Teaching for Epidemiological Literacy: Description, Prescription, and Critical Thinking

This working paper describes contrasting ideas for a sequence of topics as presented to students in a graduate course on epidemiological literacy. The premise of the pedagogical approach is that researchers develop their epidemiological thinking and practice over time through interactions with other researchers who have a variety of in-practice commitments, such as to kinds of cases and methods of analysis, and not simply to a philosophical framework for explanation. In descriptively teasing out what epidemiologists do in practice through a topic-by-topic presentation, I am prescriptively encouraging discussants to draw purposefully from across the range of topics and contrasting positions, and thereby pursue critical thinking in the sense of understanding ideas and practices better when we examine them in relation to alternatives. The initial topic concerns ways to learn in a community; after that, a number of conceptual steps follow—the characterization of the very phenomena we might be concerned with, the scope and challenges of the field of epidemiology, the formulation of categories—before linking associations, predictions, causes and interventions and examining the confounding of purported links. Building on that basis, the remaining topics consist of issues or angles of analysis related to the complexities of inequalities within and between populations, context, and changes over the life course. In the course of the description, some assertions about explanation and intervention emerge, notably, that epidemiological-philosophical discussion about causality often leaves unclear or unexamined whether a modifiable factor shown to have been associated with a difference in the data from past observations should be thought of as factor that, when modified, would generate that difference going forward. The article ends with conjectures that concern heterogeneity and the agency of the subjects of epidemiology