The health of populations

The Health of Populations Beyond Medicine The Health of Populations Beyond Medicine Jack E James Reykjavı´k University, Reykjavı´k, Iceland National University of Ireland, Galway, Galway, Ireland AMSTERDAM • BOSTON • HEIDELBERG • LONDON NEW YORK • OXFORD • PARIS • SAN DIEGO SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO Academic Press is an imprint of Elsevier Academic Press is an imprint of Elsevier 125 London Wall, London, EC2Y 5AS, UK 525 B Street, Suite 1800, San Diego, CA 92101-4495, USA 225 Wyman Street, Waltham, MA 02451, USA The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, UK © 2016 Elsevier Inc All rights reserved No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein) Notices Knowledge and best practice in this field are constantly changing As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN: 978-0-12-802812-4 Printed and bound in the United States of America For information on all Academic Press publications visit our website at http://store.elsevier.com/ This book has been manufactured using Print On Demand technology Each copy is produced to order and is limited to black ink The online version of this book will show color figures where appropriate Foreword Reverence for human suffering and human life, for the smallest and most insignificant, must be the inviolable law to rule the world from now on In so doing, we not replace old slogans with new ones and imagine that some good may come out of high-sounding speeches and pronouncements We must recognize that only a deep-seated change of heart, spreading from one man to another, can achieve such a thing in this world (Albert Schweitzer, Reverence for Life, 1969, New York: Harper and Row, p 104) For more than 50 years Albert Schweitzer lived and labored at the hospital he founded at Lambare´ne´, in Gabon, equatorial Africa His basic philosophy: meet patients on their own terms Tend the needs of individuals, but within the context of their community and of the broader society It is an ethic to which all physicians aspire When Jack James approached me about writing this foreword, I was initially puzzled Why ask a practicing emergency physician to introduce a book that disputes the utility of modern biomedicine? Emergency medicine is grounded in the French principle of triage, first promulgated by Napoleon’s surgeon-in-chief, Dominique Jean Larrey When vital supplies are limited, justice demands their distribution for efficacy Triage is practiced daily in emergency wards the world over Patients are prioritized for treatment based on the severity and acuity of their illness or injury In large disasters, emergency medical providers use colored tags to indicate the likelihood of survival: green for walking wounded; yellow for urgent; red for emergent; black for non-survivable Precious resources are preferentially allocated to the red-tagged patients, then to those with yellow tags Patients who are judged non-survivable receive comfort measures if supplies permit When resources are insufficient for everyone, impartial triage drives their distribution in a way that benefits the majority, even at the expense of individuals Physicians and surgeons have come a long way since the fields of Waterloo Modern medicine would be unrecognizable to Drs Larrey and Schweitzer, in many beautiful and positive ways But there is an economic dark side Doctors have become carnival barkers on the Great Medical Midway Our sales pitch? With enough money and unlimited access, everyone everywhere can live infinitely productive lives, if sufficiently bolstered with enough personalized pills to guarantee jeunesse dore´e until the end of our protracted and consummately healthy natural lives xiii xiv Foreword This is fantasy Biomedicine has not significantly altered the global burden of disease, global health inequality, and the global rise of noncommunicable diseases, as Dr James demonstrates