Rose's Strategy of Preventive Medicine. Geoffrey Rose with commentary by Kay-Tee Khaw and Michael Marmot.

Since its publication in 1992, Geoffrey Rose's The Strategy of Preventive Medicine has been required reading for those interested in population health, social epidemiology, or preventive medicine. Given the explosion of research on the social determinants of health that has taken place in the ensuing years, interested readers are likely to welcome a new edition of this classic text. The fact that Rose died shortly after its original publication, however, may also make readers curious as to what exactly is new in this new edition. The honest answer is nothing, if one's interest is in new material from Rose. There is, however, a new addition to the text in the form of a lengthy commentary by Kay-Tee Khaw and Michael Marmot, both of whom studied under Rose, which attempts to broaden considerably the scope of Rose's ideas. Khaw and Marmot begin by briefly recapping the main tenets of Rose's book. One of the major themes he explored was the distribution of health risks in populations, which gave rise to the notion that when risk is widely diffused a large share of the population burden of disease may come from many individuals exposed to low or moderate risks, i.e. those at levels below the threshold typically considered \u91high risk\u92. Rose mainly took his examples from univariate distributions of cardiovascular risk factors, such as blood pressure and cholesterol, noting that many, if not most, incident cases of coronary heart disease (CHD) came from those with risk factor levels below what was typically considered high risk. The implication for prevention was that traditional clinical approaches targeting those with high levels of risk factors would do little to affect population levels of disease because this missed the major source of future cases. Population strategies aimed at shifting entire distributions of risk were therefore necessary. ..