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Sick individuals and sick populations

Geoffrey Rose
- 01 Mar 1985 - 
- Vol. 30, Iss: 3, pp 427-432
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TLDR
Aetiology confronts two distinct issues: the determinant of individual cases, and the determinants of incidence rate: if exposure to a necessary agent is homogeneous within a population, then case/control and cohort methods will fail to detect it.
Abstract
Aetiology confronts two distinct issues: the determinants of individual cases, and the determinants of incidence rate. If exposure to a necessary agent is homogeneous within a population, then case/control and cohort methods will fail to detect it: they will only identify markers of susceptibility. The corresponding strategies in control are the 'high-risk' approach, which seeks to protect susceptible individuals, and the population approach, which seeks to control the causes of incidence. The two approaches are not usually in competition, but the prior concern should always be to discover and control the causes of incidence.

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Multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) within an intersectional framework.

TL;DR: By applying MAIHD within an intersectional framework, the EWOS study provides a superior theoretical and quantitative instrument for documenting health disparities and it should become the new gold standard for investigating health disparities in (social) epidemiology.
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Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care

TL;DR: This study provides new evidence of a universal, enduring preventive effect for depression in women who screen negative for depression postnatally.
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Prevalence of cardiovascular risk factors in a middle-income country and estimated cost of a treatment strategy

TL;DR: High prevalence of major risk factors was found in a rapidly developing country and costs for treatment needed to reduce risk factors in all high-risk individuals exceeded resources generally available in low or middle income countries.
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Neglectful behavior by parents in the life history of university students in 17 countries and its relation to violence against dating partners.

TL;DR: Multilevel modeling found that the more neglectful behavior experienced as a child the greater the probability of assaulting and injuring a dating partner and that the link between experiencing neglect and perpetrating violence is stronger at universities in which dating violence is more prevalent.
References
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Journal ArticleDOI

Strategy of prevention: lessons from cardiovascular disease.

Geoffrey Rose
- 06 Jun 1981 - 
TL;DR: In this article, two types of preventive measures are proposed; the first consists in the removal of an unnatural factor and the restoration of biological normality as the reduction of intake of saturated fats would be in the case of heart disease; the second does not consist of removing a supposed cause of disease but in adding some other factors in the hope of conferring protection as a high intake of polyunsaturated fat and of long-term medication would be for heart disease.
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A Co-operative trial in the primary prevention of ischaemic heart disease using clofibrate: Report1 from the Committee of Principal Investigators

TL;DR: A double-blind intervention trial to test the hypothesis that the incidence of ischaemic heart disease in middle-aged men can be reduced by lowering raised serum cholesterol levels found men with a substantial reduction of cholesterol concentration, who smoked, and also had above average blood pressure levels showed the most benefit.
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Cardiorespiratory disease and diabetes among middle-aged male Civil Servants. A study of screening and intervention.

TL;DR: In this paper, a screening survey for cardiorespiratory disease and diabetes among 18,403 male Civil Servants aged 40-64 years, representing a 77% response of those eligible.
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How well can we predict coronary heart disease? Findings in the United Kingdom Heart Disease Prevention Project.

TL;DR: Although a group of subjects at high risk can be identified, among whom will be a high proportion of potential victims of heart attack, many subjects will be wrongly classified and highlight the need for research to improve the prediction of the development of coronary heart disease.
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British Regional Heart Study: geographic variations in cardiovascular mortality, and the role of water quality.

TL;DR: A negative relation existed between water hardness and cardiovascular mortality, although climate and socioeconomic conditions also appeared to be important influences.
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