ArticleCanadian journal of public health = Revue canadienne de sante publique2019
In defense of a population-level approach to prevention: why public health matters today.
Article in Canadian journal of public health = Revue canadienne de sante publique, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Universal Digital Programs for Promoting Mental and Relational Health for Parents of Young Children: A Systematic Review and Meta-Analysis.Clinical child and family psychology review · 2024Pooled it
- Parent-focused online video intervention for promoting parenting sense of competence: a randomized controlled trial.Pediatric research · 2025Trial
- Which population-level interventions promote physical activity equitably across socioeconomic groups? A rapid systematic review.BMJ public health · 2026Article
- Decision tree for improving the impact of equity-focused public health service delivery and research.Frontiers in health services · 2026Article
- Universal ultrasound screening and early treatment of developmental dysplasia of the hip: a critical review.Journal of medicine and life · 2024Review
- Article
- Machine-learning-based high-benefit approach versus conventional high-risk approach in blood pressure management.International journal of epidemiology · 2023Article
- Public Perspectives on Lifestyle-Related Behavior Change for Dementia Risk Reduction: An Exploratory Qualitative Study in The Netherlands.Journal of Alzheimer's disease : JAD · 2023Article
- Program adaptation by health departments.Frontiers in public health · 2022Article
- Nutrition Therapy Cost-Effectiveness Model Indicating How Nutrition May Contribute to the Efficiency and Financial Sustainability of the Health Systems.JPEN. Journal of parenteral and enteral nutrition · 2021Article
- The cumulation of ill health and low agency in socially excluded city dwellers in the Netherlands: how to better identify high-risk/high-need population segments with public health survey data.International journal for equity in health · 2021Article
- [Theoretical and practical challenges of proportionate universalism: a reviewAnálise dos desafios teóricos e práticos de universalismo proporcional].Revista panamericana de salud publica = Pan American journal of public health · 2021Article
- Unpacking vulnerability: towards language that advances understanding and resolution of social inequities in public health.Canadian journal of public health = Revue canadienne de sante publique · 2020Article
- Theoretical and practical challenges of proportionate universalism: a review.Revista panamericana de salud publica = Pan American journal of public health · 2020Review
- Public health matters-but we need to make the case.Canadian journal of public health = Revue canadienne de sante publique · 2019Article
Corrections and comments
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Authors and funding
1 author.
Funding
Abstract
A focus on populations, and a corresponding population-level approach to intervention, is a foundation of public health and is one reason why public health matters today. Yet, there are indications that this foundation is being challenged. In some policy and practice domains, and alongside growing concern about the social determinants of health and health equity, there has been a shift from a population-level or universal approach to intervention, to a targeted approach focusing on those experiencing social or economic vulnerability. More than 30 years ago, Geoffrey Rose articulated strengths and limitations of population-level and high-risk approaches to prevention. In light of a strong analogy between "high risk" and "targeted" approaches, it seems timely, in a forum on why public health matters today, to revisit Rose's points. Focusing on points of overlap between strengths and limitations of the two approaches as described in public health (population-level; high-risk) and social policy (universal; targeted), I illustrate strengths of a population-level approach from the point of view of health equity. Although different circumstances call for different intervention approaches, recent discourse about the weakening of public health suggests that there is value in discussing foundations of the field, such as the population-level approach, that we as a community may wish to defend.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.