ASSIGNMENTS OF MEANING IN EPIDEMIOLOGY

Epidemiology works in a public domain, gathering the results of survey s and trials into forms of knowledge which are made available to many stakeholders. Health policy makers, lawyers, the media, medical techno logy companies, and those who use and deliver health services all have legitimate interests in epidemiology. There is unfortunately no commo n language in which each of these stakeholders can express their inter est in the outcomes of epidemiological studies. The largest and most i mportant gap exists between those who use computational data and those who use cultural acid linguistic models to generate their explanation s. Methods have been described, however, which allow the identificatio n of all legitimate stakeholders before epidemiological studies are un dertaken. Identifying the stakeholders. however, will serve no purpose unless there is a prior commitment by epidemiologists to respect both reductionist and narrative accounts of truth. (C) 1998 Elsevier Scien ce Ltd. All rights reserved.