How old is epidemiology?
Seminar by Alfredo Morabia
1. 17th century move toward centralized states, organization of Europe after 30 year war
2. Crisis of Western ideas
– tabulating data
– determinants of longevity including heredity, height and weight, age, diet, behaviour, exercise, housing, medical treatment
– only trust “evidence”
– study one determinant at a time
– ignore interactions
Jan Baptista Van Helmont
– “Dawn or the New Rise of Medicine”
– anti Galenist medicine: believed in diseases, separate from the individual, with external causes
– did not believe in blood letting (Van Helmont contest) “how many funerals each of us will have funerals” idea of fraction that will get better will be greater than your fraction that will get better was opposed to all mine will be cured and none of yours will
this is Renaissance thinking; will be implemented in the Enlightenment
Bills of Mortality (death certificates) in England
Bubonic plague – disruption of society and absolutist states
idea: plague has astrological cause or is transmitted by miasms
person would diagnose and count plague deaths, then publish them weekly
idea was to have a retreat outside of London when there was an outbreak
solution to the crisis every time there was an outbreak, based on weekly death counts, then add other causes of death, then births
4. Emergence of political arithmetic and capitalism
birth of epi is related to birth of capitalism
only merchants could deal with numbers, or intellectuals
William Petty “political arithmetic”
John Graunt: Natural and Politcal Observations made on Bills of Mortality (1662)
births and deaths = gains and losses. the same skills for tracking small margins of business was applied to deaths.
5. Royal Society of London (1661)
– centralized intellectual activity and skills
– “Nvllivs in Verba” no words or no speculation, only observation
Graunt is the convergence of these things
“The Table of Casualties” shows there is regularity of health phenomena
Was able to say that plague came from outside London, which was not the same for stable diseases
as a result, more quarantine enforced, and the plague stops affecting London
Huygen’s adaptation of Graunt’s lifetable – median survival age
why asked this? how much should ask from people buying life insurance!
So how old is epidemiology? 1662 Graunt’s observation, our Big Bang. So 353 years in 2015!
Marz. read the book, asks how to educate everyone in the world, as Morabia says we should. Need to promote “epidemiological literacy”. No one understands epi spontaneously; it requires learning to understand interpretation. That’s why epi should be taught in high school, and become part of general culture.
asks 16 year olds : what do you know about health?
marijuana does x. Can get STIs. HOW DO YOU KNOW?
Ah! That’s the question.