Author Affiliations: The Robert Wood Johnson Foundation, Princeton, NJ (Dr McGinnis) and the Bill and Melinda Gates Foundation, Seattle, Wash (Dr Foege).
When Hippocrates observed that "protecting and developing health must
rank even above that of restoring it when it is impaired,"1
he set a standard that is difficult to meet. One of the most difficult challenges
is to ensure that the urgent does not crowd out the important. In health,
this challenge is especially difficult because urgent matters can be so riveting.
At the personal level, the presence of illness or injury often overpowers
all other concerns, and the search for effective treatment often dominates
all other pursuits. At the policy level, with 15% of the US gross domestic
product devoted to health care,2 medical care
expenditures often drive decisions in which cost cutting is aimed first at
discretionary investments, such as those in prevention and public health that
offer the greatest prospects for overall health improvement. Hence, tools
are needed to facilitate the gathering, analyzing, and reporting of data in
a fashion that enables taking action not merely on the urgent but on issues
most important to the health of a population.
McGinnis JM, Foege WH. The Immediate vs the Important. JAMA. 2004;291(10):1263-1264. doi:10.1001/jama.291.10.1263