Over the past three decades, a “Causal Revolution”—introduced to Epidemiology as the Potential Outcomes framework—initiated a paradigm shift across the social sciences. This shift influences the questions we ask, the methods we use, the narratives we construct about our study results, and thus the knowledge upon which we base our fights for the people’s health. The guiding principle of the Causal Revolution is simple but profound: researchers should specify if their goal is description, prediction, or causation. Researchers should declare their causal goals even for observational studies; causation should not be reserved for randomized trials. Such declarations can prevent misalignment between inferential targets, assumptions, analytic approaches, and interpretations. This principle produced important innovations that clarified assumptions necessary to infer causation from association and produced methods to mitigate the effects of their violation. But it also reignited debates about the definition of causation, the causal status of important social constructs like class and race, the role of manipulation or intervention in causal inference, and assumptions about how change in the people’s health happens. In this talk, drawn from our recent book, Causal Inference and the People’s health, we interrogate these debates, critique inadequate attempts at their resolution, and offer a path forward—by embracing causal questions that identify and explain etiologic processes rather than solely estimate the effects of interventions. This in turn expands causal inference to include social forces as causes of the people’s health and therefore reinvigorates epidemiology’s historical role in targeting systems and structures for change. 

 

About the speakers

Sharon Schwartz is a Professor Emerita of epidemiology at Columbia University’s Mailman School of Public Health. Her research is in the area of social psychiatric epidemiology. It focuses on the unique characteristics of the “social” that make causal inference particularly difficult.

Seth J. Prins is an Associate Professor of Community Health Sciences at SUNY Downstate Health Sciences University, School of Public Health. He is a social and psychiatric epidemiologist with two main programs of research; the first concerns the consequences of mass criminalization and mass incarceration for public health, and the second investigates how the division and structure of labor influence mental illness and substance use. Prins's two programs of research are connected by an underlying interest in how political-economic arrangements, power relations, and various forms of social control affect population health.