Skip to main content
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1988 Oct;149(4):468–474.

Opportunities for health promotion and disease prevention in the clinical setting.

J M McGinnis, M A Hamburg
PMCID: PMC1026518  PMID: 3067449

Abstract

Advances in medicine offer unprecedented opportunities to improve health. New diagnostic, care, and treatment approaches are having a tremendous impact; yet, the leading causes of morbidity and mortality in the United States are intimately linked to preventable factors such as smoking, improper nutrition, alcohol misuse, lack of exercise, and maladaptive behaviors. Compelling evidence indicates that reducing risk factors yields substantial overall health benefits and saves lives. Prevention efforts can be applied effectively at many points in a disease process, and clinical medicine has a significant role. Nonetheless, a number of barriers may interfere. These include physician education and attitudes; patient education, expectations, and motivations; and aspects of the health care delivery system itself, such as access and reimbursement. The situation has been complicated by the apparent lack of consensus on the appropriate frequency and scope of such activities.

Full text

PDF
469

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blankenhorn D. H., Nessim S. A., Johnson R. L., Sanmarco M. E., Azen S. P., Cashin-Hemphill L. Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. JAMA. 1987 Jun 19;257(23):3233–3240. [PubMed] [Google Scholar]
  2. Breslow L., Somers A. R. The lifetime health-monitoring program. A practical approach to preventive medicine. N Engl J Med. 1977 Mar 17;296(11):601–608. doi: 10.1056/NEJM197703172961104. [DOI] [PubMed] [Google Scholar]
  3. Fauci A. S., Macher A. M., Longo D. L., Lane H. C., Rook A. H., Masur H., Gelmann E. P. NIH conference. Acquired immunodeficiency syndrome: epidemiologic, clinical, immunologic, and therapeutic considerations. Ann Intern Med. 1984 Jan;100(1):92–106. doi: 10.7326/0003-4819-100-1-92. [DOI] [PubMed] [Google Scholar]
  4. Fleming D. M., Lawrence M. S. An evaluation of recorded information about preventive measures in 38 practices. J R Coll Gen Pract. 1981 Oct;31(231):615–620. [PMC free article] [PubMed] [Google Scholar]
  5. Frame P. S., Carlson S. J. A critical review of periodic health screening using specific screening criteria. Part 4: selected miscellaneous diseases. J Fam Pract. 1975 Aug;2(4):283–289. [PubMed] [Google Scholar]
  6. Gemson D. H., Elinson J. Prevention in primary care: variability in physician practice patterns in New York City. Am J Prev Med. 1986 Jul-Aug;2(4):226–234. [PubMed] [Google Scholar]
  7. Grundy S. M. Cholesterol and coronary heart disease. A new era. JAMA. 1986 Nov 28;256(20):2849–2858. [PubMed] [Google Scholar]
  8. Havel R. J., Hunninghake D. B., Illingworth D. R., Lees R. S., Stein E. A., Tobert J. A., Bacon S. R., Bolognese J. A., Frost P. H., Lamkin G. E. Lovastatin (mevinolin) in the treatment of heterozygous familial hypercholesterolemia. A multicenter study. Ann Intern Med. 1987 Nov;107(5):609–615. doi: 10.7326/0003-4819-107-5-609. [DOI] [PubMed] [Google Scholar]
  9. Lurie N., Manning W. G., Peterson C., Goldberg G. A., Phelps C. A., Lillard L. Preventive care: do we practice what we preach? Am J Public Health. 1987 Jul;77(7):801–804. doi: 10.2105/ajph.77.7.801. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Martin A. R., Coates T. J. A clinician's guide to helping patients change behavior. West J Med. 1987 Jun;146(6):751–753. [PMC free article] [PubMed] [Google Scholar]
  11. Mason J. O., Koplan J. P., Layde P. M. The prevention and control of chronic diseases: reducing unnecessary deaths and disability--a conference report. Public Health Rep. 1987 Jan-Feb;102(1):17–20. [PMC free article] [PubMed] [Google Scholar]
  12. Mason J. O., Tolsma D. D. Personal health promotion. West J Med. 1984 Dec;141(6):772–776. [PMC free article] [PubMed] [Google Scholar]
  13. McGinnis J. M. Occupant protection as a priority in national efforts to promote health. Health Educ Q. 1984 Summer;11(2):127–131. doi: 10.1177/109019818401100203. [DOI] [PubMed] [Google Scholar]
  14. McGinnis J. M., Shopland D., Brown C. Tobacco and health: trends in smoking and smokeless tobacco consumption in the United States. Annu Rev Public Health. 1987;8:441–467. doi: 10.1146/annurev.pu.08.050187.002301. [DOI] [PubMed] [Google Scholar]
  15. McGinnis J. M. The 1985 Mary E. Switzer lecture: reaching the underserved. J Allied Health. 1986 Nov;15(4):293–304. [PubMed] [Google Scholar]
  16. McPhee S. J., Richard R. J., Solkowitz S. N. Performance of cancer screening in a university general internal medicine practice: comparison with the 1980 American Cancer Society Guidelines. J Gen Intern Med. 1986 Sep-Oct;1(5):275–281. doi: 10.1007/BF02596202. [DOI] [PubMed] [Google Scholar]
  17. McPhee S. J., Schroeder S. A. Promoting preventive care: changing reimbursement is not enough. Am J Public Health. 1987 Jul;77(7):780–781. doi: 10.2105/ajph.77.7.780. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Nutting P. A. Health promotion in primary medical care: problems and potential. Prev Med. 1986 Sep;15(5):537–548. doi: 10.1016/0091-7435(86)90029-0. [DOI] [PubMed] [Google Scholar]
  19. Oberman A. Exercise and the primary prevention of cardiovascular disease. Am J Cardiol. 1985 Apr 26;55(10):10D–20D. doi: 10.1016/0002-9149(85)91049-5. [DOI] [PubMed] [Google Scholar]
  20. Wechsler H., Levine S., Idelson R. K., Rohman M., Taylor J. O. The physician's role in health promotion--a survey of primary-care practitioners. N Engl J Med. 1983 Jan 13;308(2):97–100. doi: 10.1056/NEJM198301133080211. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES