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October 1981

Prevention in Clinical Practice: Problems and Challenges

Author Affiliations

Director, Health Services Research Veterans Administration Medical Center Durham, NC 27705; Department of Medicine School of Medicine University of North Carolina Chapel Hill, NC 27514; Department of Epidemiology School of Public Health University of North Carolina Chapel Hill, NC 27514

Arch Intern Med. 1981;141(11):1418. doi:10.1001/archinte.1981.00340120026007

Prevention is everywhere these days. Pe are running, trying to lose weight, and attending smoking cessation courses. The federal government has a new office with "health information" and "health promotion" in its title. Corporations are sponsoring health appraisals and fitness programs for their employees, and the medical profession, which has been "doing" prevention for years, has recently been offered several health promotion and disease prevention strategies.

In 1977, Breslow and Somers1 published a lifetime health monitoring program, a sequence of preventive activity from prenatal care to after retirement. The next year, the Institute of Medicine (IOM) convened an expert panel that recommended examination components for promoting health and screening for disease.2 In November 1979, the Canadian Task Force on the Periodic Health Examination reported an exhaustive study on the evidence for the effective use of preventive care at all ages.3 During the summer of 1980, the American

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