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IJE Advance Access originally published online on August 21, 2008
International Journal of Epidemiology 2008 37(5):914-916; doi:10.1093/ije/dyn176
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2008; all rights reserved.

Editorial

The promise and challenges of population strategies of prevention

Karin B Michels1,2

1 Department of Obstetrics, Gynecology and Reproductive Biology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA.
2 Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.

E-mail: kmichels@rics.bwh.harvard.edu

Accepted 28 July 2008

The first 10% of the full text of this article appears below.

In public health, we are concerned with improving the health of populations. When considering prevention strategies, we have to decide between a population strategy and a high-risk strategy.1 The population strategy aims to shift the distribution of a risk factor in the entire population whereas the high-risk strategy targets individuals in the population who are at highest risk of disease and might benefit most from prevention. A population-wide prevention strategy is often easier to implement as high-risk individuals do not have to be identified and targeted and may be more successful because it does not require behaviour modification and can be maintained indefinitely if appropriate. If a risk factor is well-established as causing disease, is difficult to control or modify on an individual level, and a shift of its distribution in the population does not move some people who are . . . [Full Text of this Article]


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