1 A Historical Framework for Social Epidemiology

Epidemiology is the study of the distribu tion and determinants of states of health in population,:; (Susser 1973). Ever since John Graunt (1662) counted deaths in county parishes in England in the seventeenth cen tury, social variations in morbidity and mortality have been observed. Early studies often centered on the ill effects of poverty, poor housing conditions, and work envi ronments. By the nineteenth century, physi cians such as Villerme (1830) and Virchow (1848) refined observations identifying so cial class and work conditions as crucial de terminants of health and disease (Rosen 1963). Durkheim wrote eloquently abou