Chokshi DA, Gourevitch MN. Charting a Course for Community-Level Prevention. JAMA Forum Archive. Published online May 9, 2019. doi:10.1001/jamahealthforum.2019.0019
Achieving a threshold level of vaccination helps protect a population against an infectious disease. What could bring us closer to an analogous “herd immunity” for chronic diseases such as obesity and opioid use disorder? Prevention would have to be reimagined as something not delivered person by person, like vaccines, but instead through changes to health-related policies, the built environment, and our approach to healthful behaviors.
Community-level prevention complements clinical prevention but often adds the benefit of immediate population-level scale. For example, nationwide adoption of policies that raise the minimum legal age for the sale of tobacco products to age 21 years would reduce initiation of smoking among children and avert millions of years of life lost. Yet only 9 states have enacted this lifesaving policy.
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Dave A. Chokshi, MD, MSc Dave A. Chokshi, MD, MSc, is Chief Population Health Officer at New York City Health + Hospitals, clinical associate professor at NYU School of Medicine, and primary care physician at Bellevue Hospital. Previously, Dr Chokshi served as a White House...