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Prevention Paradox: Why We are Failing to Prevent Disease

There are two types of strategies to curb diabetes and other diseases; the clinical strategy and the population strategy. Our medical system -- which treats individual patients and consumes over 95% of our health dollars -- is a clinical strategy. One BIG problem with investing so much of our health dollars in the clinical strategy is that the majority of death, disease, or disability occurs among people who are at low or moderate risk. This concept is called the “prevention paradox”. People who are very obese have a higher risk of developing diabetes than those who aren’t. Only 4% of Canadians are very obese, but over 10 years about 1 in 3 of them will develop diabetes. Twelve percent of new cases of diabetes will arise from this group. But if we only focus on people who are very obese, we will fail to prevent 88% of new cases of diabetes. What if we focus on Canadians who are obese AND very obese? About 17% of Canadians fall into this category. We would still only prevent about 38% of new cases of diabetes. That’s the paradox; unless we focus on people who are at low or moderate risk, we will fail to reach the majority of people who ultimately develop a disease, like obesity, diabetes or cancer. The keys to prevent diabetes and other chronic diseases is to design our communities to make it harder to become obese or sick: we need to make it easier to walk and cycle and make public transportation more widely available; we need to increase the availability of healthy foods and; we need to restrict marketing to children. The Canadian study on obesity and diabetes illustrated in this video was based on the Institute for Clinical Evaluative Sciences (ICES) report which can be found here: http://www.ices.on.ca/Publications/At...