Prevention research strategies.
Prevention of disease is the only method to substantially reduce morbidity and mortality in a population. The two key determinants of disease are the levels of risk factors/determinants and the adherence to efficacious therapies, and there are two approaches to these: public health and preventive medicine. Clinical trials remain the cornerstone for evaluating new approaches. Effectiveness studies are required to evaluate the best approaches to deliver efficacious therapies; public health and preventive medicine programs must include the entire population, and can be costly. Environmental changes have greater benefits and a greater likelihood of reaching large segments of the population, but the preventive medicine approach is better for high-risk diseases. New risk factors and diseases evolve from the upper to lower social classes, while preventive therapies evolve from the upper to lower education groups.
Graduate School of Public Health, University of Pittsburgh, GSPH, 130 North Bellefield Ave., Room 550, Pittsburgh, PA 15213, USA. kullerl@edc.pitt.edu
Lewis H
LH
Kuller
D002318:Cardiovascular Diseases / Q000517:prevention & control; D006801:Humans; D009765:Obesity / Q000517:prevention & control; D011322:Primary Prevention / Q000379:methods / Q000458:organization & administration; D015397:Program Evaluation; D011634:Public Health; D012307:Risk Factors