McDermott, Robyn (2009) Why primary prevention is (mostly) a better bet than clinical prevention. Public Health Bulletin South Australia, 6 (1). pp. 14-15.

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Abstract

[Extract] Gains in life expectancy in Australia and other OECD countries since 1980 are mainly due to falls in cardiovascular disease (CVD) mortality, principally stroke and coronary heart disease (CHD). CHD mortality in Australia declined dramatically from a peak in 1970, when male deaths reached almost 580 per 100 000, to below 200 per 100 000 in 2002,1 reflecting a similar trend in the US and Europe. The decline from 1980 has been analysed for US data and found to be as follows: about half (47%) is due to medical rescue (thrombolysis, angioplasty, stents, coronary artery bypass graft etc) and the other half (44%) is due to changes in risk factors, including cholesterol reduction (24%), blood pressure control (20%), smoking reduction (12%) and physical activity (5%). These reductions have been partially offset by increasing obesity and diabetes, which increased CHD deaths by 8% and 10% respectively.2 So, while life expectancy has hit a new high as deaths from CVD and cancer decline, more people are living with chronic diseases from mid-life, and have increased our reliance on using medications to manage them. The greatest growth is occurring in the number of people afflicted by multiple chronic diseases, where drug management can be expensive, complex and sometimes hazardous.3 In Australia in 2004–05, CVD was the most expensive group of diseases, consuming 11% of total allocated funds—half on hospital inpatient treatment, 28% on drugs, 19% on out-of hospital care and 3% on research.1 In the US three-quarters of the two trillion dollar health bill in 2006 was directed at treating chronic disorders, and two-thirds of the growth was attributable to worsening health habits, mainly epidemic obesity.

Item ID:	36812
Item Type:	Article (Commentary)
ISSN:	1449-485X
Date Deposited:	06 Feb 2017 00:54
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified @ 100%
SEO Codes:	92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920599 Specific Population Health (excl. Indigenous Health) not elsewhere classified @ 100%
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