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A future for epidemiology?

S Schwartz¹, E Susser, M Susser

¹Joseph L. Mailman School of Public Health (Epidemiology), New York, New York, USA. SBS5@columbia.edu

Annual Review of Public Health

|June 3, 1999

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Epidemiology needs new thinking for causes and prevention beyond the current risk factor model. A new causal paradigm considers multiple levels and historical context for future public health guidance.

Area of Science:

Epidemiology
Public Health
Causal Inference

Background:

Modern epidemiology, despite achievements, faces challenges necessitating a review of its core principles.
Current chronic disease epidemiology relies heavily on the risk factor paradigm.
There is a recognized need to reconsider the guiding principles of epidemiological research.

Purpose of the Study:

To propose a new causal paradigm for epidemiology.
To guide future epidemiological research beyond the current era.
To integrate multi-level and historical contexts into causal thinking.

Main Methods:

Historical review of dominant epidemiological eras and ideas.
Specification of premises and constraints of the current risk factor paradigm.

Related Experiment Videos

Development of elements for a future causal paradigm.

Main Results:

Identified limitations of the current risk factor paradigm in epidemiology.
Proposed a multi-level, historically-contextualized causal paradigm.
Outlined an approach to build upon past and present epidemiological contributions.

Conclusions:

A shift towards a more comprehensive causal paradigm is necessary for epidemiology.
The proposed paradigm encourages a broader understanding of disease causation.
This approach aims to enhance the future direction and impact of epidemiological research.