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Epidemiology as discourse: the politics of development institutions in the Epidemiological Profile of El Salvador
  1. L A Avilés
  1. Departamento de Ciencias Sociales, Universidad de Puerto Rico-Mayagüez, Apartado Postal 9010, Mayagüez, Puerto Rico 00681-9010
  1. Dr Avilés (l_aviles{at}


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.

  • El Salvador
  • politics

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  • The author would like this article to be a modest tribute to the memory of James Blaut, scholar and activist, who died while this article was going to press.

  • Funding: the fieldwork and research for this paper was partially funded by the University of California President's Postdoctoral Fellowship.

  • Conflicts of interests: none.