Enigmas of Health and Disease: How Epidemiology Helps Unravel Scientific Mysteries

297 Pages·2014·2.25 MB·English

by  Alfredo Morabia

Enigmas of HEaltH and DisEasE
Also by Alfredo Morabia
Epidémiologie causale: Principes, Exemples, ἀ éorie
(Geneva: Médecine et Hygiène, 1996)
L’épidémiologie clinique: Que-Sais-je?
(Paris: Presse Universitaires de France, 1996)
L’epidemiologia clinica
(Rome: Il Pensiero Scientifico Editore, 1999)
History of Epidemiologic Methods and Concepts
(Basel, Birkhauser, 2004)
Le Bus Santé: une aventure genevoise
(Geneva: Médecine et Hygiène, 2006)
Psychiatric Epidemiology: Searching for the Causes of Mental
Disorders (with E. Susser, S. Schwartz, and E. Bromet)
(Oxford: Oxford University Press, 2006)
alfredo morabia
E n i g m a s

of
H E a l t H

and
D i sE a sE
how epidemiology helps
unravel scientific mysteries
columbia university press
new york
Columbia University Press
Publishers Since 1893
New York Chichester, West Sussex
cup.columbia.edu
Adapted from Santé: Distinguer croyances et connaissance
Copyright © 2011 ODILE JACOB, Paris / Pr Alfredo Morabia
Translation Copyright © 2014 Columbia University Press
All rights reserved
Library of Congress Cataloging-in-Publication Data
Morabia, Alfredo, author.
Enigmas of health and disease : how epidemiology helps unravel scientific
mysteries / Alfredo Morabia.
p. ; cm.
Adaptation of: Santé / Alfredo Morabia. 2011.
Includes bibliographical references and index.
ISBN 978-0-231-16884-7 (cloth : alk. paper) — ISBN 978-0-231-16885-4
(pbk. : alk. paper —ISBN 978-0-231-53767-4 (ebook)
I. Morabia, Alfredo, Santé. Adaptation of (work) : II. Title.
[DNLM: 1. Epidemiology. WA 105]
RA652
614.4—dc23
2013046811
Columbia University Press books are printed on permanent
and durable acid-free paper.
This book is printed on paper with recycled content.
Printed in the United States of America
c 10 9 8 7 6 5 4 3 2 1
p 10 9 8 7 6 5 4 3 2 1
Cover design: Faceout Studio, Tim Green
Cover image: General Research Division, The New York Public Library,
Astor, Lenox and Tilden Foundations
References to websites (URLs) were accurate at the time of writing.
Neither the author nor Columbia University Press is responsible for URLs
that may have expired or changed since the manuscript was prepared.
To Léon and Bob

ContEnts
Preface to the English Edition ix
Prologue: A Science Named Epidemiology xiii
1. Comparing Groups and the Fifth Dimension 1
2. People, Bugs, and Epidemics 13
3. Plague’s Shark Teeth and Seamen’s Enigmatic Exhaustion 31
4. The Mystery of the Blue Death 41
5. The Numerical Method 63
6. Eugenics, Oysters, Sour Skin, and Breast Cancer 75
7. Tobacco and Health: The Great Controversy 97
8. Daily Life Mysteries and Epidemiology 125
9. Is This Treatment Dangerous for Health? 135
10. Does the Treatment Work? 141
11. What Is the Optimal Medical Decision? 151
viii ContEnts
12. Health Risk or Health Benefit? 157
13. Is This Screening Useful? 167
14. Group Comparisons Also Fail 171
15. Epidemiologic Literacy and “Earthly Self-Realization” 183
16. Beyond Epidemiology 193
Epilogue: The End of Epidemiology? 205
Appendix 1: Interaction of Causes 213
Appendix 2: Odds Ratio and Risk Ratio 215
Appendix 3: Why Cohort and Case–Control Studies Concur 217
Appendix 4: Where Do the Cases of Lung Cancer Come From? 221
Notes 223
Bibliography 243
Index 259
PrEfaCE to tHE EnglisH EDition
The book you are reading is the English adaptation of my 2011 French
book entitled Santé: Distinguer croyances et connaissance. My original
approach to translating Santé had been to remain faithful to its words,
style, and syntax. This proved ineffective, however, because it ignored a
key component of language: the cultural context. While I am writing now,
each word comes to my mind with a choice of synonyms, reminiscent of
books, songs, or poems. In both French and English, words, expressions,
and syntax flexibility are nested in different sets of cultural and literary
connections. On top of this, English-speaking societies are more familiar
with epidemiology than French-speaking ones and therefore necessitate
different narration.
My last incentive to adapt rather than translate Santé is more personal.
I had grown tired of reading the same prose in both English and French
and yearned to feel the same excitement from the English version I had
from the book in French. The result is that although Santé and Enigmas
of Health and Disease cover the same topics and develop the same ideas,
each book has its own distinct character.
I made two notable changes. Following the recommendations of my
reviewers and American publisher, I dropped a chapter highlighting the
use of epidemiology in everyday life when one is reading newspapers,
magazine, and blogs. Although relevant, it detracted from the main thread:
the historical process by which society embraced epidemiology to unravel
scientific mysteries. Instead, I added a new section describing the com-
plexity of distinguishing a variety of possible causes to a health event.