Health Policy, 5 (1985) 347-355 0 1985 Elsevier Science Publishers B.V. (Biomedical Division)
Oxford Textbook of Public Health, Volume 3 Investigative Methods in Public Health Edited by Walter W. Holland, Roger Detels and George Oxford University Press, Oxford, 1985 498 p., $35.00
This handsome hard covered book is the third of four volumes which together fall heir to Hobson’s historic “Theory and Practice of Public Health” which merited no less than five editions before his sad death in 1982. Whilst Hobson’s classic work particularly reflected his special interest in international health, it was decided that this successor work should concentrate on presenting a comprehensive view of public health as it relates to developed countries whilst recognising that there may now be a place for a comparable textbook concerned specifically with developing countries. It is nevertheless hoped that the content of the new work will continue to prove relevant and useful to students from developing countries. The first two volumes led the reader through the historical determinants of health to the overall scope and strategies for the promotion of the public health. The fourth volume will describe specific applications of public health methods of controlling disease processes, particularly in specific groups of people. This volume is described by George Knox in his introduction as falling effectively into five sections concerned successively with information systems in different countries, the relevant analytical approaches in epidemiology, the contributions to public health of various other professional disciplines, field investigations concerned with the control of hazards to health, and research and the development of services for the promotion of health in which the application of investigative methods is explored in a variety of health care systems. Knox draws the customary parallels between clinical practice on individual patients and the epidemiological approach to groups, but with a stimulating twist emphasising the importance of the differences rather than thesimilarities between clinical and public health research and practice. He also stimulates the reader (what a pity that so many skip the introduction) with the point that evaluation has two quite different if related meanings: the first depending upon measurement of performance in existing services, and the second relating to proposals for future services. Following the logic of Knox’s introduction, even the reviewer isencouraged to tackle the contents seriatim. It is remarkable that a work involving the contributions of nearly 50 experts, however distinguished and authoritative, should prove to be of such uniformly high quality. Much effort has clearly been made to cater for readers at every informed level.
Indeed, most of the chapters are comprehensive reviews in their own right, with bibliographies which must satisfy the most avid seeker after further reading. The first section covers health information sources in the United States and the United Kingdom, with a masterly chapter by Michael Alderson which for U.K. students would almost justify the E 35 on its own, and chapters on information systems and routine monitoring with examples of their application to health problems. The second section covers statistical methods and crossectional, cohort, intervention, experimental and case control studies with examples drawn from both universally renowned projects and no less interesting but less well known ones. The third section is devoted to the investigative approaches of economists, sociologists, educationalists and specialists in operational and systems analysis and in management science. Again there is a wealth of illustrative examples of past and current work which reveal both the similarities and the dissimilarities and which therefore emphasise the value of multidisciplinary studies. The section on field investigation covers viral diseases, including arboviruses; the principles of field investigations, for example in relation to epidemics, air, and hazards of food, water and noise; radiation and iatrogenic disease. The final section, on the application of methods to different situations, includes a well balanced review of screening, a stimulating chapter on an evaluation unit in the U.K. National Health Service, and interesting examples of the problems which researchers encounter in trying to influence policy in the real world of political calculation and unenlightened self-interest. The authors are aiming primarily at postgraduate students and public health practitioners, but they must surely be right in their belief that clinicians and others concerned with public health issues will find much to interest them. The four volumes are intended to be “a comprehensive textbook present in the library of every institution concerned with health sciences”. I suspect that every serious student of public health, at whatever age or stage in his career and whatever his discipline, will harbour a secret ambition to have his own copy of the ideal bench book on his own shelves. The cost may be daunting but the value is beyond dispute. A. Macara, M.D. Association
of Schools of Public Health in the European Region, Bristol, U.K.
The End of an Illusion The Future of Health Policy in Western Industrialized Nations
Edited by Jean Kervadoue, John, R. Kimberly and Victor G. Rodwin University of California Press, Berkely, CA, 1984 292 p.. US$32.75 This book was originally published in French under the title: “La santt ration&e? La fin d’un mirage (Paris: Economica 198 1)“. It is based on the exchange of ideas the authors