This week’s readings proved to be interesting, informative, and challenging at the same time. Each discussed causation of disease and/or causal inferences in public health in some way, along with including a good amount of opinionated and theoretical content. I’d have to say my personal favorite was “Social Conditions As Fundamental Causes of Disease” by Bruce Link and Jo Phelan. First, Link and Phelan introduce their opinion on epidemiological research and how successful it has been recently in identifying risk factors of major diseases. However, most of these risk factors are individual, such as diet, cholesterol levels, and exercise, and tell us little about social conditions in relation to disease. Hill and Phelan argue that more research attention should be focused on basic social conditions, such as socioeconomic status and level of social support, as risk factors of disease. They also claim that this type of research focus is necessary in order for health reforms and policies to reach their full potential in the future.
“Individual-based risk factors must be contextualize, by examining what puts people at risk of risks, if we are to craft effective interventions and improve the nation’s health.” (80)
I agree that by completely overlooking social conditions as “fundamental causes” of disease, we risk applying only individual-based intervention strategies that will result in ineffective solutions. However, although I see the point Hill and Phelan are trying to make, I don’t think they are putting enough emphasis on the individually-based risk factors in addition to the contextual and situational risk factors they so excessively allude to. Of course, every individual case is different, but both types of risk factors can play a significant causal role in the methodology of disease. I think it is important to not overlook any possible causal aspects of disease, including both situational and individual, because it could lead to the development of ineffective intervention methods.