Sick Populations

HIGH RISK AND POPULATION STRATEGIES FOR PREVENTIVE HEALTH WITHIN THE CONTEXT OF 21ST CENTURY AUSTRALIA.
INTRODUCTION
The concept of high risk and population strategies for preventative health was first introduced by Geoffrey Rose in his 1985 paper “Sick Individuals and Sick Populations” (Rose 2001). High risk strategy involves the identification of individuals who are more likely to get a disease and then providing treatment or preventative measures, while population strategies target population risk factors i.e. the primary cause of a disease affecting a population and either removing or preventing exposure (Rose 2001). Although Rose’s paper was written more than 30 years ago it is still relevant in the 21st century and was republished
focuses on treatment more than prevention from the risk factors
 Limited potential for population – interactions difficult to be replicated population-wise
 Behaviourally inappropriate – difficult to change behaviours and way of life of individuals than population (Rose
Cancer Australia (2016) reported that, bowel cancer is the second most diagnosed cancer in Australia and in 2015 there were 17,070 new cases of bowel cancer. The Australian Government initiated the National Bowel Cancer Screening Program (NBCSP) to help in the early detection and treatment of bowel cancer (Pignone et al. 2011). Although this strategy seems like a population strategy it targets risky individuals in the population; the NBCSP involves the home screening of colorectal cancer using immunochemical faecal occult blood test (iFOBT) of people aged 50, 55 and 65 years (Pignone et al.