Margaret Somerville is Director of Public Health and Health Policy at NHS Highland. Previously she was Senior Lecturer and Director of Public Health Learning in the Peninsula College of Medicine and Dentistry. Kumaran Kalyanaraman is Clinical Scientist and Senior Lecturer, MRC Life course Epidemiology Unit, University of Southampton Medical School. Rob Anderson is Associate Professor of Health Economics and Evaluation at the University of Exeter Medical School.

• Preface to the Second Edition viiAcknowledgements viiiAbout the Authors ixHow to Use Your Textbook xPart 1 Introduction 11 Introduction to public health 22 Public health old and new 4Part 2 Epidemiology and evidence-based practice 73 Incidence and prevalence 84 Risks and odds 105 Hierarchy of evidence and investigating causation 126 Bias, confounding and chance in epidemiological studies 147 Standardisation 168 Ecological and cross-sectional studies 189 Case–control studies 2010 Cohort studies 2211 Trials (experimental studies) 2412 Systematic reviews and meta-analysis 2613 Diagnostic tests 2814 Developing clinical guidelines 30Part 3 Assessing population health 3315 Health and illness 3416 Demographic and epidemiological transitions 3617 Health information 3818 Measuring population health status 4019 Determinants of health 4220 Lifestyle determinants of health 4421 Social determinants of health 4622 Environmental determinants of health 4823 Inequalities in health 5024 Health needs assessment 5225 Maternal and infant health 5426 Health of older people 56Part 4 Improving and protecting health 5927 Disease prevention 6028 Principles of disease transmission 6229 Communicable disease control 6430 Surveillance 6631 Immunisation 6832 Screening principles 7033 Screening programmes 7234 Health promotion 7435 Changing behaviour 76Part 5 Health economics 7936 Economic perspectives on health 8037 Economic evaluation 8238 Economic perspectives on measuring health-related outcomes 8439 Economics of public health problems 86Part 6 Effective healthcare 8940 Healthcare systems 9041 Planning health services 9242 Improving services 9443 Healthcare evaluation 98Self-assessment questions 100Self-assessment answers 102Appendix: practical issues in conducting epidemiological studies 105Further reading 107Index 108

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Margaret Somerville is Director of Public Health and Health Policy at NHS Highland. Previously she was Senior Lecturer and Director of Public Health Learning in the Peninsula College of Medicine and Dentistry. Kumaran Kalyanaraman is Clinical Scientist and Senior Lecturer, MRC Life course Epidemiology Unit, University of Southampton Medical School. Rob Anderson is Associate Professor of Health Economics and Evaluation at the University of Exeter Medical School.

• Preface to the Second Edition viiAcknowledgements viiiAbout the Authors ixHow to Use Your Textbook xPart 1 Introduction 11 Introduction to public health 22 Public health old and new 4Part 2 Epidemiology and evidence-based practice 73 Incidence and prevalence 84 Risks and odds 105 Hierarchy of evidence and investigating causation 126 Bias, confounding and chance in epidemiological studies 147 Standardisation 168 Ecological and cross-sectional studies 189 Case–control studies 2010 Cohort studies 2211 Trials (experimental studies) 2412 Systematic reviews and meta-analysis 2613 Diagnostic tests 2814 Developing clinical guidelines 30Part 3 Assessing population health 3315 Health and illness 3416 Demographic and epidemiological transitions 3617 Health information 3818 Measuring population health status 4019 Determinants of health 4220 Lifestyle determinants of health 4421 Social determinants of health 4622 Environmental determinants of health 4823 Inequalities in health 5024 Health needs assessment 5225 Maternal and infant health 5426 Health of older people 56Part 4 Improving and protecting health 5927 Disease prevention 6028 Principles of disease transmission 6229 Communicable disease control 6430 Surveillance 6631 Immunisation 6832 Screening principles 7033 Screening programmes 7234 Health promotion 7435 Changing behaviour 76Part 5 Health economics 7936 Economic perspectives on health 8037 Economic evaluation 8238 Economic perspectives on measuring health-related outcomes 8439 Economics of public health problems 86Part 6 Effective healthcare 8940 Healthcare systems 9041 Planning health services 9242 Improving services 9443 Healthcare evaluation 98Self-assessment questions 100Self-assessment answers 102Appendix: practical issues in conducting epidemiological studies 105Further reading 107Index 108

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Margaret Somerville is Director of Public Health and Health Policy at NHS Highland. Previously she was Senior Lecturer and Director of Public Health Learning in the Peninsula College of Medicine and Dentistry. Kumaran Kalyanaraman is Clinical Scientist and Senior Lecturer, MRC Life course Epidemiology Unit, University of Southampton Medical School. Rob Anderson is Associate Professor of Health Economics and Evaluation at the University of Exeter Medical School.

• Preface to the Second Edition viiAcknowledgements viiiAbout the Authors ixHow to Use Your Textbook xPart 1 Introduction 11 Introduction to public health 22 Public health old and new 4Part 2 Epidemiology and evidence-based practice 73 Incidence and prevalence 84 Risks and odds 105 Hierarchy of evidence and investigating causation 126 Bias, confounding and chance in epidemiological studies 147 Standardisation 168 Ecological and cross-sectional studies 189 Case–control studies 2010 Cohort studies 2211 Trials (experimental studies) 2412 Systematic reviews and meta-analysis 2613 Diagnostic tests 2814 Developing clinical guidelines 30Part 3 Assessing population health 3315 Health and illness 3416 Demographic and epidemiological transitions 3617 Health information 3818 Measuring population health status 4019 Determinants of health 4220 Lifestyle determinants of health 4421 Social determinants of health 4622 Environmental determinants of health 4823 Inequalities in health 5024 Health needs assessment 5225 Maternal and infant health 5426 Health of older people 56Part 4 Improving and protecting health 5927 Disease prevention 6028 Principles of disease transmission 6229 Communicable disease control 6430 Surveillance 6631 Immunisation 6832 Screening principles 7033 Screening programmes 7234 Health promotion 7435 Changing behaviour 76Part 5 Health economics 7936 Economic perspectives on health 8037 Economic evaluation 8238 Economic perspectives on measuring health-related outcomes 8439 Economics of public health problems 86Part 6 Effective healthcare 8940 Healthcare systems 9041 Planning health services 9242 Improving services 9443 Healthcare evaluation 98Self-assessment questions 100Self-assessment answers 102Appendix: practical issues in conducting epidemiological studies 105Further reading 107Index 108

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