Historical perspectives on prevention paradox: When the population moves as a whole

J Family Med Prim Care. 2018 Nov-Dec;7(6):1163-1165. doi: 10.4103/jfmpc.jfmpc_275_18.


Rose's Strategy of Preventive Medicine 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.

Keywords: Population; prevention; prevention paradox; public health.