The Strategy of Preventive Medicine, by Geoffrey Rose, first published in 1993 remains a key text for anyone involved in preventive medicine. Rose's insights into the inextricable relationship between ill health, or deviance, in individuals and populations they come from, have transformed our whole approach to strategies for improving health. His personal and unique book, based on many years research, sets out the case that the essential determinants of the health of society are to be found in its mass characteristics. The deviant minority can only be understood when seen in its societal context, and effective prevention requires changes which involve the population as a whole. He explores the options for prevention, considering them from various viewpoints - theoretical and scientific, sociological and poitical, practical and ethical. The applications of his ideas are illustrated by a variety of examples ranging from heart disease to alcoholism to road accidents. His pioneering work focused on a population wide approach to the prevention of common medical and behavioural disorders has become the classic text on the subject.
This reissue brings the original text to a new generation involved in preventive medicine. Kay-Tee Khaw and Michael Marmot retain the original text intact, but have added their own perspective on the work. They examine what relevance Rose's ideas might have in the era of the human genome project and other major scientific advances, they consider examples of how the theory might be applied and generalised in medicine and beyond, and discuss what implications it holds for the future. There is also an explanation of the population perspective, clarifying the often confused thinking and arguments about determinants of individual cases and determinants of population incidence. Rose's Strategy of Preventive Medicine will ensure that this seminal work continues to be read by future generations.
Professor Kay-Tee Khaw trained in medicine at Girton College, Cambridge and then at St. Mary's Hospital London where she had the transforming experience of being taught clinical medicine and epidemiology by Geoffrey Rose. She was one of the students on the first year of the Masters in Epidemiology course that Geoffrey Rose started in the London School of Hygiene and Tropical Medicine and his ideas have continued to inspire her through many international clinical and academic posts. She is a principal investigator in EPIC, a prospective population study on diet, cancer, and chronic disease, which involves 500,000 participants from ten European Countries which aims to identify nutritional, hormonal and other factors which determine good health. She also co-ordinates an annual World Heart Federation/World Health Organisation International Teaching Seminar, originated by Geoffrey Rose.
Commentary ; 1. The objectives of preventive medicine ; 2. What needs to be prevented? ; 3. The relation of risk to exposure ; 4. Prevention for individuals and the 'high-risk' strategy ; 5. Individuals and populations ; 6. Some implications of population change ; 7. The population strategy of prevention ; 8. In search of health