Multicausality: Confounding-Assignment, by Schoenbach (2001)

1. Complete the “Multicausality: Confounding – Assignment,” by Schoenbach (2001),TEXTBOOK USED FOR THIS CLASS IS EPIDEMIOLOGY BY LEON GORDIS FIFTH EDITION. YOU WILL FIND THE CONFOUNDING ASSIGNMENT THAT HAS TO BE COMPLETED ATTACH.2. Based on the “Multicausality: Confounding – Assignment,” by Schoenbach, discuss two significant insights you learned about confounding. Use specific examples from the assignment to support your answer.EXAMPLE THAT THE PROFESSOR GIVE US IN THE DISCUSSION.Three ConditionsThere are three conditions that must be present for confounding to occur:1. The confounding factor must be associated with both the risk factor of interest and the outcome.2. The confounding factor must be distributed unequally among the groups being compared.3. A confounder cannot be an intermediary step in the causal pathway from the exposure of interest to the outcome of interest.Not surprisingly, since most diseases have multiple contributing causes (risk factors), there are many possible confounders.· A confounder can be another risk factor for the disease. For example, in the hypothetical cohort study testing the association between exercise and heart disease, age is a confounder because it is a risk factor for heart disease.· Similarly a confounder can also be a preventive factor for the disease. If those people who exercised regularly were more likely to take aspirin, and aspirin reduces the risk of heart disease, then aspirin use would be a confounding factor that would tend to exaggerate the benefit of exercise.· A confounder can also be a surrogate or a marker for some other cause of disease. For example, socioeconomic status may be a confounder in this example because lower socioeconomic status is a marker for a complex set of poorly understood factors that seem to carry a higher risk of heart disease