Looking back on "causal thinking in the health sciences"

Annu Rev Public Health. 2000;21:101-19. doi: 10.1146/annurev.publhealth.21.1.101.


It has now been over a quarter of a century since the publication of Mervyn Susser's Causal Thinking in the Health Sciences (1973, Oxford University Press), the first book-length treatment of causal reasoning and inference in our field. Major contributions of this work were its holistic focus on the origins of health outcomes in the context of ecologic systems and its invigoration of the literature on causal criteria in epidemiology. Although a recent resurgence of interest in social context has revivified many points made by Susser, a formal basis for causal analysis consistent with this ecologic perspective has failed to emerge in public health research. Susser's discussion of causal criteria, on the other hand, helped spur a vigorous dialogue that has persisted unabated to the present day. Although the basic outline of the criteria has evolved little, their applications, interrelations, and relative contributions to causal judgments have been the subject of continued and sometimes contentious debate.

Publication types

  • Review

MeSH terms

  • Causality*
  • Ecology*
  • Epidemiology*
  • Humans
  • Judgment
  • Logic
  • Models, Statistical
  • Philosophy, Medical*
  • Public Health Practice*
  • Systems Analysis
  • Thinking