Ebook: Healing the Schism: Epidemiology, Medicine, and the Public’s Health

My conviction is that the matters addressed in this volume are of transcendental importance if we are to face up to the challenges of the 1990s and beyond. How, for instance, are we to cope with a truly ecological approach to public health and all its concomitant changes of risk groups worldwide unless there is a full appre­ ciation of the popUlation perspective throughout the health establishment? The global village has achieved a measure of interdependence requiring recognition by all concerned with the health of both individuals and communities that there is an urgent need to share our knowledge and deploy our resources in the best interests of people everywhere. The history of public health initiatives, the origins of epidemiology, and the tragic separation-virtually a divorce--of public health from medicine recounted in the chapters that follow argue strongly for an early rapprochement. Health professionals who complement each other's knowledge and skills can be reunited through their common reliance on epidemiology as a major fundamental science for the entire health enterprise. Henceforth, epidemiology should be ranked in importance with cellular and molecular biology, immunology, and the social and systems sciences; all are essential if we are to cope with the vast array of diseases and disorders that face us in both the developed and developing worlds. We need more first-rate laboratory scientists, clinicians, nurses, aides, village health work­ ers, and managers committed to serving the public.

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The term schism has been used more than once by leaders in both public health and medicine to describe the increasing separation of the two fields in the past decades. Kerr L. White argues that this illogical separation diminishes their combined scientific, organizational and institutional potentials. His book proposes the thesis that the population perspective and concerns for the public's health should be reintegrated into the clinical departments of medical schools where they once flourished. Much of the author's work was in conjunction with the Rockefeller Foundation's Health of Populations program and the International Clinical Epidemiology Network (INCLEN). His book reviews the reasons behind the neglect of public health, the institutionalization of the schism, the evolution of concepts for improving public health and the creation of INCLEN.