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Departmental Overview Departmental Overview MISSION STATEMENT MISSION STATEMENTS In effecting these goals, the Department’s scope extends well beyond the bounds of the Department of Epidemiology Department’s students and faculty. The Department has long served as a resource for The mission of the Department of epidemiologic training and research for Epidemiology of the Johns Hopkins University students and faculty in other departments of School of Public Health is to improve the the Bloomberg School of Public Health as public’s health by training epidemiologists and well as in The Johns Hopkins Schools of by advancing knowledge concerning causes Medicine and Nursing and The Johns and prevention of disease and promotion of Hopkins Hospital. The Department’s impact health. As the oldest autonomous academic reaches to the city, state, national and department of epidemiology in the world, the international levels. Department of Epidemiology has long maintained leadership in fulfilling this mission. Bloomberg School of Public Health The specific goals of the Department are to: The Johns Hopkins University Bloomberg School of Public Health is dedicated to the • provide the highest quality education in education of research scientists and public epidemiology and thus to prepare the health professionals, a process inseparably next generation of epidemiologists; linked to the discovery and application of new knowledge; and through these activities, to • advance the science of epidemiology by the improvement of health and prevention of developing new methods and disease and disability around the world. applications; • use the methods of epidemiology to “Protecting Health, Saving Lives, Millions at a investigate the etiology of disease in time” human populations; "As a leading international authority on public • use epidemiologic methods in evaluating health, the Johns Hopkins Bloomberg School the efficacy of preventive and of Public Health is dedicated to protecting therapeutic modalities and of new health and saving lives. Every day, the patterns of health care delivery, School works to keep millions around the world safe from illness and injury by • develop methodologies for translating pioneering new research, deploying its epidemiologic research findings into knowledge and expertise in the field, and clinical medicine; educating tomorrow's scientists and practitioners in the global defense of human • develop approaches for applying the life." findings of epidemiologic research in the formulation of public policy and to participate in this formulation and the evaluation of the effects of such policy. ACADEMIC GUIDE 2013-2014 A BRIEF HISTORY A BRIEF HISTORY OF THE DEPARTMENT Any modification of the conditions of life as they exist in a community . requires The following is an extract from the book something more than a knowledge of the Disease and Discovery: A History of the Johns specific organisms of disease, in terms of Hopkins School of Hygiene and Public Health. their reactions under the controlled 1916-1939 by Dr. Elizabeth Fee and presents conditions of the laboratory. It equally the early developments of the Department of requires a knowledge of the community, of Epidemiology and the critical role played by the psychology of the people, their social Wade Hampton Frost, the first Chairman of the organization, the conditions and events of Department, in organizing the Department and their everyday life. It requires that the developing a methodologic and academic knowledge of fundamental causes of structure to the discipline. disease be fitted together with the knowledge of people into a practical In 1919, when Wade Hampton Frost epidemiology, directly applicable to became head of the department of prevention. epidemiology, it was probably the first such department in the world. Epidemiology had Frost also argued that epidemiology needed not yet been constituted as a formal theoretical development, drawing on the academic discipline, despite many classic theoretical understanding of disease derived epidemiological studies, most notably, from the biological sciences. He was perhaps, those to which Frost himself often remembered for the painstaking way in referred: Snow on cholera, Budd on typhoid which he searched for theoretical fever, and Panum on measles. relationships in the disorderly accumulation of empirical facts about specific diseases. A The earliest generations of epidemiologists friend and admirer, wrote in the American undertook what would later be known as "shoe Journal of Public Health, applauded this leather epidemiology," going out into a aspect of his personality: community, visiting the homes of the sick, gathering information on water supplies, milk, “We noted [in Dr. Frost] a restlessness and foods, looking for sources of infection, whenever he confronted whatever presented talking to public officials, observing local the earmarks of an unattached fact. By conditions, and gathering data on possible "unattached" is meant some apparently sound hazards to health. observation without known relationships: a sort of toy balloon bumping against the ceiling, with Frost's own early investigations of epidemic its string dangling just out of reach. Faced with disease outbreaks -- typhoid fever, septic sore such a situation, Dr. Frost would pace the throat, poliomyelitis, and influenza -- had been floor… For him the problem could be settled models of "shoe leather epidemiology." Even only in one of two ways: the balloon must either when he became professor of epidemiology, be punctured or moored. If it rose because of and began to analyze data gathered by others hot air, then heaven help its launcher. If it ("armchair epidemiology"), he remained firmly floated merely because present knowledge was committed to field research and to recognizing not tall enough to grasp the dangling string and the special value of direct personal observation tie it into basic facts, Dr. Frost reached for and of social and environmental conditions. In a usually grasped that string.” period when laboratory research was widely regarded as providing the one route to Frost is widely recognized as having provided fundamental scientific knowledge, Frost argued that analytic base and methodological principles that epidemiology as "the method of for the subsequent development of experience" was essential in developing a epidemiology. Some have questioned whether practical knowledge relevant to the problems of his conception of the field included the chronic disease prevention: as well as the infectious diseases. In fact, his definition of epidemiology broadened over time as his work developed and expanded. In 1919, ACADEMIC GUIDE 2013-2014 A BRIEF HISTORY he defined epidemiology as "the natural history infections. The work on tuberculosis was of the infectious diseases, with special important in initiating research on the chronic reference to the circumstances and conditions diseases. Frost argued that such studies which determine their occurrence in nature." By required new methods of longitudinal analysis 1927, he raised the question whether the term and he introduced methods of measuring the "epidemiology" should be applied to risk of developing disease over different periods noninfectious diseases: "It is entirely in of the life span. conformity with good usage to speak of the epidemiology of tuberculosis; and it seems Frost had arrived at the School of Hygiene customary also to apply the term to the mass- without teaching experience and with no models phenomena of such non-infectious diseases as for developing a course of instruction. He scurvy, but not to those of the so-called cautiously introduced his first plans for the constitutional diseases, such as arteriosclerosis department: "The field of epidemiology as a and nephritis." separate department is not yet clearly defined…so that the scope and methods of In 1937, however, at the American Public Health instruction must be worked out gradually." The Association meetings in New York, Frost "laboratory method" of teaching epidemiology declared that epidemiology included all that Frost subsequently developed became so diseases and hazards to health: successful that epidemiological departments throughout the country later copied it. He used “The health officer may well think of real case studies to teach techniques of epidemiology as comprising the whole of the problem solving, he supplied original unremitting effort being made to clarify the epidemiological data from ongoing relation between the diseases and disabilities investigations, suggested methods of analysis, which men suffer and their way of life. This and then let students debate possible view brings epidemiology into its proper relation approaches and solutions. to the health officer's administrative responsibilities to modify the environment or Students were required to tabulate the crude alter the habits of people as to afford them data, state any pertinent facts known about the protection against impairment of health.” epidemiology of the disease in question, and present an interpretation of the whole set of Frost saw epidemiology as a tool to be used by data in written form. practicing public health officers and not simply as an academic specialty. Indeed, he urged Lectures on epidemiological methods and the health officers to conduct their own interpretation of field data supplemented epidemiological investigations even if they had laboratory classes. Students who loved the no specialized training: "The closer his [the laboratory style of teaching
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