The Case of the

Murphy Family’s

Jewels

© 2010 Dennis Bertram

or --

a lesson in

causation

Retired college professor

Had a successful career in banking

Their living room

Mr. Murphy

fancies

himself a

gourmet

cook

Mrs. Murphy enjoys reading a favorite book in the den

A pleasant sitting room . . .

A fake Van Gogh . . .

a favorite painting

Behind the

painting . . .

Meanwhile, back at home . . .

The Murphys forgot to notify the post office and newspaper delivery!

At first they don’t notice. But then --

Aaaagggghh!Aaaagggghh!

Question

What is the cause of the

Murphy’s loss?

One

answer:

Burglar

getting into

the safe!

Then how would you

prevent

that from happening?

Make the

safe burglar-

proof!

Add more protection

And more

And

more

And

even

more

How could we

have prevented

this from

happening?

This would

be silly!

Preventing Burglaries

Don’t leave valuables in your home

Lock doors and windows

Don’t leave key under doormat

Stop mail and newspaper delivery

Put thorny bushes under windows

Trim bushes around windows

Prevention of home

burglaries is more

than making safes

harder to open

So what

about diseases

and injuries?

CDC/ Dr. Ray Butler;

Janice Carr

Mycobacterium

tuberculosis

If you consider the

cause of tuberculosis as

only Mycobacterium

tuberculosis

CDC

Variola virus

. . . or the cause of

smallpox as only the

variola virus

. . . or only high blood

cholesterol causes

heart disease

. . . or only high blood

pressure causes

strokes

. . . or only idiots cause

automobile crashes

And ignore the other

factors that have a

causal role in disease

and injury

And ignore the other

factors that have a

causal role in disease

and injury

And ignore the

other factors that

have a causal role

in disease and

injury

And ignore the

other factors that

have a causal role

in disease and

injury

Socioeconomic

status

Knowledge, attit

udes and

beliefs

Family

relationships

Government policies

Employment

Access to

health

services

Public health

programs

Access to places to

exerciseNutritional

status

Educational

opportunitiesNeighborhood

grocery food

availability

The environment

An easily

opened safe!

Kaboom!

Individual behavior

Social, family and community

networks

Living and working

conditions

. . . and broad

social, economic, cultural, hea

lth and environmental

conditions and policies at the

global, national, state, and

local levels.

Lesson over

The End

Dr. Dennis Bertram

School of Public Health and Health Professions

University at Buffalo

Buffalo, New York

USA