Public Health Focus:
Effectiveness of Disease and Injury Prevention
Public health practice is based on scientifically sound
strategies for improving the quality of life and reducing morbidity
and premature mortality. To maximize the health benefits of
available resources, public health decision-makers require
information on the effectiveness, as well as the economic and
social impact, of disease and injury prevention strategies (1).
This report introduces a monthly series of articles to be published
in MMWR (weekly) that highlight prevention effectiveness.
The development of prevention technology begins with
researchers in the basic public health and biomedical sciences
identifying potentially effective technologies that can be used to
reduce unnecessary morbidity and premature mortality. Applied
research under carefully controlled conditions may then determine
whether such techniques are efficacious (e.g., the effect of
smoking cessation on lung cancer). As these techniques are applied
at the community level, their impact and cost can be assessed first
in demonstration settings and then in routine community settings,
and improvements in techniques can then be incorporated into
prevention strategies.
Important considerations in the assessment of disease and
injury prevention strategies (i.e., the scientific method for
evaluating the effectiveness of prevention strategies) include
identification of efficacious and effective strategies to reduce
morbidity and premature mortality and improve the quality of life;
characterization of the social, legal, and ethical impact of these
strategies; estimation of the economic impact of prevention
strategies; determination of optimal methods for implementing those
strategies; and evaluation of the health impact of prevention
programs.
Each report in the monthly series will highlight the knowledge base
regarding a specific prevention strategy and will address related
considerations, including efficacy, effectiveness, safety, and
economic factors. Topics have been selected based on their
inclusion in the national health objectives for the year 2000 (2),
CDC and other public health program efforts, and the availability
of data. In particular, the reports will present specific examples
of disease and injury prevention strategies and illustrate
approaches to evaluating the effectiveness of such strategies.
Reported by: Office of Program Planning and Evaluation, Office of
the Director; Office of the Director, Epidemiology Program Office,
CDC.
Editorial Note
Editorial Note: Public health officials and policy makers at all
levels require a scientific framework for assessing the
effectiveness of disease and injury prevention as a basis for
establishing priorities, selecting prevention strategies, and
allocating resources. The success of prevention activities can be
defined by whether they delay or avert morbidity and mortality.
However, the ability to evaluate objectively many prevention
techniques with randomized controlled trials is often limited by
fiscal, ethical, or other constraints. The MMWR Recommendations and
Reports issue, "A Framework for Assessing the Effectiveness of
Disease and Injury Prevention" (1), focuses on the challenges of
assessment that arise as a consequence of these constraints.
Reports in the MMWR (weekly) series will describe examples of how
prevention effectiveness can be assessed.
Because public health programs sometimes may begin to
implement preventive measures before appropriate assessments are
completed, gaps may exist in knowledge of the efficacy,
effectiveness, safety, or economic impact of specific prevention
strategies. The series of reports in MMWR (weekly) will
characterize many of these gaps and describe how they have been
addressed. In addition, the reports in this series are intended to
provide decision-makers with information about the potential
impact of these interventions on the health of their communities;
suggest approaches suitable for adaptation to public health
practice; and 3) encourage further examination of these topics and
stimulate additional systematic efforts by public health
professionals to assess and enhance the effectiveness of public
health programs.
References
CDC. A framework for assessing the effectiveness of disease and
injury prevention. MMWR 1992;41(no. RR-3).
Public Health Service. Healthy people 2000: national health
promotion and disease prevention objectives--full report, with
commentary. Washington, DC; US Department of Health and Human
Services, Public Health Service, 1991; DHHS publication no.
(PHS)91-50212.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
