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Causation and prevention in populations versus individuals 

Causation and prevention in populations versus individuals
Chapter:
Causation and prevention in populations versus individuals
Author(s):

J. Frank

, R. Jepson

, and A. J. Williams

DOI:
10.1093/med/9780198725862.003.0005
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date: 20 October 2020

In this chapter, the authors look at how causation and prevention, discussed in Chapter 3 largely in terms of the health of individuals, have parallel, but rather different implications when applied to entire communities or populations. A useful starting point is the ‘slow, non-infectious’ pandemic of obesity. The underlying drivers of this pandemic illustrate the principle that population-level causes of disease can be very different from individual-level causes, as brilliantly explained by the British epidemiologist Geoffrey Rose three decades ago. The chapter concludes with how the evaluation of preventive interventions operating at the whole-population level must often utilize non-randomized-control study designs, and summarizes recent guidance on how such studies can be made as robust as possible.

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