using scrupulous scientific analysis His facts are plain and stubborn They not support the genomic and informational technologies upon which personalized medicine is built, nor they support, in justice, its global expense Modern medicine is a reckless juggernaut, grinding population health under its personalized platinum wheels And yet, physicians have an intimate and deeply personal relationship with their individual patients For more than 30 years I have treasured this as a doctor As a sick patient, I have depended on it Therein lies the paradox The Health of Populations: Beyond Medicine is a wonderfully articulate, incisive, comprehensive review of the challenges facing global health It is also a call to battle Dr James offers incontrovertible evidence to support the triage of limited resources, away from efforts to control the progression of severe chronic disease in individuals, toward population-wide promotion of health and prevention of disease Biomedicine is not a magic wand; it should be used as a complement to behavioral, legislative, social, and other preventive means to achieve personal and global health For physicians, healthcare focus must shift to risk-factor reduction, from pre-birth to end of life, in a way that balances the needs of individual patients and those of society Reverence for human suffering and human life are the foundation of that argument, and of this book It will take a deep-seated change of heart to achieve such a thing in this world The Health of Populations: Beyond Medicine is our roadmap Mary Claire O’Brien, MD Professor Department of Emergency Medicine Department of Social Sciences and Health Policy Wake Forest School of Medicine Winston-Salem, North Carolina, USA About the Author Dr Jack James was born and raised in Sydney, Australia He studied psychology, biology, and social sciences, trained and practiced as a clinical psychologist, and completed a PhD in experimental clinical psychology He has been on the faculty of several universities in Australia and Europe as a professor of psychology with particular interests in health, and has been principal investigator of healthrelated research projects funded by the European Union and public bodies in Australia, Ireland, and Iceland xv Preface Health is a dynamic state, guaranteed by no one thing Rather, health derives from myriad aspects of living that comprise the habits and habitats of individuals and populations Health may be optimized, but not perfected While it is never too late to strive to recover compromised health, recovery is usually partial rather than complete Thus, optimal health is founded on ways of living that favor prevention, and prevention rests on minimizing exposure to disease and injury risk factors Authorities, national and global, fret about ways to expand biomedical healthcare to avert catastrophe from the escalating global burden of chronic noncommunicable diseases However, history and current evidence show that biomedical healthcare has contributed comparatively little to the health of populations past and present Moreover, despite occasional promises of imminent transformational discoveries, there is no realistic prospect of biomedicine succeeding in optimizing the health of current or future populations Instead of solutions, biomedicine has contributed to the current crisis by way of medical harm to patients, which is now a leading global cause of mortality and morbidity The evidence, both historical and contemporary, is incontrovertible: Susceptibility to disease and injury is determined more by behavioral and social determinants associated with ways of living than by any other factors Therefore, the proper role for biomedicine is as an adjunct to risk factor reduction throughout the lifecourse In a world characterized by an aging demographic and an unprecedented global burden of disease, individuals can much to optimize personal health by minimizing