1. Novick, Lloyd F. MD, MPH

Article Content

Evidence-Based Public Health, Ross C. Brownson, Elizabeth A. Baker, Terry L. Leet, Kathleen N. Gillespie, Oxford; 2003. 235 pages, hardcover, $39.95.


Evidence-Based Public Health by Ross Brownson and colleagues is a valuable gem for students and practitioners alike. Evidence-based public health is growing in acceptance and importance. The analogy with evidence-based medicine is apparent and referred to in the beginning of the text. The advantages of a similar approach to public health are well described and will motivate the reader. The major work of the U.S. Public Health Services Task Force on Community Health Services in providing an evidence-base for public health is used for examples and illustrations throughout the volume. Brownson, a former task force member, was instrumental in task force assessment of the evidence-base and recommendations on the subject of physical fitness and exercise.


The value of this text is its lucid stepwise progression and explanations of the evidence-based process. Chapter and organization flow in logical and helpful sequence from describing the need for evidence-based public health, how to assess scientific evidence, an exposition on the analytic tools that can be employed, searching the scientific literature, prioritizing program options, implementation, and evaluation. These subjects regarded by many as complex and technical are presented in a highly readable style.


Brownson and colleagues also address the limits of evidence in making public health decisions. They list barriers to more effective use of data and analytic processes in decision-making including leadership, inadequate training, and external or political pressures. They also acknowledge the lack of data on the effectiveness of certain public health interventions. This section needs expansion. The momentum toward evidence-based public health, which this book will increase, also has to be balanced an understanding of where this approach cannot provide guidance for contemporary decision making and policy making. Similarly, the exposition is excellent of the analytic methods for prioritizing health issues and program options. The use of analytic frameworks is described. However, the caveats listed by the authors in employing an analytic method for actual implementation of programs at state and local levels are much broader than those listed.


Despite some minor quibbles, this is a stellar text. This is a must read for all students and public health professionals. The extent of the benefit to the reader goes far beyond exploration of establishing an evidence-base for public health. Understanding and competencies in research design, data acquisition, and interpretation, analytic methods and evaluation are also rewards waiting for the reader.