Pointing out the everpresent problem of causal direction is not generally sufficient to critique a body of epidemiologic data

Disease causality is always tricky to prove, and of course even robust and persistent correlations typically require the articulation of plausible, evidence-based causal mechanisms.

However, the mere truism that correlation is not causation does not properly imply the correlation is spurious or uninteresting. It’s kind of a generic point that is always kind of obviously, and even non-trivially true, but (1) there are methodological tools for trying to minimze the possibility of mistaking causal direction; and (2) even without those tools significant, robust correlations accompanied by useful causal attributions are extremely helpful from an epidemiologic perspective.

Much of epidemiology, like much social science in general — including economics, I tend to think — relies on articulating correlations, in large part because causation, especially causation of effects produced from a nonlinear, dynamical system like that which produces human health and illness, is often times simply impossible to demonstrate, prove, or disentangle.

Without reliance on such correlations, epidemiology, public health, and many other modes of social science would be impoverished. In part, the importance of finding and evaluating correlations is in part why the fallacy of mistaking causation for correlation is so common. As cognitive scientists have noted, the human brain is far too good a pattern recognition device, such that we see causal patterns were none exist.

So it’s fair to argue that the utmost caution is needed on this front, and to argue that the fallacy is made all too often. IMO, however, it is inadvisable to dismiss or classify as spurious a robust and persistent correlation simply because the precise causal pathways remain somewhat obscure.

Thanks for the clarification. I see your point.

best

Deven

Next thing you know, he’ll propose to shut down all hospitals because more people die there than in any other type of building.

And sure, as we tax cosmetic surgey into oblivion, people predisposed to depression will be immediately cured. And, a propos Frank’s earlier post about teens and designer clothing: as soon as we tax designer clothing into oblivion, teens will stop forming cliques and bullying.

What are you saying? Because a religion employs a procedure (that only recently has some shown medical benefit) it is somehow necessary? Given your usual comments I am confused here. It is necessary as a cultural issue but not medical. So perhaps you are saying that the procedure shows that culture can dictate procedures but where are you headed with this idea?

That said, I certainly have no problem with trying to rank order procedures to try to capture some of the nuance and complexity of the issue, and even trying to better internalize the costs of procedures that seem to fall much closer to the “enhancement” domain. However, I do not agree with Aschinger’s notion that advertising created the demand.

Advertising may drive it and fuel it, but did not create it. The desire for breast implants is an intricate social phenomenon, caused by a number of different social, political, and economic factors, of which advertising is only one, and may even be more effect than cause.

For the record, I’ve never imagined any of your policy preferences or proposals to be motivated by an alleged hubris. I’ve rather found them to reflect such virtues as empathy, compassion, intelligence if not wisdom, keen political judgment, and a legal scholar’s firm grasp of the breadth and depth of the relevant law. Moreover, they exemplify the energy and courage of one who holds steadfast to a belief in the egalitarian goal of universal human flourishing wherein everyone has not only their basic physiological, psychological, and perhaps even spiritual, needs met, but is able to progressively realize their capacities and potential over the course of a lifetime. I’m one reader who remains quite grateful for the consistently high quality of your posts.

Incidentally, only a cursory acquaintance with Judaism would disabuse one of the idea that infant male circumcision is not an “unnecessary vanity procedure” (it is a ’sign in the flesh,’ of the covenant made with Abraham). And some recent evidence suggest that it may even help in the fight against transmission of the AIDS virus.

KipEsquire: I don’t think “braces are just like surgery” is much better than the haircut/manicure analogy. And I believe we have better evidence on the braces’ lasting effects than the implants.

Or how about infant male circumcision, which is also an unnecessary vanity procedure that “crowds out” other medical procedures?

More generally, do you ever have a basis for your policy proposals other than your own hubris?