Cause and Effect in Epidemiology

Ripples in water.Determining the cause of a disease or the positive effect of a health activity is an important part of decision-making in public health. But how do we know if something actually does cause a disease or improve our health? Inferring causality is a step-by-step process requiring a variety of information. In this module, Dr. Victoria Holt discusses seven guidelines to use in determining whether a specific agent or activity causes a health outcome. She illustrates each guideline with a public health example.

Suggested pre-requisites

Before you go on with this module we recommend that you become familiar, if you haven’t already, with the material presented in the following courses in this series.

• What is Epidemiology in Public Health?
• Data Interpretation for Public Health Professionals
• Study Types in Epidemiology
• Measuring Risk in Epidemiology

This course is co-provided by the Northwest Center for Public Health Practice (NWCPHP) and Continuing Nursing Education (UWCNE) at the University of Washington.

Target Audience

People working in the field of public health who would like to increase their understanding of the basic terms and concepts used in epidemiology.

Objectives for Learning Outcomes

After completing this course, you will be better able to:

  • Describe and distinguish between association and causality in epidemiology
  • List and describe features of associations that support inferences of causality
  • List principal concerns in inferring causality

Additional Information

Course summary
Maximum credit available: 
  • 0.75 Contact hours
  • 0.00 Pharmacology hours at the advanced practice level

Victoria Holt, RN, MPH, PhD
Faculty, Northwest Center for Public Health Practice, School of Public Health and Community Medicine, University of Washington, Seattle; Faculty, Department of Epidemiology, University of Washington, Seattle

Available Credit

  • 0.75 Contact hours
  • 0.00 Pharmacology hours at the advanced practice level


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