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Book Review: Cwikel, J. G. (2006). Social epidemiology: Strategies for Public Health Activism. New York: Columbia University Press (613 pp, $49.50 hardbound, ISBN 0-231-100048-5)

Social Epidemiology: Strategies for Public Health Activism by Julie Cwikel is a textbook that identifies important issues regarding health and social conditions and applies principles of social epidemiology to improve society’s well-being. Overall, the author achieves the stated purpose of the book, which is “looking at health and social problems from the population and community perspective without losing sight of the meaning of numbers” (p. xii). Although the book can be used in a variety of disciplines, the applied nature of the fields of social epidemiology and social work make it a likely fit for social work studies, especially courses related to community practice or macro-level intervention. There are several areas in which the text is especially strong. For example, the author does an excellent job of providing basic information required for understanding population-level health problems. Terms that may be easily confused (e.g., rate, morbidity, mortality, prevalence, and incidence) are well-defined. The author also describes and defines basic research terms such as sample, validity, and reliability and more complex analytic processes such as grounded theory. In addition to basic definitions, the author applies these concepts to social epidemiology and public health research. The author describes the advantages and disadvantages of crosssectional studies and specifies how cross-sectional methods are not appropriate for determining incidence of a condition due to issues of temporality. The description of both basic knowledge and applicability to complex health issues makes the book relevant to a range of student abilities and experiences. However, the research focus and complexity of the topics suggest advanced undergraduate or graduate levels as appropriate. Another perspective that makes this text especially relevant for social work students is the emphasis on problem solution rather than focusing solely on problem identification. Indeed, the author uses the first three sections of the book to set up the final section, which describes interventions and programs that are effective with specific populations and groups. The subject of the text is timely and relevant as epidemiological issues are at the forefront in national and international arenas. Recent catastrophic events such as Hurricane Katrina and anticipated pandemics such as avian flu make the understanding of social epidemiology an important topic for social work and interdisciplinary courses. Furthermore, the author draws parallels between historical and current medical or epidemiological traditions on micro and macro levels. For example, the author provides an historical view of policy efforts associated with bubonic plague (e.g., destroying commerce resulting in starvation, hierarchal society that created a preexisting disparity) and leprosy (e.g., quarantine) as well as more current topics such as HIV/AIDS. Another outstanding feature of this book is Dr. Cwikel’s ability to present both positivistic and interpretivist research designs and methods. Unlike some other researchers, she is able to describe the appropriate usage of qualitative and quantitative research methods. Rather than indicating a bias toward one method or another, she indicates when each is appropriate and gives examples of how each method contributes to the understanding of public health problems. In doing so, Dr. Cwikel consistently uses appropriate models and cases to illustrate the concepts described. Notably, the author captures the dynamic and evolving nature of the topic and guides the student or reader through the development of social epidemiology as a discipline and public health issues as they emerge. The book is well organized overall. The 613 pages of text comprise 16 chapters organized into four sections: Introduction, Historical Roots of Social Epidemiology, Methods, and Applications. This organizational framework is effective, providing both conceptual and historical context in the first two sections before introducing methodologies specific to the field of social epidemiology in the final two sections. There is a summary at the beginning of each chapter and discussion questions at the end of each chapter. References are organized by chapter but are included at the end of the book.