The prevention paradox describes the seemingly contradictory situation where the majority of cases of a disease come from a population at low or moderate risk of that disease, and only a minority of cases come from the
high risk population (of the same disease). This is because the number of people at high risk is small. The prevention paradox was first formally described in 1981 by the
epidemiologist
Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and determinants of health and disease conditions in a defined population.
It is a cornerstone of public health, and shapes policy decisions and evidenc ...
Geoffrey Rose.
Especially during the
COVID-19 pandemic
The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identi ...
of 2020, the term "prevention paradox" was also used to describe the apparent paradox of people questioning steps to prevent the spread of the pandemic because the prophesied spread did not occur. This however is instead an example of a
self-defeating prophecy or a
preparedness paradox.
Hypothetical case study
For example, Rose describes the case of
Down syndrome
Down syndrome or Down's syndrome, also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is usually associated with physical growth delays, mild to moderate intellectual dis ...
where maternal age is a risk factor. Yet, most cases of Down syndrome will be born to younger, low risk mothers (this is true at least in populations where most women have children at a younger age). This situation is paradoxical because it is common and logical to equate high-risk populations with making up the majority of the
burden of disease.
Another example could be seen in terms of reducing overall alcohol problems in a population. Although less serious, most alcohol problems are not found among dependent drinkers. Greater societal gain will be obtained by achieving a small reduction in alcohol misuse within a far larger group of "risky" drinkers with less serious problems than by trying to reduce problems among a smaller number of dependent drinkers.
See also
*
False positive paradox
*
Preparedness paradox
Notes and references
External links
"Sick individuals and sick populations", G. Rose, ''Int J Epidem'' 1985; vol. 14, no. 1: pp. 32-38."Commentary: The prevention paradox in lay epidemiology—Rose revisited", Kate Hunt and Carol Emslie, ''Int J Epidem'' 2001; vol. 30, no. 3: pp. 442-446.The Prevention Paradox Applies to Alcohol Use and Problems among Adolescents
{{Decision theory paradoxes
Medical terminology
Decision-making paradoxes