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Epidemiology and causation: a realist view

¹Academic Department of Public Health, St Mary's Hospital Medical School, London.

Journal of Epidemiology and Community Health

|February 1, 1994

Summary

This study proposes a realist ontology for understanding disease causation in epidemiology. This framework offers a robust method for identifying causal factors and improving public health interventions.

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Area of Science:

Epidemiology
Philosophy of Science
Public Health

Background:

The debate on determining causality in epidemiological associations is often centered on inferential logic.
This focus neglects deeper ontological questions about causation and disease.
Current approaches are influenced by Popperian philosophy and the goal of public health interventions.

Purpose of the Study:

To construct a realist ontology of causation and pathogenesis.
To provide a coherent framework for identifying disease causes in epidemiological research.
To re-evaluate the role of epidemiology within a unified medical science.

Main Methods:

Development of a realist ontology grounded in scientific materialism.
Application of this ontology to address confounding and interaction in epidemiological studies.
Philosophical analysis of causation and disease concepts.

Main Results:

A realist ontology provides a coherent basis for causal inference in epidemiology.
This approach offers solutions for confounding and interaction.
Epidemiology is positioned as an integral part of a unified medical science.

Conclusions:

A realist ontological framework enhances causal decision-making in epidemiology.
Unified medical science, encompassing epidemiology, is crucial for rational public health.
This perspective enriches the role and foundation of epidemiological research.

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