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1 Introduction
How do we know if a disease is caused by exposure to a particular substance? And,
what evidence can be relied upon to support such a connection? Who, if anyone,
should care?
To answer such questions, the discipline of epidemiology bridges two domains:
that of toxicology through its focus on studying disease causation in animal models examined in controlled laboratory settings, and the experience seen in human
populations in the real world. Epidemiology is thus the applied, public-interest science relied on for informing rational policy formulation to protect public health and
safety. As epidemiologists, we have a duty of care in such matters.
Epidemiology best informs policy through its systematic conduct and evaluation
of research on human populations. It is this evidence that guides individuals, constituting the public, concerning the most precautionary measures that they might take
to prevent illness and premature death. If we accept that one role of government is
to protect public health, then this is achieved by establishing regulatory regimes that
incentivize good conduct on the part of polluting industries, as well as best behaviours among members of the public exposed to such sources of exposure, and by
instituting disincentives for poor conduct. The goal is to avoid exposures to potentially harmful products that, for reasons beyond the scope of this chapter, enter
commercial markets locally, nationally and globally (Cranor 2011).
From this, it is apparent that one dimension of avoiding harm focuses on individual conduct, assuming that personal choice is available to avoid exposure with its
consequent elevation of risk of harm. The other focus is on what it takes for governments to ensure an environment that is free of harmful pollutants. In the one instance,
the individual has personal control over his/her exposure. On the other hand, some
exposures are pervasive in the environment over which the individual has little to no
control as to whether or not he/she will be exposed. Some exposures also are addictive (like tobacco products, alcoholic beverages, and a variety of drugs).
It is the obligation of professionals in public health not only to care about such
matters, but also to use appropriate scientific methods to draw valid conclusions for
use in informing rational policy; that is, policy based on evidence rather than policy
that is either ideologically or non-fact driven, or driven on the basis of invalid science. In summary, the primary interest of public health researchers and practitioners while serving as public health scientists is to care about the public interest
above any other interest.
Reports based on poor science, or misleading reports from special interest groups
(ideologically and/or financially driven), can foment uncertainty, confuse the public
and policy-makers, and lead to delayed or damaging policies that negatively impact
people (Ruff 2015, 2017) and the living systems on which they depend. While science advances through an iterative process of falsifiability and refutation (Popper
1963; Maclure 1985), this process has been corrupted by special interests that run
counter to the mission of science (Michaels 2008, 2020).
Given the many conflicting interests involved in population and community health
research, we must not be naïve about the forces at play that influence both science and
C. L. Soskolne
1 Introduction
How do we know if a disease is caused by exposure to a particular substance? And,
what evidence can be relied upon to support such a connection? Who, if anyone,
should care?
To answer such questions, the discipline of epidemiology bridges two domains:
that of toxicology through its focus on studying disease causation in animal models examined in controlled laboratory settings, and the experience seen in human
populations in the real world. Epidemiology is thus the applied, public-interest science relied on for informing rational policy formulation to protect public health and
safety. As epidemiologists, we have a duty of care in such matters.
Epidemiology best informs policy through its systematic conduct and evaluation
of research on human populations. It is this evidence that guides individuals, constituting the public, concerning the most precautionary measures that they might take
to prevent illness and premature death. If we accept that one role of government is
to protect public health, then this is achieved by establishing regulatory regimes that
incentivize good conduct on the part of polluting industries, as well as best behaviours among members of the public exposed to such sources of exposure, and by
instituting disincentives for poor conduct. The goal is to avoid exposures to potentially harmful products that, for reasons beyond the scope of this chapter, enter
commercial markets locally, nationally and globally (Cranor 2011).
From this, it is apparent that one dimension of avoiding harm focuses on individual conduct, assuming that personal choice is available to avoid exposure with its
consequent elevation of risk of harm. The other focus is on what it takes for governments to ensure an environment that is free of harmful pollutants. In the one instance,
the individual has personal control over his/her exposure. On the other hand, some
exposures are pervasive in the environment over which the individual has little to no
control as to whether or not he/she will be exposed. Some exposures also are addictive (like tobacco products, alcoholic beverages, and a variety of drugs).
It is the obligation of professionals in public health not only to care about such
matters, but also to use appropriate scientific methods to draw valid conclusions for
use in informing rational policy; that is, policy based on evidence rather than policy
that is either ideologically or non-fact driven, or driven on the basis of invalid science. In summary, the primary interest of public health researchers and practitioners while serving as public health scientists is to care about the public interest
above any other interest.
Reports based on poor science, or misleading reports from special interest groups
(ideologically and/or financially driven), can foment uncertainty, confuse the public
and policy-makers, and lead to delayed or damaging policies that negatively impact
people (Ruff 2015, 2017) and the living systems on which they depend. While science advances through an iterative process of falsifiability and refutation (Popper
1963; Maclure 1985), this process has been corrupted by special interests that run
counter to the mission of science (Michaels 2008, 2020).
Given the many conflicting interests involved in population and community health
research, we must not be naïve about the forces at play that influence both science and
C. L. Soskolne