The McKeown Thesis: A Historical Controversy and Its Enduring Influence

Colgrove, James

doi:10.2105/ajph.92.5.725

Cited by 204 publications

(79 citation statements)

References 32 publications

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“…44,45 The ongoing resonance of McKeown's work is due primarily to the importance of the question that underlies it: are public health ends better served by targeted interventions or by broad-based efforts to redistribute the social, political, and economic resources that determine the health of populations? 46 There are several potential limitations in the methodology used in our study. We have to a large extent followed the methods of Tobias and Jackson 2 and the cautions noted in that paper are also appropriate to our study: "The indicator has been constructed to measure the theoretical scope for further population health gain, not what may be considered feasible given current technology, available resources and competing values".…”

Section: Health Promotionmentioning

confidence: 99%

Avoidable mortality in Victoria between 1979 and 2001

Piers¹,

Carson²,

Brown³

et al. 2007

Aust N Z J Public Health

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Section: Health Promotionmentioning

confidence: 99%

Avoidable mortality in Victoria between 1979 and 2001

Piers¹,

Carson²,

Brown³

et al. 2007

Aust N Z J Public Health

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“…In the 1960s and 1970s commentators argued that health care had a very low impact on population health compared to individual health (23,24). However, they were writing about a period when health care had relatively little to offer compared to today (25).…”

Section: Discussionmentioning

confidence: 99%

Social inequalities in causes of death amenable to health care in Norway

Hem¹,

Næss²,

Strand³

2009

Nor J Epidemiol

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Objective: Investigate if there are educational inequalities in causes of death considered amenable to health care in Norway and compare this with non-amenable causes. Methods: The study used the concept of "amenable mortality", which here includes 34 specific causes of death. A linked data file, with information from the Norwegian Causes of Death Registry and the Educational Registry was analyzed. The study population included the whole Norwegian population in two age groups of interest (25-49 and 50-74 years). Information on deaths was from the period 1990-2001. Education was recorded in 1990 and it was grouped in four categories as: basic, lower secondary, higher secondary and higher. In the study men and women were analysed seperately. The analysis was conducted for all amenable causes pooled with and without ischemic heart disease. A Cox proportional hazard regression model was fitted to estimate hazard rate ratios. Results:The study showed educational differences in mortality from causes of death considered amenable to health care, in both age groups and sexes. This was seen both when including and excluding ischemic heart disease. The effect sizes were comparable for amenable and non-amenable causes in both age groups and sexes. Conclusions: This study revealed systematic higher risk of death in lower educational groups in causes of death considered amenable to health care. This indicates potential weaknesses in equitable provision of health care for the Norwegian population. Additional research is needed to identify domains within the health care system of particular concern.

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“…Victorian consumption patterns and their health benefits suppressing the symptoms of non-communicable degenerative diseases. These have emerged, we submit, largely due to our failing to maintain midVictorian nutritional standards 18 ( Figure 1). …”

Section: Life Expectancy Life Quality and Public Health Patternsmentioning

confidence: 99%