Who is john graunt

Even if all hospitals ultimately cooperated, the review process often delayed projects for 6—12 months. Each institution had its own application form, and often the review board of a large hospital would expect an investigator to attend a question-and-answer session on the study design. The degree of frustration that an epidemiologist faced was lamented by Prof. The maze of regulation that appeared in the s was accompanied by considerable misinterpretation by hospitals, health departments and other institutions—further hampering epidemiologic studies.

Since epidemiologic studies usually involve scanning dozens of charts to find one that matches the appropriate entry criteria for a study, these hospitals effectively blocked their participation in epidemiologic research. The validity of broad-based studies began to suffer as the participation of hospitals began to decline.

Ironically, no government regulation ever required that a patient's written consent be obtained before the chart could be examined for possible inclusion in an epidemiologic study. Some hospitals insisted on describing the hypothesis under evaluation to all subjects in full detail, thereby introducing an irremediable bias that negated the value of including such hospitals in interview studies.

The bureaucracy associated with the conduct of epidemiologic research increased with time. In , five federal agencies represented by the Interagency Regulatory Liaison Group issued a set of guidelines for the conduct and reporting of epidemiologic research. There was a resounding reaction among epidemiologists against promulgation of these guidelines, directed not so much at their mediocrity as against the intrusion of government into the planning and reporting of scientific research.

The reaction was ignored; the guidelines were adopted, and within 10 years a slightly revised version was imposed as a standard criterion for evaluation by review groups for the National Institutes of Health. Although occasionally revised, these guidelines have never been concordant with epidemiologic theory more recent than 20 years old.

Academic positions in epidemiology became less attractive during the s. A fledgling investigator could not reasonably expect to initiate and complete a single study before review for tenure. While academic salaries continued to slump, industry and government began to hire epidemiologists, as if both sides were recruiting for a coming regulatory war, which they were.

As the academic base for the discipline shrank, epidemiologists were more often representing vested interests on one side or another of the ever-controversial issues. Their credentials as health lobbyists required an official sanction, and the once ignored American College of Epidemiology became the professional union. The College, which was spurned by the profession when it was organized in as a self-proclaimed accrediting body, used its entrance examination to restrict admission to its ranks.

By , certification by the College was regarded as instrumental for success in the courtrooms and hearing rooms where nearly all epidemiologic issues were decided. Since , fewer epidemiologic studies of scientific importance have been published each year. Governmental briefing papers, industry papers and commissioned critiques have accounted for the bulk of professional activity. The few original research papers that have been published have tended to be ecological studies based, like the work of Graunt and Farr, on routinely collected population statistics, along with a few small case-control studies from single institutions.

Some enterprising closed-panel health plans have continued to support epidemiologic research on their own populations. Unfortunately, in the past decade several of these groups have terminated all research programs, probably in reaction to malpractice judgements awarded in favour of subscribers who received therapy that was subsequently found on epidemiologic follow-up to be questionable.

Ignorance may not guarantee bliss, but it does offer protection against malpractice claims. A scientific discipline that developed slowly and flourished briefly for several decades is now nearly gone, leaving behind some knowledge of disease prevention, a few controversial alarms, and a collection of techniques for assessing the health consequences of people's actions.

Among the legacies is the demise of major 20th-century epidemics attributable to tobacco, dietary fats and some carcinogens in the workplace and environment.

For many, however, epidemiology was an unpleasant science, providing frequent reminders that we are born into a dangerous world where no action is without some risk. Most of us have been persuaded to discard the belief that our modern world is a safe harbour, but now we shall have to muddle along with little specific knowledge of the risks we face.

It is a small comfort, at least, that the methods devised by epidemiologists during the latter part of the 20th century will endure to serve some future generation with sufficient curiosity to apply them. Google Scholar. Google Preview. Oxford University Press is a department of the University of Oxford.

