Question

According to McKeown's theory, the reduction in mortality due to tuberculosis is a consequence of

• A. Increased awareness and knowledge
• B. Medical advancement
• C. Behavioural modification
• D. Social and environmental factors

Hint:

McKeown said TB deaths fell before drugs and vaccines, due to better living conditions.

Answer 1

The Correct Option is D

Step 1: Recall the core argument of McKeown's thesis. Thomas McKeown analysed the historical decline in mortality from infectious diseases, including tuberculosis, in the eighteenth and nineteenth centuries.
Step 2: McKeown argued that the major fall in tuberculosis mortality occurred largely BEFORE the introduction of effective medical interventions such as specific anti-tubercular drugs (streptomycin) and the BCG vaccine.
Step 3: He attributed the decline mainly to improvements in the standard of living, particularly better nutrition, along with improved social and environmental conditions such as housing, sanitation and reduced overcrowding, rather than to medical advances.
Step 4: Eliminate the other options. Medical advancement is precisely what McKeown's theory downplays as the main cause. Increased awareness and behavioural modification were not the central explanation he proposed.
Conclusion: According to McKeown, the reduction in tuberculosis mortality was a consequence of social and environmental factors, so the correct answer is option 4.