EPIDEMIOLOGY

branch of medical science that studies the distribution of disease in human populations and the factors determining that distribution, chiefly by the use of statistics. Unlike other medical disciplines, epidemiology concerns itself with groups of people rather than individual patients and is frequently retrospective, or historical, in nature. It developed out of the search for causes of human disease in the 19th century, and one of its chief functions remains the identification of populations at high risk for a given disease, so that the cause may be identified and preventive measures implemented. Epidemiologic studies may be classified as descriptive or analytic. In descriptive epidemiology, demographic surveys are used to determine the nature of the population affected by the disorder in question, noting factors such as age, sex, ethnic group, and occupation among those afflicted. Other descriptive studies may follow the occurrence of a disease over several years to determine changes or variations in incidence or mortality; geographic variations may also be noted. Descriptive studies also help to identify new disease syndromes or suggest previously unrecognized associations between risk factors and disease. Analytic studies are conducted to test the conclusions drawn from descriptive surveys or laboratory observations. These studies divide a sample population into two or more groups, selected on the basis of suspected causal factor (for example, cigarette smoking) and then monitor differences in incidence, mortality, or other variables. One form of analytic study is the prospective-cohort study, in which members of a population are followed over time to observe differences in disease incidence. In addition to providing clues to the causes of various diseases, epidemiologic studies are used to plan new health services, determining the incidence of various illnesses in the population to be served, and to evaluate the overall health status of a given population. In most countries of the world, public-health authorities regularly gather epidemiologic data on specific diseases and mortality rates in their populaces.