Causality for population health in the exposome era

Our recent paper in Nature Health has gained significant visibility, with an Altmetric score now exceeding 590.

It has also attracted considerable attention in the mainstream media, not all of which has accurately reflected the nuances of the spatial exposomic approach. In this context, we published a correspondence to clarify certain points and ensure the work was interpreted as intended, while situating it within the emerging exposomic framework:

Bertani, S., Pineau, P., Deharo, É, Honles J. Causality for population health in the exposome era. Nat. Health (2026).

This correspondence argues that traditional single-exposure epidemiological frameworks are insufficient for understanding population health in the exposome era, where multiple, time-varying, and interacting environmental, social, and biological exposures shape disease. The authors advocate for high-dimensional, structural causal approaches (including exposomic mapping, causal graphs, and robustness criteria) that represent joint causal structures and context-dependent capacities. Such methods improve identifiability and policy relevance by capturing interactions, temporal sequencing, and spatial heterogeneity across populations. The piece emphasizes using complementary data and well-specified causal models to produce context-sensitive, actionable inferences for public health.