Mediation and mechanism

Eur J Epidemiol. 2009;24(5):217-24. doi: 10.1007/s10654-009-9331-1. Epub 2009 Mar 28.


The concepts of mediation and mechanism are contrasted and logical implications holding between theses two concepts are described. The concept of mediation can be formalized using counterfactual definitions of indirect effects; the concept of mechanism can be formalized within the sufficient cause framework. It is shown that both concepts can be illustrated using a single causal diagram. It is also shown that mediation implies mechanism but mechanism need not imply mediation. Discussion is given regarding how the distinction between "statistical causality" and "mechanistic causality" is blurred by recent work in causal inference concerning methods for testing for mediation and mechanism.

MeSH terms

  • Causality*
  • Effect Modifier, Epidemiologic*
  • Environmental Exposure
  • Epidemiologic Methods*
  • Humans
  • Models, Statistical
  • Risk Assessment / methods*