individual exposure to risk factors Ultimately, however, optimizing health requires collective action to transform healthcare by repositioning biomedicine from a dominant to an adjunctive role Change is required at all levels from the individual to the societal, and from the local to the global The alternative course, maintenance of the status quo and business as usual, will bring disaster Continued reliance on biomedical healthcare—with its immense inherent lack of safety, modest efficacy, disappointing effectiveness, and unsustainable cost-effectiveness—will exacerbate the already worsening global epidemic of noncommunicable diseases xvii xviii Preface I gratefully acknowledge the many students and colleagues who contributed in diverse ways to the evolution of this book I am especially grateful to Valmai Gendle, Drı´fa Harðardo´ttir, and Janet McQueen for their reading of drafts of the work I thank the staff of Reykjavı´k University Library, and especially Unnur Valgeirsdo´ttir, for the expert bibliographic support they supplied I also thank the publishers, Elsevier, the production team, and especially Senior Acquisitions Editor, Kristine Jones, for their unwavering encouragement and support Above all, I am grateful to Drı´fa for enduring the inordinate hours of my time that this task consumed Jack E James, PhD Reykjavı´k, Iceland Part The Science of Health Medical science and services are misdirected, and society’s investment in health is not well used, because they rest on an erroneous assumption about the basis of health [that has] led to indifference to the external influences and personal behavior which are the predominant determinants (Thomas McKeown, 1979, pp xv-xvi) Human health varies greatly within and between individuals as well as populations At any given time, illness afflicts some people and not others, and among those afflicted some are more stricken and others less so Modern biomedical healthcare has given rise to strong beliefs about the role of biology in explaining variability in health However, the science of health shows that variation in personal and population health is explained more by psychosocial variables than by biology In short, biology is not the cause of health and ill-health Biology is mostly a mediator in causal chains that begin and end in the interactions between people and the environments they inhabit Considering the evidence, biomedical dominance of healthcare is difficult to comprehend or to justify While medical research, innovation, and practice make positive contributions to health, the totality of benefit is comparatively modest Worse, harm caused by medical interventions, discussed in detail in Part 2, is widespread and of shocking proportions A profit-driven ethos, which shows no signs of abating, exacerbates much medical harm Optimizing personal and population health, wellbeing, and quality of life requires the reordering of current healthcare priorities (discussed in Part 3), which need to be directed away from predominantly biomedical preoccupations toward comprehensive recognition that human health is founded on ways of living Health and illness are due to innumerable interactive influences that can be thought of collectively as comprising the habits and habitats of human PART The Science of Health populations Habitat1 is familiar in ecology and refers to a given species’ characteristic milieu, inclusive of the physical and social features of that environment Habits can be considered broadly as comprising the usual or persistent patterns of behavior of individuals and groups Though rarely used in discussions about human health, the composite phrase habits and habitats is used in the pages that follow to encompass myriad biological, psychological, and social processes that collectively determine human health and wellbeing Terms in bold italics are defined in the Glossary Author Index Richels, C., 444–445 Richman, L.S., 