The Strategy of Preventive Medicine

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.