Rose's Strategy of Preventive Medicine

Abstract The Strategy of Preventive Medicine, by Geoffrey Rose, first published in 1993 remains a key text for anyone involved in preventive medicine. Rose's insights into the inextricable relationship between ill health, or deviance, in individuals and populations they come from, have transformed our whole approach to strategies for improving health. His personal and unique book, based on many years of research, sets out the case that the essential determinants of the health of society are to be found in its mass characteristics. The deviant minority can only be understood when seen in its societal context, and effective prevention requires changes which involve the population as a whole. Rose's book explores the options for prevention, considering them from various viewpoints — theoretical and scientific, sociological and political, practical, and ethical. The applications of Rose's book's ideas are illustrated by a variety of examples ranging from heart disease to alcoholism to road accidents. The book's pioneering work focused on a population wide approach to the prevention of common medical and behavioural disorders has become the classic text on the subject. This reissue of that text brings the original book to a new generation. This book retains the original text intact, but it includes new perspectives on the work. It examines what relevance Rose's ideas might have in the era of the human genome project and other major scientific advances, it considers examples of how the theory might be applied and generalized in medicine and beyond, and discusses what implications it holds for the future. There is also an explanation of the population perspective, clarifying the often confused thinking and arguments about determinants of individual cases and determinants of population incidence.