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Journal of Public Health VoI. 27, No. 1, p. 128 doi:10.1093/pubmed/fdh209 Advance Access Publication 7 February 2005 Book Review Monitoring the Health of Populations: Statistical Principles and the lack of political will can be followed by a withering of the Methods for Public Health Surveillance. Brookmeyer and critical mass of professional skills. Hence, the welcome appear- Stroup, Oxford University Press, 2004. ance of books such as this. The focus of this book is on the statistical principles that Every public health professional should be drawn to this title – underpin public health surveillance. Not surprisingly, therefore, it is without doubt one of the core functions of the discipline. there is a much discussion and description of the detailed statis- The sub-title suggests an even more specific objective: Statisti- tical methods. But do not be put off by these highly specific cal Principles and Methods for Public Health Surveillance. parts of the book. The first chapter, and the first parts of subse- Note the use of both words: monitoring and surveillance. quent chapters, provide excellent overviews. Although readers Cleary these are closely related methods. Monitoring implies from outside the United States might not be familiar with some the periodic performance and analysis of routine measure- of the routine data sources used, anyone reading such a book ments, aimed at longer term trends in determinants and health will know the comparable sources in their own country. Moreo- status. Monitoring tends to be reactive, post hoc, and able to ver, the authors are not exclusively from North America, a follow the ‘known’. Surveillance usually refers to the systematic quarter coming from Europe (mainly the United Kingdom). and continuous collection, analysis and dissemination of infor- There are good examples of practical applications of the mation that enables important changes in incidence and preva- methods, including detailed illustrations of the data in use lence of determinants and diseases to be detected sensitively, (often with the relevant statistical package such as SAS). Three and addressed rapidly and efficiently. Examples include bio-ter- particularly readable chapters will help people who neither need rorism and the wider determinants of health and illness, as well nor want the finer points of statistical analysis: a chapter show- as infectious diseases. Surveillance therefore tends to be proac- ing how data can be used to evaluate a screening programme tive, preventive, and able to detect the ‘new’. (the example being prostate cancer), a chapter on how on-line The distinction between monitoring and surveillance is not systems can be used to establish surveillance systems (using gas- pedantic. In many countries, an effective surveillance system for tro-intestinal disease in Wessex as the example), and a chapter communicable diseases is matched by very much poorer sys- on capture–recapture methods in surveillance. tems for non-communicable disease. This is almost entirely due The book is certainly timely – it makes frequent reference to the paucity and inefficiency of data flows. This is, in turn, not only to the current stages of the HIV-AIDS pandemic, partly (but only partly) explained by the longer incubation peri- BSE, and bio-terrorism, but it also addresses the latest statisti- ods of non-communicable diseases. cal methods and electronic opportunities for public health Moreover, one should not be obsessed with just diseases and surveillance, a probable feature of the implementation plan of other outcomes. Most countries desperately need better surveil- the UK’s latest Public Health White Paper. lance systems for determinants of health such as individual and This book is a worthy consideration for departmental book societal lifestyle behaviours (such as tobacco) and environmen- collections (if they still exist), if not for personal collections. Don’t tal determinants (electromagnetic and other radiation). Better be put off by the detailed statistics; the formulae are matched systems are also needed for issues (such as obesity) that are by clear and readable introductory prose and diagrams. sometimes seen as determinants and sometimes as outcomes. Without a clear picture of what is happening we really have no David Pencheon idea how to design and implement appropriate strategies to Eastern Region Public Health Observatory promote healthy eating, drinking, and physical activity and Cambridge address issues such as obesity, lack of physical activity, diabe- tes, and heart disease. Cancer surveillance shows us that it is Reference perfectly possible to develop surveillance and monitoring sys- 1 Department of Health. Choosing Health: making healthier choices tems in areas other than communicable diseases. Unfortunately easier. London: Department of Health, 2004. © The Author 2005, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.
Journal of Public Health – Oxford University Press
Published: Feb 28, 2005
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