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Both clinical epidemiology and population health perspectives can define the role of health care in reducing health disparities

Anderson GM, Bronskill SE, Mustard CA, Culyer A, Alter DA, Manuel DG. J Clin Epidemiol. 2005; 58(8):757-62.


Objective — To compare and contrast clinical epidemiology and population health perspectives on the role of health care in reducing socioeconomic disparities in health.

Study Design and Setting — A review of concepts outlined in selected articles on population health and clinical epidemiology and a systematic literature search for randomized controlled trials (RCTs) of therapeutic interventions for cardiovascular disease that contained analysis of outcomes by socioeconomic status.

Results — Population health has a focus on health disparities, particularly disparities related to socioeconomic status, and many of its proponents have a pessimistic view of the degree to which health care can reduce these disparities. Clinical epidemiology has a focus on the production of valid evidence on the impact of health care interventions; however, RCTs rarely report the impact of interventions across socioeconomic strata. Both population health and clinical epidemiology share the view that efficacy, effectiveness, and cost-effectiveness are all important in defining the impact of health care on health disparities.

Conclusion — Principles drawn from both population health and clinical epidemiology could be used to provide a clearer picture of the role that health care interventions can have on socioeconomic disparities in health and to identify implications for policy, research, and clinical practice.

Keywords: Access to health care Social determinants of health Health policy/reform

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