Social epidemiology? No way.

Although research into social and behavioural determinants of health and illness was conducted throughout the 20th century, it has become more common since the 1980s. Because of this, the term 'social epidemiology' is increasingly encountered in the biomedical literature. Recent commentaries by Kaufman and Cooper 1,2 and Muntaner 3 on causal explanations in social epidemiology, although of interest to the research field, take the term 'social epidemiology' for granted. With reference to Syme 4 and Susser et al., 5 the authors claim that social epidemiology is 'a distinctly recognised specialisation within epidemiology', and has been for some 30 to 40 years. This field of research has been defined as the science which studies the link between social environment and the development and distribution of disease in populations, 1,6,7 a definition which emphasizes a hybrid area of interest between sociology and epidemiology. Apparently, the term social epidemiology is so established that it is even used to describe the frequency of behaviour, without any reference to disease. 8,9 Epidemiology has evolved into many different fields of application , leading to specialities such as occupational epidemiology, cancer epidemiology, and pharmaco-epidemiology. Can 'social epidemiology' be regarded as just another branch? No, we believe the term is a misnomer. Epidemiology is part of medical science and rests on a human-biological (scientific) background. Biomedical theory about, e.g. carcinogenesis, atherosclerosis, and teratogenesis is the input for scientific discussion and empirical studies in epidemiology. All epidemiological hypotheses are, or at least should be, derived from such theories by deductive reasoning. Similarly, results of epidemiological studies are used to adapt these biomedical theories by inductive reasoning. Therefore, every epidemiologist should have a basic training in biomedicine, comparable to the training that medical practitioners need as a basis for medical practice. In broader terms: epidemiology, like every other discipline derived from medicine, rests on a human-biological (scientific) background. Frequency research (the most succinct characterization of epidemiology) is also an important approach in other scientific fields, including psychology and sociology. Unlike epidemiology however, empirical studies to assess the (determinants of) frequency of psychological problems rely predominantly on socio-psychological theories. Should we call this 'psycho-epidemiology' or 'social epidemiology'? An argument in favour of using the term epidemiology outside the field of biomedicine is to stress the similarities in methodology: the statistical approach. But epidemiology is not just defined by its statistical outlook, nor is sociology or psychology. Epidemiology deals with medical knowledge …