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.
Kuller
Lewis H
LH
Graduate School of Public Health, University of Pittsburgh, GSPH, 130 North Bellefield Ave., Room 550, Pittsburgh, PA 15213, USA. kullerl@edc.pitt.edu
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