Whither lay epidemiology in UK public health policy and practice? Some reflections on occupational and environmental health opportunities.

The problems of public and media interpretations of epidemiological studies--for instance, confusion about contradictory findings which indicate the hazards or advantages of consuming certain foods or drink or taking particular medical or pharmaceutical products, and one study on radiation exposure apparently overturning the results of another study within weeks or months--indicate the need for better communications by scientists, better education for the public on hazards and risks, and a better flow of information to the public on such topics. One democratic means for achieving this end, which would also increase community and worker participation in and control of health research affecting them, is through lay or community epidemiology. This subject has been discussed for some years but very little action has resulted in England. The concept relates to community groups and employees carrying out epidemiological research and using the expertise of professional epidemiologists. The epidemiologists work for and with the community rather than on the community: an experience which professionals may find threatening. Nevertheless, the World Health Organization and other groups rightly support such an empowering initiative, and some ways of introducing the approach into England are discussed.