[DSRP Evidence](https://dsrpevidence.org/)

# Sick Individuals and Sick Populations

## Details

**Authors** Rose, Geoffrey

**Year** 1985

**Publisher** International Journal of Epidemiology 14(1), 32–38

**Kind of work** article

**Discipline** Public Health

**Secondary disciplines** Medicine

**Applied** false

[Read it at the publisher](https://doi.org/10.1093/ije/14.1.32) 
10.1093/ije/14.1.32

## In authors' words

### What they set out to do (purpose)

To separate the question of what causes individual cases of disease from the question of what drives a population's incidence rate.

### How they did it (methods)

Conceptual and epidemiological argument.

### What they found (results)

The author argues that etiology poses two distinct questions, and that when a necessary exposure is uniform across a population, case-control and cohort studies miss it and can identify only markers of susceptibility. Prevention therefore has a high-risk strategy for susceptible individuals and a population strategy aimed at the causes of incidence; the two are usually complementary, but finding and controlling the causes of incidence has priority.

## Commentary

### In short

An epidemiologist argues that the causes of who falls ill differ from the causes of how much illness a population has, and that prevention needs both views.

### Response

The paper treats individual and population as two levels of one system, each with its own causal question, which fits the part-whole pattern. Each level is a vantage point that shows different causes, which is the perspective pattern, and the causal question is relational. The fit is partial: the argument is conceptual and does not state the structures in these terms. Source reading was from a reconstructed abstract only.

**Patterns it shows** S, R, P

Shows the structure is there

**Added** 2026-10-20

**How to cite this** Rose, Geoffrey (1985). Sick Individuals and Sick Populations. International Journal of Epidemiology 14(1), 32–38.