McDermott R
Tropical Public Health Unit, Cairns, QLD, Australia.
Soc Sci Med. 1998 Nov;47(9):1189-95. doi: 10.1016/s0277-9536(98)00191-9.
This paper briefly describes the rise of the thrifty genotype hypothesis as an explanation for the late twentieth century epidemic of diabetes, particularly in post-colonial indigenous societies. It looks at some of the ethical consequences of the biological deterministic paradigm, particularly the popular confusion of "genes" with "race" and how this paradigm served to exclude consideration of social determinants of disease in epidemiological thinking. Some alternative hypotheses to the thrifty gene theory are explored, together with the consequences of acceptance of these other theories in terms of public health action. Finally, there is a need for epidemiology to be continually conscious, critical and transparent with respect to the general disease (and wellness) theory under which it operates if it is to be truly a science rather than a collection of methodologies.
本文简要描述了节俭基因型假说的兴起，该假说用于解释20世纪后期糖尿病的流行，尤其是在后殖民时期的本土社会。文章探讨了生物决定论范式的一些伦理后果，特别是“基因”与“种族”的普遍混淆，以及这种范式如何在流行病学思维中排除对疾病社会决定因素的考量。文中还探讨了节俭基因理论的一些替代假说，以及接受这些其他理论对公共卫生行动的影响。最后，如果流行病学要真正成为一门科学而非方法的集合，就需要在其运作所依据的一般疾病（和健康）理论方面始终保持清醒、批判性和透明度。
