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My conviction is that the matters addressed in this volume are of transcendental importance if we are to face up to the challenges of the 1990s and beyond. How, for instance, are we to cope with a truly ecological approach to public health and all its concomitant changes of risk groups worldwide unless there is a full appre ciation of the popUlation perspective throughout the health establishment? The global village has achieved a measure of interdependence requiring recognition by all concerned with the health of both individuals and communities that there is an urgent need to share our knowledge and deploy our resources in the best interests of people everywhere. The history of public health initiatives, the origins of epidemiology, and the tragic separation-virtually a divorce--of public health from medicine recounted in the chapters that follow argue strongly for an early rapprochement. Health professionals who complement each other's knowledge and skills can be reunited through their common reliance on epidemiology as a major fundamental science for the entire health enterprise. Henceforth, epidemiology should be ranked in importance with cellular and molecular biology, immunology, and the social and systems sciences; all are essential if we are to cope with the vast array of diseases and disorders that face us in both the developed and developing worlds. We need more first-rate laboratory scientists, clinicians, nurses, aides, village health work ers, and managers committed to serving the public.
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FRONTIERS OF PRIMARY CARE
Series Editor: Mack Lipkin. Jr.
Frontiers of Primary Care Series Editor: Mack Lipkin, Jr.
Editorial Board Charles Bridges-Webb
Burton Singer
Sydney, Australia
New Haven, Connecticut, USA
Thomas Delbanco
Robert Taylor
Boston, Massachusetts, USA
Portland, Oregon, USA
Sheldon Greenfield
Kerr L. White
Boston, Massachusetts, USA
Charlottesville, Virginia, USA
Henk Lamberts
Maurice Wood
Amsterdam, The Nether1ands
Richmond, Virginia, USA
Robert PanteD San Francisco, California, USA
Published Volumes Barnes, Aronson, and Delbanco (eds.) Alcoholism: A Guide for the Primary Care Physician Schmidt, Lipkin, Jr., de Vries, and Greep (eds.) New Directions for Medical Education: Problem-Based Learning and Community-Oriented Medical Education Goldbloom and Lawrence (eds.) Preventing Disease: Beyond the Rhetoric WONCA Classification Committee Functional Status Measurement in Primary Care White Healing the Schism: Epidemiology, Medicine, and the Public's Health
Forthcoming Volumes Lipkin, Jr., Putnam, and Lazare (eds.) The Medical Interview
Kerr L. White
Healing the Schism Epidemiology, Medicine, and the Public's Health With Foreword by Halfdan Mahler
Springer-Verlag New York Berlin Heidelberg London Paris Tokyo Hong Kong Barcelona Budapest
Kerr L. White, M.D. Former Deputy Director for Health Sciences The Rockefeller Foundation New York, NY 10036, USA
Series Editor Mack Lipkin, Jr., M.D. Director, Primary Care Associate Professor of Medicine New York Univeristy Medical Center School of Medicine, New York, NY 10016, USA
Library of Congress Cataloging-in-Publication Data White, Kerr L. Healing the schism: epidemiology, medicine, and the public's health / Kerr L. White. p. cm. - (Frontiers in primary care) Includes bibliographical references and index. ISBN-13: 978-1-4612-7820-7 I. Public health. 2. Epidemiology. 3. Medicine-Philosophy. I. Title. II. Series. [DNLM: 1. Epidemiology. 2. Public Health. WA 105 W585hj RA427.W48 1991 614-dc20 91-5053 DNLM/DLC Printed on acid-free paper.
©1991 by Springer-Verlag New York Inc. Softcover reprint of the hardcover 1s