International journal of epidemiology
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Letter Biography Historical Article
John Snow, the Broad Street pump and modern epidemiology.
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Cohort mortality between 1875 and 1975 in Japan from cancers of the oesophagus, tongue, and larynx were examined. Death rates were compared with per capita alcohol and tobacco use which are major aetiological agents for these tumours in Westernized countries. ⋯ More consistent with this low drinking pattern are the rates for cancers of the tongue which remain among the lowest in the world. Cancers of the larynx, which have been associated with tobacco and alcohol, declined among successive cohorts, which was in contrast to the sharp cohort increases for lung cancers and tobacco use in Japan during the same period.
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Biography Historical Article
John Snow, the broad street pump and modern epidemiology.
John Snow was a genius in epidemiology. His achievement was to evolve an elegant, internally and externally consistent theory which concerned the mechanisms and processes involved in every aspect of the subject he had chosen to study. ⋯ He published his theory, and practical suggestions for the prevention of cholera arising out it, both internally in medical meetings and to the medical press, and to the public in the form of pamphlets and in reports addressed to the appropriate authority. This surely should be the objective of all epidemiological work.
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A comparison has been made of the recent changes in coronary heart disease mortality in Australia, the USA, and in the United Kingdom (England and Wales). Sharp declines in mortality dating from 1966 in Australia and from 1968 in the USA in both sexes contrast with a persistent increase in men in England and Wales until 1972 (after which a sight fall occurred) and a consistent slight fall in women since 1950. An investigation has been made of changes in 3 major risk factors-hypertension, cigarette smoking and diet in the 3 countries in an attempt to determine to what extent such changes might correlate with the different patterns of mortality. ⋯ In Australia and the USA increases in vegetable fat consumption have occurred since 1950 with a reduction in animal fat in Australia but not in the USA. In the United Kingdom increases in vegetable fat have not been observed while there has been some increase in animal fat. It is concluded that the different patterns of coronary heart disease mortality in the 3 countries do correlate to some extent with changes in diet and cigarette smoking.