Concept of Causality and Association The concept of causality lay on two premises. First, it states that disease does not occur at random; and second, disease has identifiable cnusal and preventive faclors. The Henle-Koch Postulate asserts tbat a cause of a disca5C is any event, condition. characteristic or a combination of these factot·s thut play an important role in produci,ng the disease. further, a c:mse must precede a disease irnd lhe cm1se of a disease must be necessary :md sufficient for the occurrence of disease. Necessary cnusc refers Lo the fact thnt the factor ffillfil be present for the disensc to occur. Su fficicnt cause indicates that if a factor is present, the discn. sc c..m occur, hut the foclor's presence ru:,es not ah D1YS result in the disea8e's occurrence. Thus, when Lhc spntum from a person suspe<:ted of tuberculosis demonstratc. s the bacilli in the smear examination, it confirms lhe presence of tuberculosis. The tubercle bncillus is a 11cccss,1ry cause for TB to occur. The presence of diabetes mellitus in n person dues nut. ii ways lcm. 1 to occurrence of tuberculosis; but studies have shown that il is a sufiicient cause for Til to occur. The condition of reduced blood glucose seems to lower the person's immunity and make him susceptible to communicable diseases like tuberculosis. Thenurse is not only responsible for making sure U1atthcsick in thecommnnityrecover from their illness and injury. In caringforthepopulnlic111, themoreimpo1·tantdimcnsion is for the healthy to remain in Uieir optimum level of wellness whilst preventing them from developing disec1se conditions. There arc segments of the p OJ')1Jl. 1Lion who have certain risks of acqufring certain diseases. Risk is the probability of an w1fnvurablc event-disease, disability, defect or even death. It is imporwnt for the nurse,rnd the people to have knowledge about these risk factors associated with disen.-,c conditions. Disease can only be prevented if tbe risk factors are iclen1ified and dealt with. The concept of association does not necessarily imply a c. iusal relationship. It only states that if there is concurrence of two variables more often lhan would be ex-peeled by chance, then the two variables under investigation are said lo be associated. The following are the different factors associated with increased rii:;k of disease: P. redisposing factor-any characteristi c ofan Individual, a community or an environment that predispo ses behavior or other conditions related to health; Includes knowledge, belief arid attitude but may include other factors such as soeio-economk: stat1JS Enabllng factor-any characteristic of an lndlvldual, aroup or the environment that facilitates or make po»ible a certain health behavtor or other conditions affectina health; inc:ludes any skill or resource required to attain that condition Relnforcfr,g factor-any reward or punishment or any feedback followlns or anticipat~ as a consequen ce of health behavior The relationship between a risk factor and a certain disease can be described in terms of the following types of association: L Spurious or artifactual association-association when none actually exists 2. Indirect-presence of a known or unknown factor common to both a characteristic a11d a disease may wholly or partly e.,1>lain a statistical association 3. Direct or causal-presence of a factor which wholly and directly explain the cause of disease; no intervening variables One to one causal-suggests that when one factor is present, disease results; conversely, when the disease is present, the factor must also be present 191 