Context and Environment: The Value of Considering Lay Epidemiology

"Risk" and "risk behavior" have become key terms in public health. Largely based on epidemiological categories, risk terminology in public health tends to describe health problems at the individual level. Criticisms of individualized risk discourse include the failure of these concepts of risk to address broader determinants of health. Juxtaposing "expert" and "lay" perceptions of hepatitis C viral infection we discuss the importance of social, political, and economic conditions in shaping perceptions of health and health risks. We use the lived experience of hepatitis C infection as a case study to show how lay epidemiology offers insights into the complex nature of risk and provides evidence for the connections between health problems to their social context. Although accessing and synthesizing lay and expert knowledge require research inputs and theoretical understandings from an array of disciplines and skill sets, collaborative efforts will more effectively investigate the ways in which disease often spreads along the lines of social structure. Multidisciplinary approaches expand traditional epidemiological notions of risk and vulnerability to construct more nuanced descriptions of human behavior and more contextually situated health interventions.