Preventive Medicine and Health System Reform

Abstract

PREVENTING disease, disability, and death has always made intuitive sense, long before the current debate on health system reform suddenly thrust disease prevention, health promotion, and public health onto the political center stage. Demands to control medical costs, improve the value, quality, and outcomes of health care, achieve universal access, promote generalism over specialization, and improve the responsiveness of academic health centers to their local communities¹have placed prevention and primary care in a new light. Increasingly, preventive medicine, public health, and primary care are recognized as fundamental components of a reformed health system. Concerns over environmental and occupational health hazards, the resurgence of infectious diseases, and the primacy of chronic diseases and injuries as the leading causes of mortality and morbidity focus attention on the need for researchers, educators, and practitioners trained in preventive medicine, public health, and other population-based fields. The inadequacy of undergraduate medical education and