Setting up the risk society - the rise of the epidemiological risk factor model into Finnish public health research and policy
- National Consumer Research Centre Finland Helsinki, Finland
How is a style of reasoning adopted by a scientific community? How do its modes of analysis become established in a policy field? These two questions guide my paper that looks at the rise of the epidemiological risk factor model into Finnish public health research and policy in the post-WWII era.
A risk factor is "a pattern of behavior or physical characteristic of a group of individuals that increases the probability of the future occurrence of one or more diseases in that group relative to comparable groups without or with different levels of the behavior or characteristic" (Rothstein). The tracking of epidemiological risks has a long and scattered history from the studies of Farr and Villermé to insurance medicine, but the risk factor model was consolidated in the discussions on the aetiologies of lung cancer and coronary heart disease (CHD) during the epidemiological transition after WWII. This discussion concerned not only the question whether smoking and other lifestyle factors actually caused chronic disease, but also a more fundamental issue, the status of epidemiological explanations based on statistical correlations. In the process, a new way of conceptualising health problems or a new style of reasoning (Hacking) was introduced into the professional world of health experts. It also had a profound impact on public health policy, guiding e.g. tobacco legislation and preventive health care measures to fight CHD.
My paper discusses this development in the context of CHD prevention in Finland from 1950s to 70s. How were epidemiological risk models and risk analysis adopted by Finnish health professionals? How were the new insights translated into action plans and public health policies to reduce cardiovascular risks in the population? Based on historical archive material, the paper contributes to the salient discussion on risk society. Its emergence is not viewed as an epochal rupture, but a gradual process that involves specific technologies of risk put into operation in concrete settings. Through its focus on a specific national path in adopting new technologies of risk, the paper also addresses the general theme of the conference.