I would like to disagree with this comon-sense idea of multiple causes. To
my understanding, this just reflecta our ignorance about diseases causality.
I have been trying to make this point with CHD causation. It is not so much
multiple risk fators as it is multiple diseases (CHDs), which present at the
population level as combination of rates, each rate resulting from an
interaction between a the level of particular environental exposure AND the
historically built vulnerability (inherited and acquired in the lifecourse)
to the correspondent exposure at that given point in time.
In the case of CHD, I suggeted that the hipercholesterolemic cases
associated with high rates of mortality in the 19150s and 1960s resulted
from a 1918 Influenza Priming of vulnerable cohorts - those that showed the
higest mortality in 1918 - which set the stage of vulnerability that
resulted in CHD deaths due to coronary trombosis during the 1950s and 1960s
influenza epidemicas. CHD cases today belog mostly to the pull of
insulin-resistance cases. Those coursing with hypercholesterolemia should be
investigated regarding infection and auto-immunity.
(see
http://muse.jhu.edu/login?uri=/journals/perspectives_in_biology_and_medicine/v050/50.2azambuja.html
Obesity shoul also be called obesities.
There are several conditions associated with this phenotype. The epidemic
type, as it occurred with CHD, possibly depended not as much on a change in
the environmental exposure as on a change in the population vulnerability to
that exposure. We need to look for the determinant of vulnerability to
understand the epidemic.
Maria Inês
----- Original Message -----
From: "Carlos Quinonez" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, July 26, 2007 1:25 PM
Subject: Re: [SDOH] more... -- The Spread of Obesity in a Large Social
Network over32 Years
>I would argue that one can't simply blame society, which appears to be the
>tendency amongst advocacy stakeholders.
>
> Blame sucks.
>
> Yet I agree, there really is no fundamental cause for anything, it is a
> (un)natural complex of events and states that results in any given
> outcome, some are just more probable and predictable than others.
>
> So food and exercise policies may be a good way to structurally impact
> health deterring behaviours, whereas education and social marketing may
> be a good way to individually impact populations.
>
> And blame lays at every level and in everyone's hands.
>
> We're on a boat, all of us together, and if people die on the boat, it
> has to do with them, the weather, and the accomodations on the boat, and
> suffice it to say, it is in EVERYONE's best interest that the boat remain
> afloat!
>
> CQ
>
> Quoting Dennis Raphael <[log in to unmask]>:
>
>> I think the point is that many public health researchers will look for
>> anything that can take the place of considering "fundamental causes" of
>> ill health. As Picard points out, networks and contacts are themselves a
>> result of political, economoic, and social conditions.
>>
>> So rather than blame policies that make societies unhealthy, blame people
>> and their friends!
>>
>> By the way the "obesity epidemic" appears to be non-existant in Norway,
>> Sweden, and Denmark (a result of my three weeks of detailed
>> examinations).
>> Perhaps having basic income and other security makes you less likely to
>> stuff your face!
>>
>> dennis
>>
>>
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