Content area

Abstract

To describe causally predictive relationships, model parameters and the data used to estimate them must correspond to the social context of causal actions. Causes may act directly upon the individual, during a contact between individuals, or upon a group dynamic. Assuming that outcomes in different individuals are independent puts the causal action directly upon individuals. Analyses making this assumption are thus inappropriate for infectious diseases, for which risk factors alter the outcome of contacts between individuals. Transmission during contact generates nonlinear infection dynamics. These dynamics can so attenuate exposure-infection relationships at the individual level that even risk factors causing the vast majority of infections can be missed by individual-level analyses. On the other hand, these dynamics amplify causal associations between exposure and infection at the ecological level. The amplification and attenuation derive from chains of transmission initiated by exposed individuals but involving unexposed individuals. A study of household exposure to the only vector of dengue in Mexico illustrates the phenomenon. An individual-level analysis demonstrated almost no association between exposure and infection. Ecological analysis, in contrast, demonstrated a strong association. Transmission models that are devoid of any sources of the ecological fallacy are used to illustrate how nonlinear dynamics generate such results.

Details

10000008
Title
The ecological effects of individual exposures and nonlinear disease dynamics in populations
Publication title
Volume
84
Issue
5
Pages
836-42
Number of pages
7
Publication year
1994
Publication date
May 1994
Publisher
American Public Health Association
Place of publication
Washington
Country of publication
United States
ISSN
00900036
CODEN
AJPHDS
Source type
Scholarly Journal
Language of publication
English
Document type
Journal Article
Accession number
8179058, 02037228
ProQuest document ID
215110344
Document URL
https://www.proquest.com/scholarly-journals/ecological-effects-individual-exposures-nonlinear/docview/215110344/se-2?accountid=208611
Copyright
Copyright American Public Health Association May 1994
Last updated
2025-11-13
Database
ProQuest One Academic