Social Factors in Epidemiology

The coupling of social and biological contagion in human populations can have positive or negative outcomes. [Also see Perspective by Kahan] Despite the invention of control measures like vaccines, infectious diseases remain part of human existence. Ideas, sentiments, or information can also be contagious (1, 2). Such social contagion is akin to biological contagion: Both spread through a replication process that is blind to the consequences for the individual or population, and if each person transmits to more than one person, the explosive power of exponential growth creates an epidemic. Social contagions may cause irrational “fever.” Isaac Newton, having lost £20,000 in the speculative South Sea Bubble, commented that he could “calculate the movement of the stars, but not the madness of men” (3). Systems in which both contagion types are coupled to one another—an infectious disease spreading by biological contagion and a social contagion concerning the disease—offer unique scientific challenges and are increasingly important for public health (4–15).