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Topic 2: Sick individuals and Sick populations
Transcript of Topic 2: Sick individuals and Sick populations
Image by Tom Mooring
Range of responses
Sick individuals and Sick populations
Geoffrey Rose's paper
Individual preventive strategy
- identify high-risk susceptible individuals and offer individual protection
Why do some populations have much hypertension, whilst in some others it is rare?
Why is hypertension absent in Kenyans and common in London?
the causes of cases
the causes of incidence
- control the determinants of incidence
difficulties and cost of screening
palliative/temporary, not radical
limited potential for individuals and populations
weak ability to predict future disease
‘benefit-risk ratio’ favourable
large potential for population
small benefit to individual
poor motivation of subject and physicians
benefit:risk ratio worrisome
a large number of people at low risk gives rise to more cases than a small number of people at high risk
critical thinking revolution/epidemiological wars
Seminal article has been cited over 2000 times
What makes people healthy?
Health of Nation, UK, 1992-1997
WHO Healthier Cities
Health Promotion schools, prisons, universities
Health in all policies, Finland
two prevention strategies
high-risk individual approach
High Risk Approach
Prevention and management of obesity and diabetes
Ottawa Charter for Health Promotion Action Areas
Strengthening community action
Healthy public policy
Reorienting health services
Creating supportive environments
Developing personal skills
Makenbach et al., 2010
Adams & White, 2012
Cooney et al., 2009
Combination of both
Burton et al., 2012