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Editorial
January 4, 2010

Broadening Understanding of the Long-term Effects of Risk- and Protection-Focused Prevention on the Public HealthLessons From Nurse-Family Partnerships

Arch Pediatr Adolesc Med. 2010;164(1):92-94. doi:10.1001/archpediatrics.2009.246

In the current debate over health care reform, the question of the cost vs benefit of investing in prevention has become a hot topic. In a recent letter to Congressman Nathan Deal, the Congressional Budget Office concluded that for preventive medical care, including services such as cancer screening and cholesterol management, expanded use will lead to higher, not lower, medical spending overall.1 This is largely because many individuals must be screened, at relatively high cost per individual, to identify those individuals with early symptoms of the diseases subsequently prevented through early intervention. However, this conclusion is based on a very narrow definition of what constitutes preventive services; it includes only what prevention scientists have called “indicated prevention.”2 Indicated prevention refers to preventive interventions provided to those with early symptoms of disease or disorder.

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