Resumen de Epidemiology and policy: the post-war context
Chronic disease epidemiology emerged after the Second World War as the dominant public health research technology. It was important in the developing relationship between research and policy. The post-war years saw the rise of the randomized controlled trial and of the “evidence-based” movement, which also influenced the drugs field. Research collaboration between the United States of America and the United Kingdom of Great Britain and Northern Ireland was strong. A multitude of theories has been used to explain the relationship between research and policy. The present article outlines four broad tendencies: the evidence-based model, the journalistic view, sociology of scientific knowledge and science policy approaches. Four examples from the field of substance use underline the relationship: the discovery by Doll and Hill of the relationship between smoking and lung cancer; the Ledermann hypothesis that limiting alcohol consumption in a society reduces drinking problems and its impact on the alcohol field; the study by Hartnoll and Mitcheson of prescribing injectable heroin versus oral methadone; and the evaluation of needle exchange in 1987. Conclusions are drawn about why research had an impact and the forms of impact that can be identified. Quantitative methodologies, epidemiology above all, dominated research in the post-war period. There has been a complex process of mutual accommodation between policy makers and researchers, to which this public health technology has been central.
