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A brief history of prevention … and causation 

A brief history of prevention … and causation
A brief history of prevention … and causation

J. Frank

, R. Jepson

, and A. J. Williams

Page of

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date: 17 September 2021

In this chapter, the authors use the historical case-study of John Snow’s investigations into the London cholera epidemics, about 160 years ago, to introduce a widely-used epidemiological study design—the cohort study—for quantifying the strength of association between a putatively causal exposure and an adverse health outcome. This historical example is a springboard to a comprehensive explanation of widely-used epidemiological criteria for assessing the quality of the scientific evidence that any putative ‘cause’ of disease, injury, or death is actually causal. These criteria, based on Bradford Hill’s original ideas (Bradford Hill 1965) have been recently updated by Gee for use in environmental disease causation; each of them is thoroughly explained, using clear environmental health examples.

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