McKeown and the idea that social conditions are fundamental causes of disease.
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.
Link
Bruce G
BG
Mailman School of Public Health, Columbia University, New York, NY, USA. bgl1@columbia.edu
Phelan
Jo C
JC
D019049:Developed Countries / Q000191:economics; D006304:Health Status; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008017:Life Expectancy; D011158:Population Growth; D011634:Public Health / Q000191:economics* / Q000266:history; D012924:Social Conditions; D012946:Social Welfare / Q000191:economics / Q000266:history