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The Case of the
Murphy Family’s
Jewels
© 2010 Dennis Bertram
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or --
a lesson in
causation
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Retired college professor
Had a successful career in banking
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Mr. Murphy
fancies
himself a
gourmet
cook
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Mrs. Murphy enjoys reading a favorite book in the den
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A pleasant sitting room . . .
A fake Van Gogh . . .
a favorite painting
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Behind the
painting . . .
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Meanwhile, back at home . . .
The Murphys forgot to notify the post office and newspaper delivery!
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At first they don’t notice. But then --
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Aaaagggghh!Aaaagggghh!
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Question
What is the cause of the
Murphy’s loss?
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One
answer:
Burglar
getting into
the safe!
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Then how would you
prevent
that from happening?
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Make the
safe burglar-
proof!
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Add more protection
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How could we
have prevented
this from
happening?
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This would
be silly!
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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
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Prevention of home
burglaries is more
than making safes
harder to open
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So what
about diseases
and injuries?
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CDC/ Dr. Ray Butler;
Janice Carr
Mycobacterium
tuberculosis
If you consider the
cause of tuberculosis as
only Mycobacterium
tuberculosis
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CDC
Variola virus
. . . or the cause of
smallpox as only the
variola virus
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. . . or only high blood
cholesterol causes
heart disease
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. . . or only high blood
pressure causes
strokes
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. . . or only idiots cause
automobile crashes
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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
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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
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An easily
opened safe!
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Individual behavior
Social, family and community
networks
Living and working
conditions
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. . . and broad
social, economic, cultural, hea
lth and environmental
conditions and policies at the
global, national, state, and
local levels.
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Lesson over
The End
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Dr. Dennis Bertram
School of Public Health and Health Professions
University at Buffalo
Buffalo, New York
USA