Graunt studied the statistics compiled in the Bills of Mortality, along with christening records from churches and data from an area of rural England. A practical man, he decided that these carefully collected facts could be analyzed and the results put into book form. On February 5, , Graunt's newly-printed page work, Observations, was distributed to the members in attendance at a meeting of England's Royal Society.

Graunt had grouped together similar facts from the 70 years of records displayed in the Bills, and noted the comparisons of findings for different population groups. From his studies he drew a number of interesting and important conclusions. Graunt modestly described his own work as "to have reduced several great confused volumes [of Bills of Mortality] into a few [easy to understand] Tables, and abridged such Observations as naturally flowed from them, into a few succinct Paragraphs, without any long series of [wordy] Deductions.

Egerton, III pointed out that Graunt's deduction of various characteristics of populations from the data he analyzed, "indicate a good understanding of the kinds of questions that are significant for demography.

Furthermore, his indirect approach sometimes went beyond the reliable use of his data, and the accuracy of some of his answers was difficult to evaluate. Egerton nevertheless commended Graunt for realizing the shortcomings of his data, and pointed out that Graunt sometimes "set an excellent example by seeking verification of his estimates by different indirect methods. In a article in the British medical journal Lancet, Kenneth J. Rothman pointed out some of Graunt's major achievements as a pioneer demographer: Graunt was the first to publish the fact that more boys than girls are born but that the mortality rate is greater for males, resulting in the population's being almost evenly divided between males and females.

Graunt reported the first time-trends for many diseases; he offered the first well reasoned estimate of London's population; he used evidence from medical records to refute the idea that plague spreads by contagion and that it occurs early during the reign of a new king; he showed that doctors have twice as many female as male patients, but that males die earlier than females; he produced early hard evidence about the frequencies of various causes of death.

The invention that some historians have called Graunt's most original was his creation of "life tables"—a new way to present population and mortality statistics by calculating survivorship on a chart. Using this method Graunt was able to predict the number of persons who would survive to each successive age on his chart and the life expectancy of the groups from year to year.

Development of the life tables has been hailed as marking the beginning of the science of demography. Such charts are said to have made an impact on the pioneer demographic work of other noted astronomers and scientists, including Edmund Halley , England's astronomer royal. The types of charts Graunt originated remain in use today. The widspread acceptance of Graunt's work also led to his being acclaimed as the founder of the science of statistics, particularly the branch that deals with the analysis of population data.

Yet Graunt never made a formal study of mathematics. Some historians have speculated that Graunt received more help with his book from his better-educated friend, William Petty , than is generally acknowledged. However, while Petty surely offered support to his friend and probably made some contribution to the book, most historians agree that Graunt wrote at least a major portion of the work.

Graunt's book on the Bills of Mortality had great influence throughout Europe. It has been noted that soon after its publication, France embarked on the most precise registering of births and deaths in all of Europe.

To call Graunt a statistician and an epidemiologist, while true, is misleading, because neither discipline existed until Graunt published his milestone book, Natural and Political Observations Made Upon the Bills of Mortality , in The task of compiling the records was assigned to the Company of Parish Clerks, and the census takers, called Searchers, were elderly women who would visit every death victim and try to ascertain the cause of death.

Every week the results from each parish were compiled and collected, and on Thursday, a Bill of Mortality was drawn up, listing the numbers of deaths attributed to each cause for that week. After , these were printed and could be had by subscription. The most famous bill of mortality, often reproduced, is one compiled after Graunt wrote his book, issued for the week of Aug.

It is sobering to see that 54 people died of old age and 23 in childbirth, but succumbed to plague in that one week. At the end of the year, the weekly bills were compiled into an annual one.

We see here a bill for , which Graunt reproduced in his book. That was not a plague year, only one person dying of it, but consumption, infant deaths, and fever took their toll. Did you notice that only 7 people were murdered in all of London that year? In some ways, 17th-century cities could be more civilized than those of modern times. The bills of mortality were compiled for 60 years, available to all, before anyone made any use of them.