Guest contributor Dr. David C. Goff offers perspective on the future of epidemiology
A year ago, the NHLBI launched this forum in an effort to open an active discussion with the larger epidemiology research community about the future of epidemiology as it relates to cardiovascular disease. We want to thank everyone for their thoughtful contributions to the forum and look forward to further engaging with the research community on this important topic.
We are pleased to welcome guest contributor, David C. Goff, Jr., M.D., Ph.D., chair of the American Heart Association (AHA) Council on Epidemiology and Prevention, and dean of the Colorado School of Public Health, who will help us mark the one-year anniversary by sharing his perspective on the future of epidemiology:
Strong epidemiology has been a critical component of advances in public health over at least the past half-century and will remain important in the future. The potential contributions of strong epidemiology include further elucidation of the social determinants of health, the molecular determinants of health, and the comparative effectiveness of various interventions, whether based on changes in policies, systems, environments, behaviors, or the use of pharmacologic, biologic, or device-based therapies.
We need better science regarding the social influences that constrain healthy behaviors and the policy changes that can redress those constraints. The best science will likely come from strong collaboration between epidemiologists and social scientists. We need better science regarding the molecular basis of health, including how environmental exposures and behavioral patterns interact with the genome and microbiome to influence biologic systems, that can be examined with increasingly complex methods, such as epigenomics, proteomics, and metabolomics. The best science will likely come from strong collaboration between epidemiologists and systems biologists.
We need better science regarding the impact of various interventions on population health. In some instances, randomized trials will be the best approach, but for many policy-based interventions, other approaches may be needed. For example, cross-sectional observational studies have shown associations between density of public food advertisements (e.g., billboards) and obesity prevalence, but association is not necessarily causation. Evaluation of natural experiments in public food advertising could clarify this issue.
Strong epidemiology has contributed greatly to advances in cardiovascular health over the past half-century, and will be critical to efforts to advance global cardiovascular health for decades to come.
David C. Goff, Jr., MD, PhD
Chair, AHA Council on Epidemiology and Prevention
Dean, Colorado School of Public Health