The strategy of preventive medicine

Abstract

Part 1 The Objectives of Preventive Medicine: The scope for prevention. Why seek to prevent?: the economic and humanitarian arguments. Priorities: a matter of choice Part 2 What needs to be prevented?: Sick individuals: a continuum of disease severity case definitions. A continuum of risk: the prevention paradox mass and individual measures. A unified approach Part 3 The Relation of Risk to Exposure: The dose-effect relationship. The limitations of research methods. Small but widespread risks: a public health disaster? Part 4 Prevention for Individuals and the High-risk Strategy Prevention and clinical care The high-risk strategy. Identifying risk-screening. Strengths and weaknesses of the high-risk strategy Part 5 Individuals and Populations: Individual variation: genetic, social and behavioural determinants of diversity. Variation between populations. Sick and healthy populations Part 6 Some Implications of Population change: Effects of the population average on the occurrence of deviance examples from mental health. Health implications for the population as a whole: cardiovascular disease body weight birth weight early development and adult health Down's Syndrome alcohol osteoporosis and fractures occupational and environmental health other fields of application. Safety Part 7 The Population Strategy of Prevention: Principles: the sociological, moral and medical arguments scope proximal and underlying causes. Strengths. Limitations and problems 8. In Search of Health: How do populations change?: the alcohol example. Scientific justification for change. Social engineering versus individual freedom. Freedom of choice. Role of governments. Who takes the decisions? The largest threat to public health: war. Social and economic deprivation. Responsibility for health.