The Cost-Effectiveness of Environmental Approaches to Disease Prevention
Dave A. Chokshi,and Thomas A. Farley
From Brigham and Women’s Hospital and
— both in
N Engl J Med 2012; 367:295-297July 26, 2012
“…..How can society prevent the most disease and deaths per dollar spent? This question arose throughout the debate on
Although preventive approaches to disease are intuitively appealing — and frequently presented as a way to reduce costs — analyses have suggested that, as a whole, they're no more cost-effective than therapeutic interventions.1 But are some preventive approaches more cost-effective than others?
The National Commission on Prevention Priorities attempted to address this question, ranking clinical preventive services in terms of cost-effectiveness and “clinically preventable burden” of disease.2 Yet some preventive services, such as tobacco taxes or water fluoridation, are not delivered in health care settings. Understanding whether certain approaches are more cost-effective than others requires a framework for categorizing preventive interventions.
Medicine traditionally classifies preventive interventions on the basis of disease course: primary prevention aims to prevent new cases of disease; secondary prevention and tertiary prevention mitigate the effects of existing disease. We propose two overlapping dimensions to further characterize primary preventive interventions: environmental versus person-directed, indicating whether the proximate target is an element of the environment or an individual, and clinical versus nonclinical, indicating where an intervention takes place…..”
* * *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues. [DD/ KMC Area]
“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.