Epidemiology as discourse: the politics of development institutions in the Epidemiological Profile of El Salvador

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Abstract
STUDY OBJECTIVE To determine the ways in which institutions devoted to international development influence epidemiological studies. DESIGN This article takes a descriptive epidemiological study of El Salvador,Epidemiological Profile, conducted in 1994 by the US Agency for International Development, as a case study. The methods include discourse analysis in order to uncover the ideological basis of the report and its characteristics as a discourse of development. SETTING El Salvador. RESULTS TheEpidemiological Profile theoretical basis, the epidemiological transition theory, embodies the ethnocentrism of a “colonizer's model of the world.” This report follows the logic of a discourse of development by depoliticising development, creating abnormalities, and relying on the development consulting industry. The epidemiological transition theory serves as an ideology that legitimises and dissimulates the international order. CONCLUSIONS Even descriptive epidemiological assessments or epidemiological profiles are imbued with theoretical assumptions shaped by the institutional setting under which epidemiological investigations are conducted.