title: Evaluating Public Health Interventions: 5. Causal Inference in Public Health Research-Do Sex, Race, and Biological Factors Cause Health Outcomes?
abstract: Counterfactual frameworks and statistical methods for supporting causal inference are powerful tools to clarify scientific questions and guide analyses in public health research. Counterfactual accounts of causation contrast what would happen to a population's health under alternative exposure scenarios. A long-standing debate in counterfactual theory relates to whether sex, race, and biological characteristics, including obesity, should be evaluated as causes, given that these variables do not directly correspond to clearly defined interventions. We argue that sex, race, and biological characteristics are important health determinants. Quantifying the overall health effects of these variables is often a natural starting point for disparities research. Subsequent assessments of biological or social pathways mediating those effects can facilitate the development of interventions designed to reduce disparities.
authors.affiliation: M. Maria Glymour is with the Department of Epidemiology and Biostatistics, University of California, San Francisco. Donna Spiegelman is with the Departments of Epidemiology, Biostatistics, Nutrition, and Global Health, Harvard T. H. Chan School of Public Health, Boston, MA.
authors.forename: M Maria
authors.initials: MM
authors.lastname: Glymour
authors.affiliation: M. Maria Glymour is with the Department of Epidemiology and Biostatistics, University of California, San Francisco. Donna Spiegelman is with the Departments of Epidemiology, Biostatistics, Nutrition, and Global Health, Harvard T. H. Chan School of Public Health, Boston, MA.
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
mesh_terms: D001685:Biological Factors; D015984:Causality; D015986:Confounding Factors, Epidemiologic; D005006:Ethnicity; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D015233:Models, Statistical; D011287:Prejudice; D011634:Public Health; D012107:Research Design; D012737:Sex Factors
chemical_list: D001685:Biological Factors