ABSTRACT
Environmental threats are one of the highest concerns of communities seek-
ing to improve public health. University researchers seek to assist communities
with these concerns by providing technical expertise. But these community-
science collaborations are often frustrating to both parties. Communities often
find that the scientific studies have not “proven” what they believe the problem
to be, while scientists often feel at least pestered, if not manipulated, by the
“dirty” politics of the community. This paper investigates the proposition that
environmental scientists must learn to combine their quantitative studies with
qualitative views on the community and its health, if their studies are to be useful
and indeed even fully accurate. The goal of the presentation is to explore changes
in the methods of one particular field, environmental epidemiology, that might
make it more relevant to current environmental debates. After a brief history of
the field, limitations in the current practice of epidemiology are presented. These
can be grouped under two headings: an over-emphasis on quantitative results,
and an under-estimation of uncertainties in study results. Some suggestions are
given for changes that might address these problems, and make epidemiology
more useful for citizens and policy-makers. These are:
1. nest quantitative results in qualitative descriptions of study populations;
2. fit two different kinds of statistical models-one very simple, the other quite
complex;
3. conduct sensitivity analyses; and
4. use precautionary guidelines for causal inference.
