Does Epidemiologic Theory Exist?
On Science, Data, and Explaining Disease Distribution
Chapter 1 opens with a series of figures displaying epidemiologic data about trends and disparities in diverse measures of health status in the US and worldwide—and asks what assumptions, and hence underlying theories, guide generating and interpreting these data. Tackling the question of what constitutes a scientific theory, it then describes domain-specific features of epidemiologic theory—which by definition must exist if epidemiology is a science, and not simply a set of methods. Documenting, however, that epidemiologic textbooks from 1980–2000 are silent about epidemiologic theory—and earlier and later textbooks offer only little discussion—the chapter considers alternative arguments about why this gap exists. It argues the gap reflects the dominance of implicit, rather than explicit, use of epidemiologic theory to inform epidemiologic research. The chapter concludes with a call for the explicit analysis of these theories, so as to improve the intellectual rigor of the field.
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