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Two distinct views of the roles and responsibilities of epidemiologists have emerged in a decades-long debate: one keeps professional practice constrained to science; the other adds active participation in public health policymaking. In defense of the narrower view are several claims: that epidemiologists lack expertise in policymaking; that advocating policy adversely affects scientific objectivity; that the limits of epidemiologic science work against translating results into policy; and that participation in policy can bring on personal attacks. In this study, each claim is addressed. Epidemiologists already participate fully in educational, research funding, and editorial policymaking and thereby have an experiential foundation in some of the basics of policymaking. Policymaking can enhance scientific objectivity because it requires not only the use but more importantly the improvement of empirical methods. Finally, the comforts of professional life are not the primary yardsticks of our responsibilities. Arguments in favor of active involvement in public health policymaking are presented. Epidemiologists have been mixing science and policymaking for a long time and there is a strong sense that the benefits of public stewardship outweigh the risks. The American College of Epidemiology's Ethics Guidelines support this view. Active participation in public heath policymaking will, however, require curriculum changes in graduate training programs. With additional training and a broader recognition that public health policymaking is an appropriate professional pursuit, epidemiologists can look to a bright and challenging future in the science and practice of public health. [ABSTRACT FROM AUTHOR]

Causation is an essential concept in epidemiology, yet there is no single, clearly articulated definition for the discipline. From a systematic review of the literature, five categories can be delineated: production, necessary and sufficient, sufficient-component, counterfactual, and probabilistic. Strengths and weaknesses of these categories are examined in terms of proposed characteristics of a useful scientific definition of causation: it must be specific enough to distinguish causation from mere correlation, but not so narrow as to eliminate apparent causal phenomena from consideration. Two categories-production and counterfactual-are present in any definition of causation but are not themselves sufficient as definitions. The necessary and sufficient cause definition assumes that all causes are deterministic. The sufficient-component cause definition attempts to explain probabilistic phenomena via unknown component causes. Thus, on both of these views, heavy smoking can be cited as a cause of lung cancer only when the existence of unknown deterministic variables is assumed. The probabilistic definition, however, avoids these assumptions and appears to best fit the characteristics of a useful definition of causation. It is also concluded that the probabilistic definition is consistent with scientific and public health goals of epidemiology. In debates in the literature over these goals, proponents of epidemiology as pure science tend to favour a narrower deterministic notion of causation models while proponents of epidemiology as public health tend to favour a probabilistic view. The authors argue that a single definition of causation for the discipline should be and is consistent with both of these aims. It is concluded that a counterfactually-based probabilistic definition is more amenable to the quantitative tools of epidemiology, is consistent with both deterministic and probabilistic phenomena, and serves equally well for the acquisition and the application of scientific knowledge. [ABSTRACT FROM AUTHOR]

Although Salvadoreans are the fourth largest group of Hispanics in the United States, little is known about their cancer knowledge, attitudes, and practices. There are no publications assessing cancer knowledge among Salvadorean men. In this cross-sectional survey, information was gathered from 706 immigrant Salvadorean men in Washington, D.C. The majority of these men knew that smoking causes cancer and that some cancers can be cured if detected early. However, the men in this survey had inadequate knowledge about symptoms of cancer and early detection methods. The most important predictor of cancer screening among older participants was enrollment in health insurance plans. Our study suggests that Salvadorean men would participate in cancer screening efforts if they had access to medical care. Educational programs to increase awareness of cancer and availability of preventive services may help prevent cancer in this population. [ABSTRACT FROM AUTHOR]

Keywords:Character, education, ethics, philosophy, public health, scientific misconduct, virtues [ABSTRACT FROM PUBLISHER]

Background: Two recent accounts of the use of causal criteria make opposite claims: that criteria should be used more often to avoid bias in assessments of weak associations and, in direct contrast that criteria are scientifically invalid. [ABSTRACT FROM PUBLISHER]

Women's magazines are an important source of health information. To evaluate the relevancy of articles in these publications to known disease risks, seven women's magazines were reviewed to assess their coverage of colon cancer, the third leading cause of cancer mortality in U.S. women. Specifically, the amount of coverage devoted to colon cancer as well as the presentation of issues in the prevention, risks, treatment, diagnosis and genetics of colon cancer were recorded. Twenty articles were published on colon cancer in these magazines during the years 1987-1995. Compared to five other cancers that also affect women, colon cancer was the focus of the fewest articles in the seven magazines analyzed. [ABSTRACT FROM AUTHOR]

This is the second part of a two part glossary on terms used in public health ethics. This glossary focuses on terms related to the professional practice of epidemiology and public health. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study examined the quality of recent reviews in epidemiology. METHODS: All 1995 issues of 7 widely read epidemiology journals were searched to identify reviews. RESULTS: Twenty-nine reviews were identified. Methodology was not specified or incomplete for literature searches in 79% of reviews; the same was true for inclusion criteria in 83% and for combining studies in 62%. More than 60% of the reviews were not methodologically systematic. CONCLUSIONS: There is a need to improve the quality of review papers in epidemiology. If systematic methodology were followed more frequently, epidemiologic science and its application could be improved. [ABSTRACT FROM AUTHOR]