The Future of Epidemiology: Exploring Emerging Trends in Public Health
Epidemiologists are real-world superheroes, drawing on the power of health data to conquer a myriad of threats. Working tirelessly to quell the spread of infection, these passionate professionals hold the ultimate power: the ability to predict potential health crises and respond proactively to reduce the public's risk.
Simply put, epidemiologists' hard work saves lives and limits suffering. Thankfully, they don't need to go it alone. They are aided by emerging technologies, research breakthroughs, and a cross-disciplinary spirit of collaboration. Together, these essentials produce powerful new strategies that epidemiologists can unleash in their fight against infection. Unfortunately, though, new challenges threaten to set back their efforts — with everything from climate change to labor shortages introducing major obstacles.
Thus, epidemiologists can never expect to get comfortable with the status quo. Every new outbreak or technological opportunity forces these adaptable professionals to shift their approach, yet this is actually one of the field's greatest strengths.
Offering a glimpse into this unique professional environment, below we explore several emerging trends in public health, along with recommendations for keeping up with the fast pace of change.
The Evolution of Epidemiology: A Brief Overview
Epidemiology has come a long way in a few short years, with many advancements spurred by rapidly progressing technologies — and others brought to light by the COVID-19 pandemic. One of the biggest evolutions in epidemiology involves the public's awareness (and perception) of epidemiologists, who once largely worked in the background but quickly became household names in 2020.
Long before COVID, however, epidemiology played a critical role in expanding our understanding of disease and helping the public get on board with crucial health measures. These, in turn, have dramatically reduced mortality rates and extended the human lifespan.
Historical Foundations
Epidemiology experts believe that "epidemiological thinking" emerged nearly 2,500 years ago, with Hippocrates, most notably, highlighting diseases as a rational phenomenon rather than attributing them to supernatural causes. In the essay On Airs, Waters, and Places, Hippocrates even suggested that environmental factors may influence the spread of disease.
However, it was not until the 1600s that this concept took another step forward. John Graunt and William Farr deserve credit, drawing on extensive mortality data to pinpoint significant patterns in disease occurrence. Despite their contributions, John Snow is often referred to as the "father of field epidemiology," largely due to his groundbreaking investigation into the spread of cholera. This involves statistical mapping methods, which helped him identify a public water pump as the source of a major outbreak.
By the 20th century, researchers began applying epidemiological thinking to many health concerns, with groundbreaking studies on lung cancer and cardiovascular disease shaping efforts to boost long-term health and wellness. One of the field's most exciting achievements occurred in 1980, when the World Health Assembly (WHA) recognized the eradication of smallpox.
Epidemiology's Modern Role
Today, epidemiology reveals how a vast range of diseases and conditions impact populations, including how they arise, how they spread, and how their risk can be mitigated via preventative strategies and early interventions. Epidemiology allows public health experts to monitor populations for changes in health outcomes. When new challenges arrive, epidemiological initiatives ensure that the public is fully informed. This allows potentially vulnerable individuals to take steps to protect themselves, their loved ones, and their communities.
Key Drivers of Change: Emerging Trends in Public Health
Today's epidemiologists face unprecedented challenges from various sources: environmental issues, funding constraints, data-driven ethical challenges, and more. Many challenges are inextricably linked to technologies that also offer numerous advantages, such as expanded access to health data. Emerging trends in public health and accompanying solutions have already shifted perceptions and driven evolution in epidemiology, moving the practice into a more tech-driven era.
Big Data and Analytics
Epidemiology relies on data to make informed decisions and recommendations — and these days, there is no denying that such data is prolific. From the Internet of Things (IoT) to mobile health (mHealth) apps, epidemiologists enjoy access to numerous data sources. In addition, they acquire extensive data through collaboration with environmental scientists, healthcare providers, and many other professionals.
Experts from the National Academies of Sciences, Engineering, and Medicine point to a "tsunami of data" encompassing "genomic, molecular, clinical, epidemiological, environmental, and digital information." Unfortunately, once-impactful technologies are simply not powerful enough to fully leverage such an abundance of data. Fortunately, machine learning and deep neural networks promise to bridge the gap, identifying patterns and hidden opportunities that may be difficult for humans to discern on their own.
Genomics and Precision Medicine
Personalized strategies are increasingly valued, and we now have the research and technology needed to drive uniquely customizable interventions. Genomics aims to reveal why certain people are more likely to suffer specific diseases and whether any exacerbating factors can make them more likely to develop these conditions. This could thereby shape preventative strategies and treatment initiatives.
The National Human Genome Research Institute refers to this as "the study of all of a person's genes...including interactions of those genes with each other and with the person's environment." Moving forward, there will be a greater emphasis on genomic epidemiology, which will reveal the distribution of genetic traits (and how this influences the distribution of disease).
Climate Change and Environmental Health
Temperature and precipitation have a documented impact on disease vectors and seasonality. This has long influenced public health initiatives, but this field can no longer rely on 'typical' weather patterns to inform its approach. As the effects of climate change become readily apparent, it is ever-evident that environmental factors will need to play an even greater role in epidemiological strategies — especially disease surveillance and infection control.
Hence, the emergence of climate epidemiology, which (as the American Journal of Epidemiology explains) "leverages deep, integrated collaborations between epidemiologists and climate scientists to understand the current and potential future impacts of climate-related exposures on human health." This could be one of the most influential epidemiological specialties of the next several decades.
