MICHEL GARENNE, MONICA DAS GUPTA, GILLES PISON,
AND PETER AABY
The idea of a systematic prospective study of a community to understand basic processes of births, diseases, and deaths started with the development of Public Health, Epidemiology, and Demography as major subjects of scientific research at the beginning of the twentieth century. The Pellagra Study ( 1916-21) is usually quoted as the first scientific prospective study of a community, in the cotton mill villages of South Carolina. It was designed to study the etiology of pellagra, a nutritional disorder, and was based on a comprehensive follow-up of a deprived Southern community. About twenty years ago, Kessler and Levin ( 1970) published a book summarizing experiences on prospective studies of communities conducted in the USA. The book presents ten studies conducted in American communities, covering a wide range of issues: comprehensive studies of diseases, epidemiological surveys of specific diseases, social surveys, psychiatric surveys, and three national health surveys which had some common features with the local studies Most of these studies were of medium or long duration, the record being the Washington County Study in Maryland, which has been going on for some sixty years.
A recent paper by Mosley ( 1989) summarizes those experiences and provides a perspective for similar endeavours conducted in developing countries. The first documented prospective demographic community study conducted in a so-called developing country is probably the Yang-Tse River Valley Study conducted in China in the 1930s ( Chiao, Thompson, and Chen 1938). Another little-known study was conducted in Guanabara, in Brazil in the 1940s. Many other prospective community studies were started after the Second World War, mostly in Africa and Asia. Some of them were of relatively short duration, others are still going on, as exemplified in this book. The Appendix in this book gives an idea of the wide variety of studies conducted in developing countries, variety in size, duration, and research focus. Closely related to the more demographic studies were the studies of health systems that Carl Taylor presents in this book (Chapter 1). Here again China was a pioneer, with the work of C. C. Chen and J. Grant in the 1930s, followed by the work of Sidney Kark in South Africa, which is presented here by Steve Tollman (Chapter 9).
Many of us who had spent many years in the field studying the health and