Book: Evidence-Based Public Health

The preface of this book, which aims to describe how to implement evidence based public health interventions, sets high expectations. In it Jonathan Fielding, director of public health for the county of Los Angeles, states: “If every public health practitioner absorbed and applied the key lessons from this volume, public health would enjoy a higher return on the tax payer's investment.” Figure 1 Ross C Brownson, Elizabeth A Baker, Terry L Leet, Kathleen N Gillespie Oxford University Press, £29.50, pp 235 ISBN 0 19 514376 0 Rating: ★★★ I was looking for a book that was grounded in the familiar territory of evidence based medicine much documented in the pages of the BMJ in recent years. I was not disappointed. I then looked for sensible application of this territory to public health practice and for an easily understood and systematic approach to making it happen. Again, I was pleased to see precisely this emerge. The excellent opening chapter sets the structure for the rest of the book. The book's authors (all from the St Louis University School of Public Health) describe a simple adaptation of evidence based knowhow to form a six step public health guide: Develop an initial statement of the issue Quantify the issue Search the scientific literature and organise the information Develop and prioritise programme options Develop an action plan and implement interventions, and Evaluate the programme (then discontinue, remodel, or disseminate it widely). Before dealing with the detail of these steps in the last six chapters the authors address two difficult subjects in chapters two and three. The first is how to decide when the time has come for public health action. The key issues they look at here include the reliability of evidence, the relation between cause and effect, and the wider influences on successful intervention in the community. The second subject is how to use complex reports to inform policy decisions. The authors focus on systematic reviews, meta-analyses, decision analyses, and economic analyses and the “implementation” of findings through expert panels and guidelines. Although useful, the information in these two chapters would have been better integrated into the chapters dealing with the first three steps described above. The rest of the book describes the details of the six steps. The descriptions are practical and illustrated with examples from the United States. The section on searching the scientific literature and organising information was particularly useful.