This article distinguishes three current theories that purport to account for the etiology of chronic diseases: a germ theory, a lifestyle theory and an environmental theory. Since each of these proposals about disease causality implies a different locus of responsibility for disease prevention, the medical disputes surrounding the theories often mask more fundamental political controversies over the proper organization of society. This article reports briefly on the medical debate accompanying each theory and more fully on the political argument each gives rise to. It concludes with a critique of the multifactorial theory of disease causality, calling it both ineffective and biased against those people most at risk of becoming ill.

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