This second edition of this text returns to the question: How much of our work in public health is evidence based? The exact answer to that question can never be known, however, the answer would certainly include the words “not enough”. Public health has successfully addressed many challenges. Programs and policies have been implemented and, in some cases, positive results have been reported that show improvements in population health. Yet some populations still suffer health disparities and social inequalities. This leads us to questions such as: Are there ways to take the lessons learned fro ... More

This second edition of this text returns to the question: How much of our work in public health is evidence based? The exact answer to that question can never be known, however, the answer would certainly include the words “not enough”. Public health has successfully addressed many challenges. Programs and policies have been implemented and, in some cases, positive results have been reported that show improvements in population health. Yet some populations still suffer health disparities and social inequalities. This leads us to questions such as: Are there ways to take the lessons learned from successful interventions and apply them to other issues and settings? Are we applying the evidence that is well established in scientific studies? How do we foster greater political will that supports evidence-based decision making? How do we develop incentives so practitioners will make better use of evidence? The format for this second edition is very similar to the approach taken in the course and the first edition. Chapter 1 provides the rationale for evidence-based approaches to decision making in public health. Chapter 2 presents concepts of causality that help in determining when scientific evidence is sufficient for public health action. Chapter 3 describes a set of analytic tools that can be extremely useful in finding and evaluating evidence—these include economic evaluation, health impact assessment, meta-analysis, and expert guidelines. The next seven chapters lay out a sequential framework which includes: conducting a community assessment, developing an initial statement of the issue, quantifying the issue, searching the scientific literature and organizing information, developing and prioritizing intervention options, developing an action plan and implementing interventions, and evaluating the program or policy.