The Future of Epidemiology: Predictions and Possibilities
Epidemiology has expanded greatly in scope these last several years, and experts anticipate this shift to continue. This represents one of the most notable forces shaping the future of epidemiology: the gradual (but undeniable) move from focusing primarily on infectious disease to a more holistic and nuanced view of what the American Journal of Epidemiology terms "health-related states." These include "injury and chronic, noncommunicable diseases," which, although possessing different determinants, hold a distinctly public component.
As the scope of the field expands, so do the challenges of keeping up with an ever-expanding range of health concerns, research initiatives, and interventions — not to mention an abundance of data. The goal, now, is to leverage emerging technologies to help address these challenges. Thankfully, many powerful opportunities lie in wait, and some have already started to pay dividends.
Artificial Intelligence (AI) and Machine Learning (ML)
Today's epidemiologists have no shortage of information, but this sea of data can be overwhelming. In the journal Pathogens, experts explain that AI can help them understand the relationships between numerous variables including, most promisingly, gene expression and disease risk.
Already, the AI system AlphaFold contributes to the epidemiological body of knowledge by predicting protein structures. In turn, these play heavily into vaccine development and drug design. Structural data generated by AlphaFold and similar artificial intelligence solutions can enhance epidemiological models and may even help shape more effective public health strategies.
As experts tell Pathogens, however, the promises of AI and ML are accompanied by a few distinct challenges. Strong training models and validation strategies will be needed to limit the potential for misinformation; otherwise, we risk jumping "from the post-factual age directly into the non-factual age."
Mobile Health (mHealth) and Digital Epidemiology
Mobile solutions promise to expand accessibility to critical health services while also helping epidemiologists carry out key tasks from afar. This has proven particularly influential for field epidemiologists, who no longer rely strictly on in-person visits to collect information. mHealth apps facilitate real-time data collection, with users reporting symptoms. On a wide scale, this can promote early outbreak detection.
Beyond this, mHealth should prove useful for educational purposes, alerting users to emerging health crises or even helping them implement behavioral changes (such as nutritious diets or smoking cessation) that make them more resilient to disease.
One Health Approach
As an integrated approach to public health and environmentalism, One Health represents an exciting evolution in epidemiology. This movement acknowledges that the health and well-being of humans does not exist in a vacuum. Rather, how we fare closely reflects the health and vitality of other species and of Mother Nature at large.
Increasingly recognized as an "effective way to fight health issues at the human-animal-environment interface," the One Health approach calls for insights from experts in several disciplines: epidemiology, public health, environmental science, veterinary medicine, and beyond. As a One Health resource from the Centers for Disease Control (CDC) reminds us, "No one person, organization, or sector can address issues at the animal-human-environment interface alone."
Implications for Public Health Practice and Policy
The emerging trends in public health highlighted above hold major implications for how we prevent, mitigate, and treat today's most threatening diseases and conditions. Epidemiologists advocate strongly for policies that address the many manifestations of disease, including the social determinants of health (SDOH). Advancements can equip epidemiologists with the research-backed insights needed to pursue ambitious solutions, but a few significant challenges will need to be addressed along the way:
Workforce Development
Technological advancements may spark compelling innovations, but these will only reach their full potential if they accompany a well-educated workforce. Demand is already quite high in this field, with insights from the United States Bureau of Labor Statistics (BLS) revealing a strong outlook of 27% between 2022 and 2032. A significant skill gap already exists, however, and there is a strong need for additional epidemiologists to contribute to research and help implement public health initiatives.
Ethical Considerations
Though many of the aforementioned trends aim to promote innovation via data-driven insights, these possibilities must be weighed against significant ethical concerns. Many of these relate to data privacy; while a wealth of data will be critical for fueling new findings via machine learning, this calls for access to highly sensitive data, especially given the rise of genomic epidemiology. There must also be a strong effort to combat bias, as some AI solutions could potentially amplify this and consequently perpetuate inequalities in public health services.
Your Role in Shaping the Future of Epidemiology
While challenges abound, technological innovations and extensive research promise to bring epidemiology into a new era — one in which proactive strategies will make communities far more resilient to disease. Your first step toward shaping a bright future involves embracing epidemiological thinking. This could involve pursuing your Master of Public Health (MPH), among various other ways to contribute:
Staying Informed
A well-informed public should prove highly adaptable and resilient, even in the face of new health risks. Epidemiologists play a central role in spreading the word, but anybody can benefit from expanding their understanding of epidemiological concepts and developments.
There are numerous ways to stay abreast of epidemiological trends. When in doubt, begin by reading peer-reviewed journals, including top titles in epidemiology and from the broader world of public health. Essentials include:
- American Journal of Epidemiology
- International Journal of Epidemiology
- Journal of Epidemiology & Community Health
- Emerging Infectious Diseases
- American Journal of Public Health
Other easily accessible opportunities include listening to industry-relevant podcasts or following content from public health influencers such as Dr. Sanjay Gupta and Omari Richins (The Public Health Millennial).
Conventional strategies for staying informed (while also expanding your network) include joining professional associations and attending conferences. Influential organizations include the Society for Epidemiologic Research (SER) and the American Epidemiological Society (AES).
Supporting Research and Innovation
Although technological opportunities can drive many exciting innovations, these must be accompanied by extensive research, including longitudinal studies that impart crucial insights into the dynamics of disease over time. As a graduate student, you have the opportunity to contribute to this growing body of research. Otherwise, it's possible to show support by advocating for research funding, engaging with public health campaigns, and sharing relevant insights via mHealth.