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Volume 1: No. 1, January 2004
FROM THE EDITOR IN CHIEF
Welcome to Preventing
Chronic Disease
Lynne S. Wilcox, MD, MPH
Suggested citation for this article: Wilcox LS. Welcome to
Preventing Chronic Disease. Prev Chronic Dis [serial online] 2004
Jan [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2004/
jan/03_0023.htm
My father was born in rural southern Georgia in 1924. His baby sister,
the 12th child, arrived 2 years later. Ten days after her birth, my
grandfather — the family patriarch — and my father's 5-year-old sister died
of influenza.
Those were the last deaths from infectious disease in my family. My
grandmother and her children ran the farm throughout the Great Depression,
the sons went off to World War II and returned, the daughters received
teaching scholarships and sent money home for the next sibling's education,
several offspring married and started new families. The eventual deaths of
my grandmother and all her children were due to chronic diseases. One
daughter, age 94, survives today.
Many families can tell similar stories. The centuries-old scourge of
infectious disease remains so close in generational experience that many
people my age never had 4 living grandparents. And certainly, as old
infections fade, new ones take their place. Nevertheless, for the
foreseeable future, most of us will live long enough to develop a chronic
disease.
Over the last 50 years, diseases of the heart, lungs, pancreas, and blood
vessels, as well as tumors of all sorts, have pushed public health in new
directions. These diseases require new and different interventions. We have
fulfilled the prophesy of Charles-Edward Winslow, a prominent voice in public health
during the early 20th century: "[P]ublic health which in its
earliest days was an engineering science and has now become also a medical
science must expand until it is, in addition, a social science" (1).
Today, public health practitioners and researchers use more than
epidemiology, biostatistics, and program management to fulfill their
objectives. Their education includes social networks, stages of behavior
change, street grids, advocacy politics, cultural differences, and multiple
other topics. Few magic bullets for chronic disease equal the impact of
early antibiotics on infectious disease; hence, the constant search for
better ways to reduce chronic disease risk.
These challenges point to the mission of this journal. Preventing
Chronic Disease: Public Health Research, Practice, and Policy will
emphasize a comprehensive view of the challenges in preventing chronic
disease — by promoting dialogue, encouraging interdisciplinary and multisectorial approaches, and exploring new theories and concepts.
Our primary audience includes researchers in chronic disease prevention
and intervention and health practitioners responsible for chronic
conditions and population health. In addition, many other professionals,
students, and advocates will have an interest in these topics, and we
welcome them as readers and contributors.
Population-based disease prevention appears in many forms and at many
levels. We will be interested in all aspects of health promotion — from
community-based screening programs to statewide laws and regulations. We
will look for formal research and lived experience and encourage rigorous
examination of both.
This journal will seek to promote dialogue between researchers and
practitioners by publishing original research and community case studies:
both will be peer-reviewed by scientists and practitioners. Eisenberg noted
that scientific evidence is an important part, but not the only aspect, of
effective decision-making (2). Local culture and circumstances also shape
the decision-making process, and local decision makers determine how
evidence translates into practice. While evidence-based interventions may
not generate sufficient political support in the community, popular
community programs may not effectively prevent disease. Critical discoveries
will occur only when researchers and practitioners work in concert with each
other and the community.
We will encourage interdisciplinary and multisectorial approaches
by calling for reports that examine more than one dimension of public health
intervention. For progress to occur in health promotion, we need to
understand the interpretation of cost effectiveness; the complexity of
interventions, including health care access; the dynamics of interest groups
and resources; and the overall policy arena, including factors within and
across multiple domains (3,4). Many of today's threats to good health and
quality of life arise from the interplay of multiple risk factors and
require comprehensive interventions.
We will explore new theories and concepts of research and practice
in editorials and commentaries as well as in original articles. For example,
how does fetal stress, infectious disease, or genomic structure cause
chronic conditions, and how can we develop prevention strategies around
them? And then, how do we assess these novel strategies in field settings
before we accept them as standard public health practice? We are eager to
explore new territory in preventing disease and improving health.
This time in history offers unique challenges. The aging population of
the United States positions chronic diseases among our most consuming health
issues. The epidemic of obesity among younger citizens suggests that
increases in chronic disease rates will not end with the baby boomer
generation. Both health care costs and the numbers of uninsured Americans
continue to rise. Finally, our sense of community has changed — we may
define community by workplace, sports field, or even an internet list serve,
rather than geography.
All these changes increase the complexity of developing population-based
approaches to health. But reducing the impact of chronic diseases can
prevent premature deaths and enhance the quality of life well into the elder
years. We look forward to partnering with you in addressing the challenges
of preventing and controlling chronic disease.
References
- Winslow C-EA. The evolution and significance of the modern public
health campaign. New Haven (CT): Yale University Press; 1984: p. x. (Book
is reprint of 1923 publication; Winslow is quoted by Milton Terris in
the introduction to the reprint.)
- Eisenberg MJ.
Globalize the evidence, localize the decision:
evidence-based medicine and international diversity. Health Aff
2002;21:166-8.
- McGinnis JM, Williams-Russo P, Knickman JR.
The case for more active
policy attention to health promotion. Health Aff 2002;21:78-93.
- Adler NE, Newman K.
Socioeconomic disparities in health: pathways and
policies. Health Aff 2002;21:60-76.
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