiologists try to find causes of health related events, including syndromes, diseases, and injuries. The discipline is analytic in nature, trying to work out what factors, other than biology, cause diseases to occur in populations.
- “States or events” – epidemiology, when first developed, focused specifically on outbreaks of communicable diseases. Over time, it started to include noncommunicable infectious diseases and communicable diseases as well. Today, it applies to injuries, chronic diseases, maternal-child health, birth defects, environmental health, and occupational health. In fact, it even focuses on behaviors.
- “Specific populations” – both physicians and epidemiologists concern themselves with controlling diseases, but the concept of “patient” is very different across these two disciplines. A physician looks at an individual, whereas an epidemiologist looks at an entire community. While both aim to find a diagnosis, a physician will care for and treat an individual. An epidemiologist is concerned about disease exposure, putting measures in place to stop it from spreading further.
An epidemiologist studies patterns of events related to health, focusing specifically on:
- Time – does it occur annually, each season, every hour, just once, and so on?
- Place – does it occur in specific geographical locations, is there a difference between the rural and the urban, and so on?
- Personal – is it linked to race, age, marital status, gender, socioeconomic status, personal behavior, professional behavior, and so on?
Essentially, epidemiology focuses on the ‘who, what, where, and when’. Epidemiologists, therefore, do more than just study things, and this is also where the link with public health is found. The studies and research they conduct are used to drive actions within public health. They work hand in hand with a range of other professionals across the field of medicine and the health care industry. As such, epidemiology is both related to science and to the practice of public health. It is also for this reason that it is often possible to complete a Master in Public Health (MPH) degree with an epidemiology concentration.