Population-based medicine extends the single patient view to the examination of the distribution of disease and health in the whole population, population subgroups, regions and communities (community medicine, public health medicine).
For this purpose an interdisciplinary cooperation with several public health disciplines like social sciences, health economics, environmental, ecological and life sciences becomes necessary. Particularly, the international dimensions of health and illness have to be considered in the age of globalisation and information technology.
Our group develops models based on WHO data about the future trends of the burden of disease in Europe and beyond. These trends have to be linked with risk factors and protective factors in the population. Via mathematical and epidemiological models the efficiency of certain intervention scenarios are tested for limiting the burden of disease.
Epidemiology of Infectious Diseases
New infectious diseases (e.g. SARS, AIDS, and Ebola) and the recurrence of "old" infectious diseases (diphtheria, tuberculosis, malaria, etc.) indicate the enormous impact of epidemiological research in this field for public health. Determining factors for the spread of infectious diseases may be an increase in population density, urbanization, climate changes, globalisation and international travel and migration of population subgroups.
In the EU-funded project POLYMOD the social contact patterns for the spread of infections are studied in several European countries. On the basis of improved empirical data bases, mathematical transmission models are developed including the economical evaluation of public health interventions with implications for public health policy (epidemic preparedness).
Another emphasis is the analysis of the burden of infectious diseases in vulnerable subpopulations. In the EU-funded project “Migrant Health” we monitor the burden of infectious diseases in migrants in Western and Eastern European countries and develop improved health indicators for ethnic minorities. Further projects deal with the epidemiology of hepatitis and HIV infections in migrants and intravenous drug users in Germany including health services research related to these infections.
Burden of Disease in Germany
As in other Western countries the burden of disease in Germany is characterised by a decrease in mortality and an increase in morbidity in the population.
In the industrialised countries the spectrum of diseases has shifted to chronic diseases (cancer, cardiovascular diseases, obesity, etc.) along with the demographic transition. However, many countries do not have systematic and evidence-based strategies for decreasing new burdens of disease. Several years ago WHO developed the Burden-of-Disease methodology for evaluating mortality, morbidity and healthy life expectancy. A national burden of disease study for Germany is planned based on improved data sources and methods.
An increasing proportion of the world population lives in cities and megacities (more than 10 million inhabitants) which are growing particularly in South and South East Asia. In multidisciplinary projects in Dhaka, Bangladesh, and Guangzhou, Southern China, we characterise the burden of disease in vulnerable subpopulations in these cities, develop geo-epidemiological models in collaboration with geographers, meteorologists and urban planners and community-oriented public health interventions with our local counterparts. The theme of this priority programme of the German Research Council is: Megacities – megachallenge: informal dynamics of global change.
Health Promoting University
In the health lab of the Bielefeld University we try to strengthen and to promote the health potentials of students for preventing later development of chronic diseases. For example, we offer counselling programmes for preventing back pain or nicotine withdrawal. We aspire the realisation of a setting approach and of a "Health Promoting Universities" network as it is suggested by the WHO. The "Health Promoting Universities" programme comprises universities in Germany, Europe and in many countries outside Europe for conducting comparative epidemiologic surveys about students' health.