Whose Burden? Synthesizing Evidence from Diverse Perspectives for a Comprehensive Description of Disease Burden

INTRODUCTION: To address public concerns about a specific health threat and develop effective public health strategies aimed at reducing related health risks, it is necessary to describe the extent of the health threat in the target population. This typically involves assessing the impact of the health threat using quantitative measurement of pertinent epidemiologic and economic indicators. While existing literature espouses the benefits of building collective knowledge to capture the depth and complexity of health and disease, there is limited information about the most effective ways to synthesize different forms of evidence to construct a comprehensive assessment of the burden of disease.

METHODS: Research is currently underway in northern Canadian Aboriginal communities concerned over their high prevalence of Helicobacter pylori infection and the associated risk of stomach cancer. This community-driven research program will be used to illustrate the value of incorporating multiple perspectives in characterizations of disease burden when attempting to address public health concerns, with emphasis on the application of methods for synthesizing diverse types of evidence on disease burden.  

RESULTS: To ensure that public health strategies developed through the investigative process are relevant to the target population, valuable insights can be gained by ascertaining how affected community members and their health care providers view related risks. This kind of information can inform quantitative research questions by identifying disease consequences that may further impact population health and well-being, can help support the development of effective knowledge translation and risk communication strategies, and can inform public health policies so that meaningful and effective interventions may be implemented.   

CONCLUSIONS: Information regarding public perspective and quantitative assessments of health indicators are both essential so that resulting solutions are culturally-sensitive and cost-effective for the target population, particularly when attempting to address public concerns about a specific health threat.