455 Ridker, P.M., 398–399 Rimer, B.K., 352–353 Rimm, E.B., 394 Risberg, B.M., 119–121 Risica, P.M., 36 Rising, K., 233–234 Ritter, J.M., 235 Roberts, A.H., 314–315 Roberts, R.E., 455 Robertson, L., 253 Robertson, T.L., 90–91 Robinson, J., 183–184 Robinson, M., 409 Roddam, A.W., 399 Roddy, S., 411 Rodgers, A., 398 Rodrigues, L.C., 12–13 Rodriguez-Sanz, M., 361–362 Rodwin, M.A., 218–219 Rogoff, K.S., 410 Rolain, J.M., 158 Roland, M., 362–364 Romero, M., 414 Romundstad, S., 184–185 Ronit, K., 417 Ronksley, P.E., 394–395 Roobol, M.J., 260–261 Roos, E.M., 304 Ros, E., 271 Rose, G., 82–100, 332–348, 356–357, 365–367, 372, 381, 385–386, 388–389, 407, 412, 454–455 Rose, S.L., 197 Roseman, M., 201 Rosen, G., 454 Rosenberg, H.G., 271 Rosenberg, W.M., 290, 292–293 Rosengren, A., 74 Rosenthal, D.G., 343 Rosenthal, M.B., 191 Roskam, A., 356, 359–362 Ross, J.S., 185–186, 234–235 Roswall, N., 391–392, 394 Rothman, D.J., 196 Rothman, S.M., 196 Rothschild, J.M., 122–123 Round, J., 368 Rouse, M.H., 344 Rousson, V., 387 Rowley, K.G., 36 Rozin, P., 36 Ruan, Y., 14 Rubin, P.H., 202–203 Rubinstein, A., 448 Rudberg, M.A., 72, 367, 372, 404 Rudisill, C., 346 Ruff, C.B., 34 Rummel-Kluge, C., 435 Runciman, W.B., 115–117 Rupnik, B., 139–140 Ruscin, J.M., 137 Ruscio, A.M., 453–454 Russell, N., 323–324 Rutberg, H., 119–121 Ryan, S.M., 455 Ryner, G., 363 S Sabia, S., 403, 411 Sackett, D.L., 290, 292–293 Sacks, G., 417 Safer, D.J., 232–233 Saffran, B., 218 Sah, S., 192, 238 Saha, S., 435, 437 Saito, E., 60–61 Salas-Salvado´, J., 271 Sallis, J.F., 352–353, 402–403 Salmon, J., 406 Salomon, J.A., 65, 66t, 74, 404, 431 Salum, G.A., 443–444 Sa´nchez-Martı´nez, F.I., 373–374 Sa´nchez-Moreno, J., 445–446 Sanders, L., 301 Sandler, I., 447 Santosham, M., 12–13 Saquib, J., 257–258 Saquib, N., 257–258 Sargent, R.P., 341–342 Sari, A.B.-A., 126 Sarmiento, O.L., 402 Sasieni, P., 258 Sattelmair, J., 404 Savill, N.C., 444 Sawrey, D.L., 232–233 Sax, H., 153–154, 154f Saxena, D., 272 Saxena, S., 448 Scarborough, P., 271–273 Schatman, M.E., 415 Schatz, N.K., 445 Schedlowski, M., 316–317 Schenk, J.J., 344 503 504 Author Index Schievink, B.P., 408 Schiffman, J., 441 Schiffman, M., 415–416 Schiller, J.T., 28 Schleif, A.C., 14 Schlesinger, M., 203–204 Schmalfuss, F., 261 Schmidt, W., 20 Schneider, L., 438 Schnohr, P., 387 Schoelles, K., 415 Schofield, C.B., 158 Schofield, R., 9f Schomerus, G., 432 Schonlau, M., 191 Schott, G., 184–185, 232–234 Schraer, C.D., 36 Schr€ oder, F.H., 260–261 Schroeder, K., 300–301 Schroll, J., 186 Schueller, S.M., 439 Schwahn, C., 432 Schwartz, G.E., 326 Schwartz, J., 356 Schwartz, L.M., 256 Scott, J., 438 Seagroatt, V., 444 Seamon, M.J., 142f Sebastian, A., 32–33, 33t, 35 Seckler, A., 230 Seddon, J.A., 13 Seddon, M., 74 Sedikides, C., 192–193 Seife, C., 229, 233–234 Seiler, C.M., 304 Seligman, M.E.P., 70–71 Sentis, K., 192–193 Sepkowitz, K., 164–165 Settersten, R.A., 247–248 Seya, M.J., 138, 414–415 Sghedoni, D., 335 Shah, D.R., 263 Shah, K.K., 367–368, 373–374 Shah, N.G., 138, 414–415 Shah, R.R., 263 Shakir, S.A., 122, 139–140 Shapiro, D.A., 454 Sharma, L.L., 417 Shaughnessy, A.F., 176 Shaw, G.B., 180, 200, 215 Shea, C., 442 Shekelle, P., 237 Sheldon, T.A., 126 Shelton, J.D., 253 Shepard, R.M., 341–342 Sherman, S., 343 Sherwood, A., 455 Shi, L., 345 Shield, K.D., 341 Shiell, A.W., 343 Shiffman, J., 448 Shipley, M.J., 355–356 Shiroma, E.J., 402–403, 403b Shkolnikov, V.M., 392–393 Shlipak, M.G., 192 Shoham, V., 442–443 Shopland, D.R., 386–387 Shortell, S.M., 111–114, 127 Si, S., 347 Sibley, M.H., 444–445 Sichetti, D., 414 Siersma, V.D., 259260 Sievaănen, H., 294296 Siewers, A.E., 126 Sigelman, D.W., 235 Sigurdsson, J.A., 184–185 Sihvonen, R., 303, 307 Simasek, M., 157 Simmons, B., 202 Simmons, V.N., 391 Simoni, M., 390 Simoons, F.J., 40–41 Sin, N.L., 455 Singh, G.P., 135 Singh-Manoux, A., 356 Sirovich, B., 300 Sismondo, S., 216–218, 235–236 Sizemore, C.F., 14 Sj€odahl, R., 119–121 