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Dr Colin Butler (National Centre for Epidemiology and Population Health in Canberra, Australia) addresses the need for modern day epidemiologists to focus on unpopular public healthcare issues, including poverty and resource depletion. He notes that these issues are today's "elephants in the room" of public health. Butler was named as one of the "100 Doctors for the Planet" by the French Environmental Health Association in 2009.


Epidemiology has made major contributions to public health beginning in the 1850s when John Snow identified a location of a London well associated with cholera. Butler reports current popular areas of interest to epidemiologists, including the obesity epidemic, health consequences of junk food, chronic diseases such as diabetes, cancer, and the impact of our health knowledge on marketing practices. Butler expresses concern that interest in these topics may contribute to funding for epidemiological academic studies but are not the major health issues of our time.


Butler encourages epidemiologists to focus on the public health consequences of one-seventh of the world's population going to bed hungry each night. He also notes that epidemiological studies could identify factors that contribute to more than 2 billion people dealing with chronic fatigue as a consequence of dietary iron deficiency. In addition, the potential depletion of fossil fuels and phosphates threatens food security worldwide. Global climate change will likely alter the infrastructure of communities, agricultural practices, and even strategies to transport foods.


As we look to the past, Butler notes that dirty hands were not seen as related to childbed fever, nor was the incidence of cholera directly linked to sewage. Currently, poverty, resource scarcity, and climate change are issues that are indeed relevant to public health but are not a focus for epidemiologists. Butler strongly notes that epidemiology could provide answers and solutions to these problems of poverty if the science would focus on the issues at hand.


As an afterthought, should we consider whether nursing is focusing adequately on these issues?


Source: Butler C. An evolving science for an evolving time. The Scientist: Magazine of the Life Sciences. January 1, 2012. Available at Accessed January 13, 2012.


Submitted by: Robin E. Pattillo, PhD, RN, CNL, News Editor at