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Prevention and Control Strategies for Non-Communicable Disease: Goldberger, Pellagra and Rose Revisited
This paper argues that the public health conceptual framework of epidemiologist Geoffrey Rose, first published as “Sick Individuals and Sick Populations” in 1985, provides a useful way to critically analyze prevention and control options for modern non-communicable diseases (NCD) and their forerunne...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9620930/ https://www.ncbi.nlm.nih.gov/pubmed/36417251 http://dx.doi.org/10.3390/epidemiologia3020015 |
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author | Frank, John W. |
author_facet | Frank, John W. |
author_sort | Frank, John W. |
collection | PubMed |
description | This paper argues that the public health conceptual framework of epidemiologist Geoffrey Rose, first published as “Sick Individuals and Sick Populations” in 1985, provides a useful way to critically analyze prevention and control options for modern non-communicable diseases (NCD) and their forerunner, obesity, a pandemic now engulfing Lower-and-Middle-Income-Countries. That framework is based on the notions of primordial, primary, secondary and tertiary prevention—the full spectrum of “more upstream and more downstream” approaches, each with its pros and cons. These are illustrated using the pellagra epidemic in the southeastern USA from 1900 to the 1940s, which still has much to teach us about these same basic policy options for controlling the modern NCD pandemic. In particular, Rose’s dictum, “Seek the causes of (population) incidence, not of (individual) cases”, points up the compelling advantages of upstream prevention for controlling both epidemics. |
format | Online Article Text |
id | pubmed-9620930 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96209302022-11-18 Prevention and Control Strategies for Non-Communicable Disease: Goldberger, Pellagra and Rose Revisited Frank, John W. Epidemiologia (Basel) Review This paper argues that the public health conceptual framework of epidemiologist Geoffrey Rose, first published as “Sick Individuals and Sick Populations” in 1985, provides a useful way to critically analyze prevention and control options for modern non-communicable diseases (NCD) and their forerunner, obesity, a pandemic now engulfing Lower-and-Middle-Income-Countries. That framework is based on the notions of primordial, primary, secondary and tertiary prevention—the full spectrum of “more upstream and more downstream” approaches, each with its pros and cons. These are illustrated using the pellagra epidemic in the southeastern USA from 1900 to the 1940s, which still has much to teach us about these same basic policy options for controlling the modern NCD pandemic. In particular, Rose’s dictum, “Seek the causes of (population) incidence, not of (individual) cases”, points up the compelling advantages of upstream prevention for controlling both epidemics. MDPI 2022-04-06 /pmc/articles/PMC9620930/ /pubmed/36417251 http://dx.doi.org/10.3390/epidemiologia3020015 Text en © 2022 by the author. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Frank, John W. Prevention and Control Strategies for Non-Communicable Disease: Goldberger, Pellagra and Rose Revisited |
title | Prevention and Control Strategies for Non-Communicable Disease: Goldberger, Pellagra and Rose Revisited |
title_full | Prevention and Control Strategies for Non-Communicable Disease: Goldberger, Pellagra and Rose Revisited |
title_fullStr | Prevention and Control Strategies for Non-Communicable Disease: Goldberger, Pellagra and Rose Revisited |
title_full_unstemmed | Prevention and Control Strategies for Non-Communicable Disease: Goldberger, Pellagra and Rose Revisited |
title_short | Prevention and Control Strategies for Non-Communicable Disease: Goldberger, Pellagra and Rose Revisited |
title_sort | prevention and control strategies for non-communicable disease: goldberger, pellagra and rose revisited |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9620930/ https://www.ncbi.nlm.nih.gov/pubmed/36417251 http://dx.doi.org/10.3390/epidemiologia3020015 |
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