Now, what exactly is an applied epidemiologist, and why are they needed? In the late 90s- early 2000's there were a series of articles in AJPH, AJE, JECH, and IJE dedicated to answering these questions. I'll focus on Stephen Thacker's review.

He states, “The applied epidemiologist is by definition an activist, moving rapidly from findings to policy, putting epi knowledge to good use. The 21st century epi must do all these things while maintaining a foundation of high-quality epi research and practice.”
Susser warns the field of what he considers “the black box paradigm… the current international focus on risk factor epidemiology.” He advocates for expanding our academic training to include socializing epis to “keep the improvement of the public’s health as a primary value”
Morabia argued that epidemiology has historically found its balance in the tension between the search for causal relations and the improvement of public health; overemphasis on either perspective puts epidemiology at risk of losing its value.
How does this play out in real life? I’ve been an applied epi for 13 years, working mainly in local, state, and federal health agencies. My work has focused on conducting cool analysis that lead to policy or systemic change.
A quick example from my time as Chief MCH epi for a state, using Medicaid data, I noticed that postpartum people weren’t returning for their six week check-up. Using PRAMS data I noticed that people with extremely short birth intervals stated the pregnancies were missed timed.
Using family planning data I noticed that postpartum people made appointments for LARCs, but weren’t coming in to get them placed. Knowing state Medicaid policy, I knew that postpartum people were only insured 60 days post delivery.
Empirical evidence tells me that mistimed pregnancies have health consequences for both baby and mom, and that short birth intervals are a risk factor for maternal mortality. What can I do? Before I tell you that, are you impressed at all the data I can easily get my hands on?
Back to what can I do- being a #govepi also means knowing health policy. At the time, state Medicaid policy didn’t allow for LARC placement at time of delivery, order could be made, and placement occur at 6 week follow-up. An appointment that on average 60% of people missed.
With all my data in hand, I requested Medicaid change their rules. Medicaid requested cost benefit analysis and a policy analyses, which I conducted. Ultimately leading to me helping to write policy allowing for no cost family planning services at any point during care.

More from Education

Time for some thoughts on schools given the revised SickKids document and the fact that ON decided to leave most schools closed. ON is not the only jurisdiction to do so, but important to note that many jurisdictions would not have done so -even with higher incidence rates.


As outlined in the tweet by @NishaOttawa yesterday, the situation is complex, and not a simple right or wrong https://t.co/DO0v3j9wzr. And no one needs to list all the potential risks and downsides of prolonged school closures.


On the other hand: while school closures do not directly protect our most vulnerable in long-term care at all, one cannot deny that any factor potentially increasing community transmission may have an indirect effect on the risk to these institutions, and on healthcare.

The question is: to what extend do schools contribute to transmission, and how to balance this against the risk of prolonged school closures. The leaked data from yesterday shows a mixed picture -schools are neither unicorns (ie COVID free) nor infernos.

Assuming this data is largely correct -while waiting for an official publication of the data, it shows first and foremost the known high case numbers at Thorncliff, while other schools had been doing very well -are safe- reiterating the impact of socioeconomics on the COVID risk.

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