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© 2005 American Public Health Association
DOI: 10.2105/AJPH.2004.059204
PUBLIC HEALTH MATTERS |
Kenneth J. Rothman is with the Boston University Medical Center, Boston, Mass. Sander Greenland is with the University of California, Los Angeles.
Correspondence: Requests for reprints should be sent to Kenneth J. Rothman, DrPH, Boston University School of Public Health, Department of Epidemiology, 715 Albany St., Boston, MA 02118 (e-mail: krothman{at}bu.edu).
Concepts of cause and causal inference are largely self-taught from early learning experiences. A model of causation that describes causes in terms of sufficient causes and their component causes illuminates important principles such as multicausality, the dependence of the strength of component causes on the prevalence of complementary component causes, and interaction between component causes.
Philosophers agree that causal propositions cannot be proved, and find flaws or practical limitations in all philosophies of causal inference. Hence, the role of logic, belief, and observation in evaluating causal propositions is not settled. Causal inference in epidemiology is better viewed as an exercise in measurement of an effect rather than as a criterion-guided process for deciding whether an effect is present or not.
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