Commentary: The McKeown debate: time for burial

Abstract

The work of Thomas McKeown, in one form or another, has for several decades featured on countless student reading lists and in virtually all Anglophone accounts of population change and the epidemiological transition. It has additionally provoked or exacerbated a range of fierce debates on the role of medicine, links between nutrition and health, the costs and benefits of industrial capitalism, associations between economic development and population growth, and the influence of bias on research and interpretation of research findings.1,2 All this started with an article published in Population Studies in 1955 (with RG Brown) in which McKeown entered a debate on the causes of population growth during the 18th century.3 In the chapter considered here—‘Medical issues in historical demography’—McKeown4 rehearsed and elaborated the arguments developed in this initial paper and a series of subsequent ones; arguments subsequently dubbed ‘the McKeown thesis’. So what in this work has provoked such fierce debate?

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