Prospects for improving health through reducing risk factors

Intervention against both bodily risk factors such as hypertension, high serum cholesterol, cervical dysplasia, and trisomy 21; and behavioral risk factors such as cigarette smoking, too little exercise, and excessive alcohol consumption, offers improving prospects for reducing major current causes of death. The MRFIT program and other trials of intervention in North Karelia, Finland, and in northern California, are aimed at delineating how effective this strategy may be. Already it is clear that the risk factor intervention strategy may incorporate one or both of two tactics: the “medical model,” i.e., selecting individuals for intervention efforts on the basis of medical examinations; or the “community model,” i.e., directing efforts for risk factor reduction at a total community. This new approach to prevention represents a shift away from the clinical entities as the focus of medicine toward the identification and reduction of the factors that lead to clinical disease. The aim is not just to avoid clinical disease but to maintain health in the sense of physiologic function, anatomic regularity, chemical balance, genetic integrity, immunologic status, and healthful behavior.