Ayres, José R. Sobre o risco : P ara comprender a epidemiolog í a. [Concerning risk: To understand epidemiology.] São Paulo, Brazil: Editora Hucitec; 1997. Parte 2, O conceito de risco e o espaço público de saúde: uma hermenêutica da epidemiolog í a moderna. [Part 2, The concept of risk and of public space in health: a hermeneutics of modern epidemiology.]
Objectives: To analyze the development and transformation of the concept of risk as an organizing principle in epidemiological discourse and in its relationship to medical practices.
Methodology: Critical review of the epidemiological literature concerning the category of risk.
Results: The study of North American and European epidemiological literature enables the author to contextualize the historical development of the concept of risk. He emphasizes the lack of literature dealing with the epistemological history of epidemiology, and in particular with the concept of risk, despite the centrality of risk in modern epidemiology. He highlights the early formative period of epidemiology, beginning in 1872 with the founding of the American Public Health Association. From this date until the first third of the 20th century, the concept of risk reached greater prominence. Yet, even in the 1920s it still occupied a relatively small niche in epidemiology. At that point, the notion of risk was tied to ideas of threat or danger, but not to those of probability, chance, or gradation of risk.
During the 1930s and 1940s, the notion of risk took on an analytical dimension. As risk became defined as a condition of individual susceptibility, affecting infectious disease epidemics, risk no longer denoted only a condition of the broader population. It instead indicated a relationship between individual and collective phenomena.
After World War II the concept of risk reached its full development and its centrality within the discipline, characterized by its technical and quantifiable attributes. Risk designated probabilities of susceptibility, attributable to an individual from a given group and that persons degree of exposure to specific agents.
Conclusions: The concept of risk has changed historically. This perspective provides an historical and epistemological critique of North American and European epidemiology.
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