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The end of the epidemiology wars? Epidemiological ‘ethics’ and the challenge of translation

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Abstract

This article presents findings from a content analysis of the epidemiological literature from 1990 to 2007. We argue that the notion of multi-causality served as a boundary object that, on the surface, helped to defuse many of the conflicts raised by the so-called ‘epidemiology wars’ of the mid-1990s. But underneath this apparent consensus, we find that epidemiologists have forged two largely divergent ways of navigating their way through a thicket of questions about units and levels of analysis, the nature of disease causation, and the role of epidemiologists in public affairs. The inductive ethic delineates a data-driven enterprise, in which the mission of epidemiology is articulated as determining disease etiology, and it is frequently espoused by epidemiologists interested in the effects of genetic and behavioral risk factors. In contrast, the deductive stance argues for a theory-driven approach, reflecting a historical concern in epidemiology with population-level dynamics. These ethics encompass commitments to differing causal frameworks and views of scientific credibility and social responsibility. Based on these findings, we offer some reflections on the relationships among boundary objects, translation processes, and methods standardization, and how these highlight the challenges to interdisciplinarity in scientific work.

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Notes

  1. At the most general level, epidemiology refers to ‘the study of the distribution and determinants of health-related states or events in specific populations, and the application of this study to the prevention and control of health problems’ (Last, 2001, p. 62).

  2. Using PubMed and nine permutations of 19 keywords (see Appendix), we conducted searches for articles published between 1990 and 2007 in nine epidemiological journals selected according to impact factor. After obtaining an initial sample of 1719 articles, we eliminated those that only presented research findings, as well as those focused on occupational health and infectious disease (because of our ultimate interests in complex, chronic conditions such as heart disease). This resulted in a pool of 75 articles. We then supplemented this initial pool in two ways: (1) 17 other articles published by the same authors in our original pool of publications; and (2) four articles in explicit conversation with those in our sample, including commentaries and letters to editors. Our final sample contained 96 articles (complete list may be obtained from corresponding author). We uploaded the articles into the qualitative software program Atlas.ti, and one of us (LKT) coded the entire sample paragraph by paragraph using a 66-item, inductively derived coding scheme. After all the articles had been coded, we designed and conducted 25 queries which enabled comparisons of text units tagged with specific codes, and this led to the development of the themes we discuss in this article.

  3. Pearce (1996) differentiates ‘bottom-up’ approaches from ‘top-down’ ones, which correspond to our distinction between inductive and deductive ethics. But while Pearce examines their epistemological and methodological implications, we are more interested in the claims being mobilized, definitions of credibility, the relationships to the public they demarcate, and so on.

  4. We do not take divisions between social and biological causes to be self-evident. When we discuss these distinctions within the article, we are reflecting on and analyzing the ways in which the language and practices of biological and social differences are mobilized in the context of epidemiological discussions.

  5. For example, Shostak (2005, 2007) found that the use of molecularization as a means of translation in the environmental health sciences required new technologies to translate information across levels of analysis (from molecular to social or geographical levels), along with new protocols for assessment, and standardization of methods (along with negotiations among scientists and regulatory agencies).

  6. Callon (1995) adds that when networks are not so interwoven, a diversity of translation networks may coexist peacefully.

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Acknowledgements

We dedicate this article to the memory of Leigh Star, whose combination of theoretical insight, empirical scholarship, and concern for social justice inspires our own work. We are indebted to the University of California, San Francisco, who provided funds to support this research. We are also grateful to audiences at the 2007 Society for Social Studies of Science and the 2008 American Sociological Association Annual Meetings, who commented on previous versions of this article.

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Authors and Affiliations

  1. Department of Social and Behavioral Sciences, University of California San Francisco, Box 0612, 3333 California Street, Suite 455, San Francisco, 94143-0612, California, USA

    Janet K Shim & L Katherine Thomson

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  1. Janet K Shim
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Correspondence to Janet K Shim.

Appendix

Appendix

Journals and Terms Used to Conduct Searches

Journals in Sample:

  1. 1

    American Journal of Epidemiology

  2. 2

    American Journal of Public Health

  3. 3

    Annals of Epidemiology

  4. 4

    Annual Review of Public Health

  5. 5

    Epidemiological Reviews

  6. 6

    Epidemiology

  7. 7

    Genetic Epidemiology

  8. 8

    International Journal of Epidemiology

  9. 9

    Journal of Epidemiology and Community Health

Keywords for Search:

  1. 1

    causation

  2. 2

    crossroad

  3. 3

    epidemiologists

  4. 4

    epidemiology

  5. 5

    health

  6. 6

    history

  7. 7

    legacy

  8. 8

    methods

  9. 9

    model

  10. 10

    society

  11. 11

    past

  12. 12

    current

  13. 13

    present

  14. 14

    contemporary

  15. 15

    next

  16. 16

    future

  17. 17

    role

  18. 18

    purpose

  19. 19

    mission

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Shim, J., Thomson, L. The end of the epidemiology wars? Epidemiological ‘ethics’ and the challenge of translation. BioSocieties 5, 159–179 (2010). https://doi.org/10.1057/biosoc.2010.6

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