Journal article
Towards a realistic and relevant public health: the challenges of useful simplification
Journal of public health (Oxford, England), v 30(3), pp 230-231
Sep 2008
PMID: 18621788
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Ian McDowell discusses many of the limitations of the risk factor paradigm in public health and epidemiology, building and amplifying on prior work.1–3 As discussed by McDowell, an important and perhaps unintended consequence of the focus on risk factors is that it has shifted epidemiologic inquiry from understanding causes to estimating ‘independent’ associations. This has impoverished epidemiology and has constrained not only the methods that we use but also the way in which we formulate research questions and even the research questions that we ask. For example, many epidemiologic investigations routinely formulate research questions in terms of identifying the presence of an ‘independent association’ of a given factor with an outcome, rather than on understanding the causes of an outcome or explaining (in McDowell's sense) differences in health between people or between groups. In many ways, the methods that we use (in terms of both study designs and analytical approaches) which largely focus on enhancing our ability to estimate ‘independent effects’ constrain the questions that we ask and the answers that we obtain. The task is to develop an alternative approach that is rigorous, feasible and informative for public health. Unfortunately, as is often the case, this is easier to say than do. Three challenges that I will briefly discuss in turn are the challenge of multiple levels, the challenge of systems and the tension between full explanation and identification of intervention points.
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Details
- Title
- Towards a realistic and relevant public health: the challenges of useful simplification
- Creators
- Ana V Diez Roux - University of Michigan
- Publication Details
- Journal of public health (Oxford, England), v 30(3), pp 230-231
- Publisher
- Oxford University Press
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:000259375100006
- Scopus ID
- 2-s2.0-54249151380
- Other Identifier
- 991020111973804721
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- Web of Science research areas
- Public, Environmental & Occupational Health