Abstract
No one can question the remarkable contribution of US public health to understanding the causes and consequences of illness, disability, and death. However, some commentators question the agenda: the endless pursuit of individual risk factors and the cursory attention to social determinants of disease. We attempt to illustrate some limitations of US public health by focusing on type-2 diabetes (adult-onset non-insulin-dependent diabetes)--an increasingly prevalent but still poorly understood medical condition with devastating complications and implications for quality of life. A more theoretically based multilevel approach to diabetes, outlined for the 21st century, has an almost exclusive downstream curative focus, that ranges from midstream preventive programmes to upstream healthy public policy.
Keywords
MidstreamPublic healthUpstream (networking)DiseaseMedicineDiabetes mellitusDownstream (manufacturing)Social determinants of healthQuality of life (healthcare)GerontologyPolitical scienceDevelopment economicsIntensive care medicineBusinessEconomicsPathologyNursing
MeSH Terms
Blood GlucoseDiabetes MellitusType 2HumansPublic HealthQuality of LifeRisk FactorsUnited States
Affiliated Institutions
Related Publications
Globalization, coca‐colonization and the chronic disease epidemic: can the Doomsday scenario be averted?
Abstract . Zimmet P (International Diabetes Institute, Melbourne, Australia). Globalization, coca‐colonization and the chronic disease epidemic: can the Doomsday scenario be ave...
The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health
The Lancet Countdown tracks progress on health and climate change and provides an independent assessment of the health effects of climate change, the implementation of the Paris...
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
1. The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life. 2. A team-based ...
Fatalism in the context of COVID-19: Perceiving coronavirus as a death sentence predicts reluctance to perform recommended preventive behaviors
To manage the spread of coronavirus, health entities have urged the public to take preventive measures such as social distancing and handwashing. Yet, many appear reluctant to t...
Publication Info
- Year
- 2000
- Type
- review
- Volume
- 356
- Issue
- 9231
- Pages
- 757-761
- Citations
- 204
- Access
- Closed
External Links
Social Impact
Altmetric
PlumX Metrics
Social media, news, blog, policy document mentions
Citation Metrics
204
OpenAlex
4
Influential
144
CrossRef
Cite This
John B. McKinlay,
Lisa Marceau
(2000).
US public health and the 21st century: diabetes mellitus.
The Lancet
, 356
(9231)
, 757-761.
https://doi.org/10.1016/s0140-6736(00)02641-6
Identifiers
- DOI
- 10.1016/s0140-6736(00)02641-6
- PMID
- 11085708