Lost in Causality: How Epidemiology’s Counterfactual Causal Inference Revolution Upholds Class, Race and Gender Inequities

  • Carles MuntanerEmail author
  • James R. Dunn
Conference paper


We critique empiricism, the dominant epistemology in epidemiology and public health from a scientific realist perspective. Building on our previous work, we also take on the popular counterfactual/potential outcomes epistemology based on its neglect of ontology and shunning causal mechanisms which are reduced to statistical methods (e.g., mediation). We the argue that ontology, epistemology, axiology and ethics constitute a philosophical system in epidemiology, and, in particular in social epidemiology and health equity/social inequalities research that ends up supporting capitalism, patriarchal/gendered and racialize social systems.


Scientific realism Empiricism Counterfactual Potential outcomes Ethics Epidemiology Public health Social determinants of health Social inequalities in health Social epidemiology 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of TorontoTorontoCanada
  2. 2.McMaster UniversityHamiltonCanada

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