Historical development of epidemiology and of the concepto of risk

Abstract

The use of probability reasoning in health practices was first introduced by epidemiology and is today largely used in the diverse areas of medicine. The aim of this study was to revisit the historical development of epidemiology and the formalization of its central epistemological feature, the concept of risk, responsible for the emergence of probability as part of causal thinking in health sciences. The study is situated in the frontiers of the disciplines of preventive and social medicine, history and philosophy of sciences, defined as a historical-critical epistemology. The studied period goes from 1872 to 1965 and its documental base was formed by articles of scientific journals related to the construction of the epidemiological field, particularly the American Journal of Hygiene, books, conference annals, scientific brochures etc. Three phases of the development of epidemiology were identified and discussed: Epidemiology of constitution, epidemiology of exposure and epidemiology of risk, pointing out epistemological and socio-cultural aspects related to each one of them. It was stressed the relevance of critical reflection on epidemiologic science, and health sciences in general, to optimize its present use and to favor its permanent and creative transformation.