252645 Is an Ounce of Prevention Actually Worth an Ounce of Cure? Accounting for the Decline in Coronary Heart Disease Mortality, 1974-2010

Tuesday, November 1, 2011: 12:30 PM

Jeremy A. Greene, MD, PhD , Harvard University, Cambridge, MA
David Jones, MD, PhD , Harvard Medical School, Boston, MA
The dramatic decline in coronary heart disease mortality since the 1960s has fueled a decades-long effort to understand the mix of factors that contributed to the decline. Even as the “Decline Debate” increased in sophisticated, from arguments based on gestalt assessments of the data to analyses based on sophisticated computer models, the consensus has remained stable: half credit each to medical treatments and risk factor reductions. This talk explore how and why such a stable consensus has been preserved over nearly forty years of methodological innovation and debate.

Learning Areas:
Social and behavioral sciences

Learning Objectives:
Demonstrate how doctors and health researchers have attempted to attribute the decline in cardiovascular mortality since the 1970s to various medical and public health interventions, and appreciate the limits of the methods used to make these arguments. Explore the changing meanings of ‘treatment’ and ‘prevention’ of chronic disease over a 40 year period, as played out in the structure and interpretation of cardiovascular epidemiology. Compare how the advent of modeling has transformed cardiovascular epidemiology, making it decreasingly accessible to non-specialists even as the field has sought increasing influence over public policy.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an experienced historian of medicine and public health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.