Use and non-use of epidemiologic methods for social/societal problems: could political decisions be based on more solid evidence?
Keywords:Societal problems, public health problems, case control studies, public health paradigm
Many societal and social problems cause severe disease and suffering among the persons directly or even indirectly affected. Examples are diverse and include school massacres, fatal car accidents or long-term homelessness. What they have in common is that the political response to such events often varies extremely suggesting that more scientific grounding for policy decisions may lead to stronger support across different political interest groups. In comparison, other areas, such as medical therapies, benefit from sound scientific methodologies, e.g. the GRADE approach (“Grading of Recommendations Assessment, Development and Evaluation”) leading to well-accepted recommendations. This approach gives preference to studies with the highest methodological rigor. Experimental studies, such as placebo-controlled randomized trials, are ranked highest, however, when ethical or logistical reasons prohibit their use solid observational studies, for example case-control studies may provide valid results, too. For the path from evidence to policy the “public health paradigm” is a useful concept leading to the development of intervention or prevention strategies. Their implementation need to be evaluated to test their effect and form the basis for improved policies.