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1、>TableofContents>Chapter1-IntroductionChapter1IntroductionKennethJ.RothmanSanderGreenlandTimothyL.LashAlthoughsomeexcellentepidemiologicinvestigationswereconductedbeforethe20thcentury,asystematizedbodyofprinciplesbywhichtodesignandevaluateepidemiologystudiesbegantoformonlyin
2、thesecondhalfofthe20thcentury.Theseprinciplesevolvedinconjunctionwithanexplosionofepidemiologicresearch,andtheirevolutioncontinuestoday.Severallarge-scaleepidemiologicstudiesinitiatedinthe1940shavehadfar-reachinginfluencesonhealth.Forexample,thecommunity-interventiontrialsof
3、fluoridesupplementationinwaterthatwerestartedduringthe1940shaveledtowidespreadprimarypreventionofdentalcaries(Ast,1965).TheFraminghamHeartStudy,initiatedin1949,isnotableamongseverallong-termfollow-upstudiesofcardiovasculardiseasethathavecontributedimportantlytounderstandingt
4、hecausesofthisenormouspublichealthproblem(Dawberetal.,1957;Kanneletal.,1961,1970;McKeeetal.,1971).Thisremarkablestudycontinuestoproducevaluablefindingsmorethan60yearsafteritwasbegun(KannelandAbbott,1984;Sytkowskietal.,1990;Foxetal.,2004;Eliasetal.,2004;www.nhlbi.nih.gov/abou
5、t/framingham).KnowledgefromthisandsimilarepidemiologicstudieshashelpedstemthemodernepidemicofcardiovascularmortalityintheUnitedStates,whichpeakedinthemid-1960s(Stallones,1980).ThelargestformalhumanexperimenteverconductedwastheSalkvaccinefieldtrialin1954,withseveralhundredtho
6、usandschoolchildrenassubjects(Francisetal.,1957).Thisstudyprovidedthefirstpracticalbasisforthepreventionofparalyticpoliomyelitis.Thesameerasawthepublicationofmanyepidemiologicstudiesontheeffectsoftobaccouse.Thesestudiesledeventuallytothelandmarkreport,SmokingandHealth,issued
7、bytheSurgeonGeneral(UnitedStatesDepartmentofHealth,EducationandWelfare,1964),thefirstamongmanyreportsontheadverseeffectsoftobaccouseonhealthissuedbytheSurgeonGeneral(www.cdc.gov/Tobacco/sgr/index.htm).Sincethatfirstreport,epidemiologicresearchhassteadilyattractedpublicattent
8、ion.Thenewsmedia,boostedbyarisingtideofsocialconcernabouthealthandenvironme
