G.J. Melendez-Torres

About G.J. Melendez-Torres

G.J. Melendez-Torres is currently completing his MPhil in Evidence-Based Social Intervention in the Department of Social Policy and Intervention at the University of Oxford. A registered nurse, he holds degrees in nursing and health economics from the University of Pennsylvania. His interests include research synthesis methods and programme evaluation, HIV prevention in substance users, and geriatric mental health.

The Rose Hypothesis: Hello, Demography. Time to Make Friends.

One of the critical texts of modern public health, The Strategy of Preventive Medicine (Rose, 1992) outlines British epidemiologist and physician Geoffrey Rose’s insights on how prevention programmes should work to improve the health of populations. Rose postulated that risk for a specific condition (for example, as Rose points out, hypertension) follows a single distribution for each population. While most people at the ‘upper end’ of this risk distribution might eventually experience hypertension, most cases would occur in the people in the rest of the distribution with low to medium-high levels of risk. Following on, Rose suggests that the best way to address large-scale public health problems is to shift the entire risk distribution, rather than target only those people at highest risk. This points to an intervention approach that is not individual, but structural—that manipulates the environment and context.

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