Tuesday, June 26, 2012

Measuring disease

I realize you may not actually have asked for it, but the chart in the screenshot is one of my favorite charts ever, starting with the name. It illustrates the cover of the New York City Department of Health and Mental Health annual package of vital statistics, (2010 version available here). I like it for its clarity, the way it puts even the horror of 9/11 into perspective, and the short history of successful tackling of public health problems it offers.

I was reminded of it when I saw this broader take on theatlantic.com:
The bar chart comes from an interactive graphic from a New England Journal of Medicine article discussing the differences in disease between 1810, when the Journal published its first issue, and 2010. (Nephropathy, according to the Free Dictionary, is any disease of the kidney.) I found the discussion in the NEJM article about the social definitions of disease equally interesting.
Disease is always generated, experienced, defined, and ameliorated within a social world. Patients need notions of disease that explicate their suffering. Doctors need theories of etiology and pathophysiology that account for the burden of disease and inform therapeutic practice. Policymakers need realistic understandings of determinants of disease and medicine's impact in order to design systems that foster health. The history of disease offers crucial insights into the intersections of these interests and the ways they can inform medical practice and health policy.
And measurement, as always, is complex. The authors say:
Disease is always generated, experienced, defined, and ameliorated within a social world. Patients need notions of disease that explicate their suffering. Doctors need theories of etiology and pathophysiology that account for the burden of disease and inform therapeutic practice. Policymakers need realistic understandings of determinants of disease and medicine's impact in order to design systems that foster health. The history of disease offers crucial insights into the intersections of these interests and the ways they can inform medical practice and health policy.

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