American Journal of Epidemiology Vol. 154, No. 6 : 588
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
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From the Editor
Differences in burdens of disease among populations exposed to differing environments were recognized even in ancient times. In Airs, Waters, and Places, Hippocrates gives an eloquent recital of factors affecting disease occurrence (1
). Among other factors, including physical aspects of the environment, he mentions (in translation): "...the mode in which the inhabitants live, and what are their pursuits, whether they are fond of drinking and eating in excess, and given to indolence, or are fond of exercise and labor...For if he knows all these things well..., he cannot miss knowing, when he comes to a strange city, either the diseases peculiar to the place, or the particular nature of common diseases" (1, p. 156–7). In the 19th century, the association between the deplorable living conditions of the "laboring classes" and their excess mortality was a major factor initiating widespread sanitary reform in Europe and North America (2, 3). Probably the most comprehensive evaluation of geographic and socioeconomic variations in disease prevalence and mortality in the United States population during the 20th century is contained in the 26 studies carried out by the Committee on the Costs of Medical Care between 1927 and 1932 (4).
British epidemiologists have been in the forefront of research to elucidate the causes of social, economic, and geographic variations in disease occurrence. Their recent work is summarized in a new book, The Widening Gap (5). The editors—Shaw, Dorling, Gordon, and Davey-Smith—are all well-known in Britain and are likely to become so in the Western Hemisphere because of their dynamic approach to epidemiology. The book is favorably reviewed by John Lynch in the International Journal of Epidemiology (6). According to the reviewer, "...it provides a marvelous template for similar efforts to investigate the worst and best health millions in other countries around the world" (6, p. 1099). Unfortunately, at present, it is available only by special order from the British publisher.
References
- The genuine works of Hippocrates. Translated from the Greek by Francis Adams. New York, NY: William Wood & Company, 1891.
- Sanitary condition of the labouring population of Great Britain. From the Poor Law Commissioners, London, England: W. Clowes and Sons, 1842.
- Report of a general plan for the promotion of public and personal health. Commissioners, Boston, MA: Dutton & Wentworth, 1850.
- Medical Care for the American People (final report). Committee on the Costs of Medical Care. Chicago, IL:University of Chicago Press, 1932.
- Shaw M, Dorling D, Gordon D, et al., eds. The widening gap. Bristol, England: The Policy Press, 1999.
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Lynch J. The widening gap. (Book Review). Int J Epidemiol 2000;29:1099.
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  ERRATUM Am. J. Epidemiol., November 15, 2001; 154(10): 980 - 980. [Full Text] [PDF]
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