Health and greening the city; setting for health promotion: the importance for an evidence base. (Commentaries: Urban Green Spaces).(community and health promotion)

For some time epidemiology has been criticised for focusing almost exclusively on individual disease risk factors. Thus Shy (1) maintains that academic epidemiology has served clinical medicine well because of its narrow biomedical perspective, dealing with risk factor and disease associations, rather than contributing to a population understanding of disease patterns. Others have been critical of this biomedical individualism and pointed to the lack of social, economic, environmental, and political analysis. (2,3) In particular Rose has urged the need to recognise the crucial but subtle difference between sick individuals and sick populations. He suggested that epidemiology should understand disease as a consequence of how society is organised and behaves, what impact social and economic forces have on incidence rates, and what community actions will be effective in changing incidence rates. Epidemiology has been the main scientific method of public health and …