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IJE Advance Access originally published online on July 15, 2004
International Journal of Epidemiology 2005 34(1):44-45; doi:10.1093/ije/dyh273
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IJE vol.34 no.1 © International Epidemiological Association 2004; all rights reserved.

Commentary

Commentary: The message is rarely simple: the J-curve and beyond

B Rockhill

University of North Carolina, Department of Epidemiology, Chapel Hill, NC 27599, USA. E-mail: beverly_rockhill@unc.edu

The first 150 words of the full text of this article appear below.

In their article in this issue of the International Journal of Epidemiology, Adams and White1 take on the important topic of population-based prevention strategies. Their central thesis is that when the relation between exposure and average risk of an outcome is J-shaped, a population-based prevention strategy has the obvious potential to harm a group of individuals by pushing them into a higher risk level through a reduction in exposure. In their paper, the authors focus mainly on the outcome of all-cause morbidity/mortality.

In their first paragraph, the authors invoke the name and work of Geoffrey Rose, and note that his reasoning has been so persuasive that the population approach has been described2 as one of the ‘absolute truths’ of preventive medicine. In this era of market individualism3 and consumer-driven medicine, I believe this description of Rose's impact is, unfortunately, highly debatable in the US, but this is not the . . . [Full Text of this Article]


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