domingo, 27 de julio de 2014

JAMA Network | JAMA | New Opportunities in the Changing Landscape of Prevention

JAMA Network | JAMA | New Opportunities in the Changing Landscape of

New Opportunities in the Changing Landscape of Prevention FREE ONLINE FIRST

Derek Yach, MBChB, MPH1; Chris Calitz, MPP2
JAMA. Published online July 17, 2014. doi:10.1001/jama.2014.8900
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The focus of medical research has historically been on curative medicine, yielding better drugs, medical devices, and clinical procedures. Prevention science—the systematic application of scientific methods to the causes and prevention of diseases in populations—has yet to receive the necessary investment and support required to reduce the growing burden of largely preventable noncommunicable diseases (NCDs).1


Recent assessments of the burden of risk and disease found that morbidity and chronic disability account for nearly half of the US health burden.2 Despite the largest per capita health expenditure of all industrialized nations, the United States has fallen behind peer countries in terms of improvements in population health.3 Americans reach age 50 with a less favorable cardiovascular risk profile, lung disease is more prevalent and associated with higher mortality, and the death rate from heart disease is the second highest among peer countries. Leading NCD risk factors are unhealthy diets, tobacco smoking, high body mass index, high blood pressure, high fasting plasma glucose levels, physical inactivity, and alcohol use.2 Many of these risks are amenable to preventive interventions based on behavior change, yet comprehensive action by development sectors across the economy to disseminate evidence-based interventions targeting these modifiable risks is inadequate.4 Furthermore, knowledge about effective prevention interventions for mental illness and musculoskeletal diseases is limited even as their contribution to chronic disability increases.2

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