Both clinical epidemiology and population health perspectives can define the role of health care in reducing health disparities.
OBJECTIVE
To compare and contrast clinical epidemiology and population health perspectives on the role of health care in reducing socioeconomic disparities in health.


METHODS
A review of concepts outlined in selected articles on population health and clinical epidemiology and a systematic literature search for randomized controlled trials (RCTs) of therapeutic interventions for cardiovascular disease that contained analysis of outcomes by socioeconomic status.


RESULTS
Population health has a focus on health disparities, particularly disparities related to socioeconomic status, and many of its proponents have a pessimistic view of the degree to which health care can reduce these disparities. Clinical epidemiology has a focus on the production of valid evidence on the impact of health care interventions; however, RCTs rarely report the impact of interventions across socioeconomic strata. Both population health and clinical epidemiology share the view that efficacy, effectiveness, and cost-effectiveness are all important in defining the impact of health care on health disparities.


CONCLUSIONS
Principles drawn from both population health and clinical epidemiology could be used to provide a clearer picture of the role that health care interventions can have on socioeconomic disparities in health and to identify implications for policy, research, and clinical practice.
Anderson
Geoffrey M
GM
Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, McMurrich Building, 2nd floor, 12 Queen's Park Crescent West, Toronto, Ontario M5S 1A8, Canada. geoff.Anderson@uToronto.ca
Bronskill
Susan E
SE
Mustard
Cameron A
CA
Culyer
Anthony
A
Alter
David A
DA
Manuel
Douglas G
DG
D004812:Epidemiologic Methods; D006291:Health Policy; D006304:Health Status; D006801:Humans; D011203:Poverty; D016032:Randomized Controlled Trials as Topic; D012935:Social Justice; D012959:Socioeconomic Factors