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Learning Center Experience
By Tiffany Stallings, Adjunct Faculty, Kaplan University School of Health Sciences
Both leather shoes and gigabytes have been used to make
advancements in the field of public
health. These key terms refer to methods of collecting public health
data. Leather shoes relates to a more
old-fashioned method of physically traveling to the data source to gather
information while gigabytes corresponds to modern electronic data sources
stored digitally. Gigabytes may appear
to be the way of future research, however the leather shoe method still has an
important place in today’s research, and its previous accomplishments should be
reviewed and built upon.
Public health research includes, but is not limited to,
vaccines, medications, medical treatments, lifestyle modifications, safety
measures, proper food handling, and environmental exposures. John Snow is a historical figure in public
health and is often known as the “father of modern epidemiology.” Epidemiology has been defined as “the study
of how disease is distributed in populations and the factors that influence or
determine this distribution.”1 Public
health research uses epidemiologic methods, statistical tests, and modeling
techniques to help understand how risk factors (e.g. genetics, lifestyle behaviors,
or environmental exposures) may cause certain diseases or health
conditions. It is through identifying
and limiting these risk factors that diseases can be prevented or the severity
of the condition lessened.
Much of today’s public health research
consists of digital data sources such as medical records, online surveys, and
electronic imaging techniques. Research hypotheses are often tested using
computer-based data analysis systems such as Statistical Product and Service
Solutions (SPSS) and Statistical Analysis System
(SAS). This allows for some primary and
many secondary data analyses to be completed without physically interviewing
study participants or leaving the computer desk. Digital data sources and
analyses often reduce the time needed to complete research which in turn allows
for quicker implementation of study findings. However, first-hand accounts that
aid in deeper understanding of the problem could be missed with this method.
Public health research has not always been so
Take for example the story of John Snow’s admirable pen and
paper research on cholera. Snow conducted
leather shoe epidemiology or field epidemiology, meaning that he was out walking the streets of London to see and
interview patients/study participants. John Snow was born in York, England in 1813 and by 1843 he
was practicing medicine in London.2 A common disease of that time
was cholera. It causes such
severe dehydration due to diarrhea and vomiting that death can occur within
hours.3 The cause of cholera, a bacterium called vibrio cholerae, and the method of
transmission or spread of disease was unknown at that time.1
Following the 1848–1849 cholera epidemic, Snow published his
hypothesis that cholera affected the stomach and intestines by consumption of water
contaminated with feces from those ill with the disease.4 At first,
Snow’s theory was not accepted by the medical community. However, his research
through an investigation during the 1854 cholera epidemic helped prove his
theory to be true.
For this investigation, Snow went door to door with a list
of names and addresses of the fatal cholera cases, asking family and friends
for the deceased’s source of drinking water.
This research found that more than three-fourths of the cases had
consumed water from the public water pump on Broad Street.4 Further,
Snow created a map of the streets, water pumps, houses, and businesses
encompassing the area of the cholera outbreak. He marked the location and
number of cholera deaths and found they centered around the location of the Broad
Street pump. A note of interest is that there were no reported cholera deaths
among the workers at the brewery because cholera bacteria were killed during
the beer’s fermentation process.5 Following Snow’s report of these
findings, the handle of the contaminated pump was removed and the number of
cases was greatly reduced.4 This research provided convincing
support of his theory. While Snow’s work was time consuming, he viewed the full
extent of the problem first-hand.
Whether you use the leather shoes or gigabyte method of data
collection, we as Kaplan University
faculty hope that you contribute to advancements in the field of public health.
Whether through following Dr. Snow’s example and building on field epidemiology
or staying at your computer and expanding on the advancements of current heath
information and technology, we encourage you to put to use the knowledge and skills learned at Kaplan University
to conduct public health research. We
also invite you to visit the Center for
Public Service resources section for health and public service
Bergman, N.A. (1958). The Legacy of John Snow: An
Appreciation of His Life and Scientific Contribution on the 100th
Anniversary of His Death. Anesthesiology,
Centers for Disease Control and Prevention.
(2011, February 24). Cholera – Vibro
cholerae infection. Retrieved from http://www.cdc.gov/cholera/general/
Gordis, L. (2004). Epidemiology (3rd ed.). Philadelphia, PA: Elsevier Saunders.
Mackenzie, J. (n.d.). Mapping the 1854 London Cholera Outbreak. Retrieved from http://www.udel.edu/johnmack/frec682/cholera/
Snow, S. (2002). Commentary: Sutherland, Snow
and water: the transmission of cholera in the nineteenth century. International Journal of Epidemiology, 31(5),
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