Gary Hirsch is an independent consultant based in Wayland, MA. Jack Homer is with Homer Consulting, Voorhees, NJ. At the time of the study, Justin Trogdon was with RTI International, Research Triangle Park, NC. Kristina Wile is with Systems Thinking Collaborative, Stow, MA. Diane Orenstein is with the Centers for Disease Control and Prevention (CDC), Atlanta, GA.
Am J Public Health. 2014 Jul;104(7):1187-95. doi: 10.2105/AJPH.2013.301816. Epub 2014 May 15.
The Prevention Impacts Simulation Model (PRISM) projects the multiyear impacts of 22 different interventions aimed at reducing risk of cardiovascular disease. We grouped these into 4 categories: clinical, behavioral support, health promotion and access, and taxes and regulation. We simulated impacts for the United States overall and also for a less-advantaged county with a higher death rate. Of the 4 categories of intervention, taxes and regulation reduce costs the most in the short term (through 2020) and long term (through 2040) and reduce deaths the most in the long term; they are second to clinical interventions in reducing deaths in the short term. All 4 categories combined were required to bring costs and deaths in the less-advantaged county down to the national level.
预防影响模拟模型（PRISM）预测了 22 种不同干预措施的多年影响，这些措施旨在降低心血管疾病的风险。我们将这些干预措施分为四类：临床、行为支持、健康促进和获得途径以及税收和监管。我们对美国整体和死亡率较高的欠发达县进行了模拟。在这 4 类干预措施中，税收和监管在短期内（截至 2020 年）和长期内（截至 2040 年）降低成本的效果最为显著，长期内降低死亡人数的效果也最为显著；在短期内降低死亡人数方面，仅次于临床干预措施。所有四类干预措施结合使用，才能使欠发达县的成本和死亡人数降至全国水平。
