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Sick Individuals and Sick Populations
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Abstract
Aetiology confronts two distinct issues: the determinants of individual cases, and
the determinants of incidence rate. If exposure to a necessary agent is homogeneous
within a population, then case/control and cohort methods will fail to detect it:
they will only identify markers of susceptibility. The corresponding strategies in
control are the 'high-risk' approach, which seeks to protect susceptible individuals,
and the population approach, which seeks to control the causes of incidence. The two
approaches are not usually in competition, but the prior concern should always be
to discover and control the causes of incidence.