American Journal of Epidemiology Advance Access originally published online on October 11, 2006
American Journal of Epidemiology 2006 164(10):1026; doi:10.1093/aje/kwk077
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Book Review |
Methods in Social Epidemiology Edited by J. Michael Oakes and Jay S. Kaufman
ISBN 0-7879-7989-9, John Wiley & Sons, Inc., San Francisco, California (Telephone: 800-956-7739, Fax: 317-572-4002, Website: http://www.josseybass.com), 2006, 504 pp., $65.00 (Hardcover)
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261
(e-mail: repro{at}pitt.edu)
Aptly titled, Methods in Social Epidemiology focuses on a discussion of methodological challenges, with the intent to build a stronger foundation for social epidemiology. Unlike a handful of predecessor texts in this field, the book specifically avoids lengthy or encyclopedic examples and sticks to the discrete task of considering definitions and analytical approaches. As such, the organization of chapters is divided as follows: "Background"; "Measures and Measurement"; and "Design and Analysis." Examples of chapters within these groupings include "Indicators of Socioeconomic Positions"; "Using Census Data to Approximate Neighborhood Effects"; "Community-Based Participatory Research: Rationale and Relevance for Social Epidemiology"; "Multilevel Studies"; and "Natural Experiments and Instrumental Variable Analyses in Social Epidemiology." Several of the chapters conclude with worked examples, wherein the conceptual framework articulated earlier in the chapter is explained by way of example. This is a real strength.
A recurrent theme in the book is the difficulty in operationalizing and deconstructing many of the most fundamental themes in social epidemiology, such as race, class, poverty, and inequality. Various chapters catalogue a myriad of approaches to the measurement of these constructs, certainly a useful endeavor, yet one underscoring the degree to which the conceptual underpinnings of this subdiscipline remain a work in progress.
Another theme is the integration of methods from epidemiology, sociology, anthropology, and economics. Both orientation and approach are flavored by the fusion of these interacting disciplines. Surely social epidemiology is much more than the measurement of a few more variables within chronic disease epidemiology. For example, the discussion of propensity score matching and its origins in a counterfactual framework nicely exemplifies a transition from basic epidemiology principles into application in a social and sociologic context. Also of note is an excellent chapter on multilevel modeling, anchored in conceptual considerations and extended to statistical implementation.
Shortcomings are as follows. First, the overall conceptualization of the subdiscipline of social epidemiology is never considered. Why should poverty be considered a social construct, whereas smoking is not? To what degree should social variables be deconstructed into biologically relevant factors, and to what degree should they be held up as important, independent of mediation?
Second, explication of how theory impacts practice is variably successful from chapter to chapter. Although the theoretical underpinnings of constructs are well described in all chapters, the move from theory to reality is not always detailed. This limits the usefulness of some chapters.
Third, the intense focus (on methods) has both benefits and detriments. The benefit is the clear bounds of what the reader can expect and the detail in addressing methodological considerations. The detriment is a lack of context with respect to public health and policy implications.
Notwithstanding these shortcomings, Drs. Oakes and Kaufman have produced a highly useful text that contributes to the field of social epidemiology. Students of social epidemiology will likely benefit from using Methods in Social Epidemiology to hone their thinking and skills.
ACKNOWLEDGMENTS
Conflict of interest: none declared.
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