Course Description


P9485   Advanced topics in epidemiologic methods, 3 points

Prerequisites: Course for advanced doctoral students in epidemiology.

The past two decades have witnessed both a maturation of the field of epidemiology and a proliferation of critiques of the field. The debates around these critiques were so fierce that Rothman and Poole labeled them “the epidemiology wars”. These wars have abated and spawned two different and sometimes opposing currents in epidemiology: a renewed interest in causal inference and an acceptance of social and lifecourse epidemiology.

One response to the epidemiology wars reinvigorated methodological rigor through attention to fundamental principles of causation. In its role as a basic science of public health, discovering the causes of disease is a critical task. However, for a long time epidemiology side-stepped causality. The caution “association does not equal causation” became the prevailing glass ceiling with epidemiologists studying “risk factors” rather than causes. This has changed radically in the past few decades with the ascendance of “counterfactual approaches” to epidemiologic methods. These methods begin with and are developed from explicit definitions of causal effects.

Another response broadened epidemiology’s purview. The narrow focus of risk factor epidemiology on individual level exposures -- behaviors and characteristics of individuals proximate to disease onset -- gave way to consideration of causes more distal from the level of the individual and the time of disease onset. Social epidemiology and lifecourse perspectives have become mainstream.

But these changes arose from different camps in the epidemiology wars which coexist less than peacefully. While some researchers see these perspectives as complementary, radicals in both camps deny that coexistence is possible or even desirable. Some feel that social factors cannot be considered causes. Others contend that counterfactual methods cannot address important public health needs. A third camp thinks that both outcomes of the epidemiology wars are misguided and that a more radical solution is necessary. This course is designed to engage this debate through a critical examination of basic epidemiologic concepts and methods. The purpose of this examination is to facilitate a deeper understanding of and fuller appreciation for the strengths and limitations of current epidemiologic methods and to assess the possibilities for future developments.