Systemic Materialist Realist Ontology, Epistemology, Semantics, Axiology and Ethics: Why Pearl’s counterfactuals and Pawson’s methods are insufficient for causation in Social Epidemiology and Public Health

We evaluate counterfactual empiricism, the dominant philosophy of science in contemporary epidemiology and public health from a scientific realist perspective. Building on our earlier work, we critique the dominant counterfactual/potential outcomes epistemology in epidemiology and public health, based on its neglect of ontology and exclusion of causal mechanisms which are confused with statistical inference methods (e.g., mediation). We argue that a realist systemic materialist ontology of levels , scientific realist epistemology, and realist semantics, axiology and ethics could constitute a best philosophical system for the disciplines of social epidemiology and public health, and their social inequalities in health subdivisions