McKeown and the idea that social conditions are fundamental causes of disease

Am J Public Health. 2002 May;92(5):730-2. doi: 10.2105/ajph.92.5.730.


In an accompanying commentary, Colgrove indicates that McKeown's thesis-that dramatic reductions in mortality over the past 2 centuries were due to improved socioeconomic conditions rather than to medical or public health interventions-has been "overturned" and his theory "discredited." McKeown sought to explain a very prominent trend in population health and did so with a strong emphasis on the importance of basic social and economic conditions. If Colgrove is right about the McKeown thesis, social epidemiology is left with a gaping hole in its explanatory repertoire and a challenge to a cherished principle about the importance of social factors in health. We return to the trend McKeown focused upon-post-McKeown and post-Colgrove-to indicate how and why social conditions must continue to be seen as fundamental causes of disease.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Developed Countries / economics
  • Health Status*
  • History, 18th Century
  • History, 19th Century
  • History, 20th Century
  • Humans
  • Life Expectancy
  • Population Growth
  • Public Health / economics*
  • Public Health / history
  • Social Conditions*
  • Social Welfare / economics
  • Social Welfare / history