Raza Syed Ahsan, Salemi Jason Lee, Zoorob Roger Jamil
Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.
J Family Med Prim Care. 2018 Nov-Dec;7(6):1163-1165. doi: 10.4103/jfmpc.jfmpc_275_18.
Rose's is critical reading for students and teachers in public health as well as practitioners of family and preventive medicine. In his classic, Geoffrey Rose outlines the prevention paradox that led to a discussion of two main preventive approaches to a disease, the individual- and population-based. This commentary briefly provides historical perspectives and viewpoints on the message of fundamental importance that when the population moves as a whole, the relative differences are the characteristics not of individuals but of populations. The "population as a whole" has been adopted in the lexicon of public health, enriched by Hippocrates' treatise on air, water, and places; Durkheim's collective consciousness; Pickering's continuous unimodal distribution; and Keys' charts of contrasting distributions. These readings should provide the public health professionals with a critical understanding of prevention paradox when they tend to focus only on the expression of the root cause above ground but fail to at the roots beneath the ground.
罗斯的著作对于公共卫生专业的学生和教师以及家庭医学和预防医学从业者来说都是批判性阅读材料。在他的经典著作中,杰弗里·罗斯概述了预防悖论,引发了对一种疾病的两种主要预防方法的讨论,即基于个体和基于人群的方法。这篇评论简要提供了关于一个至关重要信息的历史视角和观点,即当整个人口群体发生变化时,相对差异是人群而非个体的特征。“整个人口群体”已被纳入公共卫生词汇中,希波克拉底关于空气、水和地方的论述、涂尔干的集体意识、皮克林的连续单峰分布以及凯斯的对比分布图表丰富了这一概念。这些读物应能让公共卫生专业人员在倾向于只关注地面上根本原因的表现而未能深入探究地面下的根源时,对预防悖论有批判性的理解。