Skene, A., 234 Skerrett, P.J., 402, 404 Skinner, B.F., 41–42, 366–367, 454 Skinner, J.S., 300 Skog, O.J., 392 Skoyles, J., 286 Skyttner, L., 352 Slawson, D.C., 176 Sleiman, M., 390 Slovic, P., 366 Small, D.A., 366 Smart, R.G., 392 Smeeth, L., 296, 409 Smit, E.S., 388 Smith, A., 23 Smith, B., 401 Smith, J., 109–110 Author Index Smith, P.J., 323–324 Smith, R., 6, 179, 199–200, 230, 232 Smith, R.L., 263 Smith, S., 448 Smithells, R.W., 135 Smolen, J.S., 265–266 Smorenburg, S.M., 115–116, 116f, 140 So, T.T., 456–457, 457t Sobol, A.M., 405–406 Soleva˚g, A.L., 119–121 Solomon, R.C., 202 Søndergaard, J., 234–235 Soop, M., 115–116 South, M., 323–324 Sox, H.C., 186–187 Spence, D., 106 Spielmans, G.I., 223, 232–233 Spigset, O., 135–136 Spyker, D.A., 136 Squassina, A., 250 Staats, D.O., 60 Stafford, R.S., 191 Stahl, D.L., 143 Stainer, K., 234 Stamatakis, E., 404 Stampfer, M.J., 394 Stanton, D., 253 Stapleton, J., 388 Starfield, B., 335–337, 345 Steadman, K.J., 323–324 Steckler, A., 352–353 Steel, N., 293 Steel, Z., 430 Steinman, M.A., 189, 192, 203 Stell, L.K., 203 Stenlund, H., 346 Stephenson, J., 386–387 Steptoe, A., 404, 455 Stern, P.J., 143 Sterne, J.A., 12–13 Stevens, G.A., 60–61, 361, 409 Stevens, R.A., 175–176 Stevenson, C., 74 Stevenson, D., 64 Stewart, D., 325 Stewart, M.A., 324 Stewart-Brown, S., 455 Stewart-Williams, S., 316 Stickland, N.C., 37 Stinson, T.J., 218 Stirbu, I., 356, 359–362 Stobberingh, E.E., 159 Stockwell, T., 394–395 505 Stojiljkovic, D.J., 344 Stokes, H.W., 166 Stokes, T., 293 Stone, A.A., 455 Stone, M.R., 405–406 Stone, N.J., 183–184 Stone, S., 164–165 Stop TB Partnership, 14 Streicher, E.M., 15 Strong, W.B., 405 Stroup, T.S., 437 Stubbs, J., 437 Stuckler, D., 228, 353, 361–362, 410, 417–418 Studdert, D.M., 140–142, 191, 236 Stukel, T.A., 126 Sturkenboom, M.C.J.M., 135–136 Suchiman, H.E.D., 252 Sugaya, L.S., 443–444 Suhrcke, M., 362–364 Sulheim, S., 253 Sulkowska, U., 392–393 Sullivan, T.R., 347 Sundstr€om, J., 408 Sunstein, C.R., 362–363 Suokas, J.T., 437 Surkan, P.J., 448 Suvisaari, J.M., 437 Swami, N., 414 Swanson, J.M., 444 Swinburn, B.A., 411 Szasz, T.S., 79–80, 286–304 Szreter, S., 23, 23 T Talmud, P.J., 252 Tanne, J.H., 235 Tappero, J.W., 167 Tarı´n, J.J., 394 Tarini, B., 262 Tarzi, S., 164–165 Tausk, F., 316–317 Tay, L., 455 Taylor, P., 258–259 Taylor, R., 74, 86–88 Tendal, B., 218, 233 Teret, S.P., 417 Teshale, S., 345 Tewari, M., 351–352 Thaler, R.H., 362–363 Thapar, A., 443 Thielges, S.A., 223 Thomas, E.J., 140 506 Author Index Thompson, A.L., 36, 157 Thornburg, K.L., 409–410 Tikhomirov, E., 147–149 Tilyard, M., 157 Timmerman, M.E., 455 Ting, H.H., 269–270 Tingvall, C., 84 Toblin, R.L., 415 Toh, M.P., 325 Toleman, M.A., 158–159 Tolman, A.W., 15 Tomasetti, C., 266 Tomlinson, M., 448 Topol, E.J., 235 Treadwell, J.R., 415 Tregear, S.J., 415 Trelle, S., 296 Trevathan, W.R., 32–33 Trevena, H., 417 Trinidad, S.B., 250–251 Trogdon, J.G., 86–88 Troyen, A., 125–126 Trumble, B., 285 Trunz, B.B., 12–13 Truswell, A.S., 88 Tsang, C., 118–119 Tsuchiya, A., 373–374 Turkheimer, E., 247–248, 264–265 Turnbull, A., 126 Turner, B.J., 394–395 Turner, B.L., 36, 157 Turner, E.H., 201, 232–233, 440–441 Turner, R.D., Tutton, R., 247 Tyrer, P., 435 Tyrrell, R., 401 Tzoulaki, I., 396 U Uckay, I., 153154, 154f Udoh, E.E., 301 Uhl, W., 304 ă nal, B., 7475, 9495, 9596f, 98, 99t, 404 U Unuătzer, J., 448 V Valenstein, M., 138, 414–415 Vallga˚rda, S., 362–363 Van de Kaa, D.J., 56–57 van den Akker, M., 293 Van den Bergh, O., 36 van den Bogaard, A.E., 159 van den Brink-Muinen, A., 324–325 Van den Broucke, S., 360 van der Hooft, C., 135–136 van Grootheest, K., 135–136 van Ravesteyn, N.T., 360 van Staa, T.P., 296 Van Vlack, T., 408 Vangeli, E., 388 Varbo, A., 398–399 Vartiainen, E., 74 Vaăstfjaăll, D., 366 Vaughan, M.B., 60 Vaupel, J.W., 60 Venhuis, B.J., 182 Venter, J.C., 246 Verma, A., 13 Vesely, S.K., 185 Vesin, A., 164 Victora, C.G., 387 Vijayaraghavan, M., 438 Vilamovska, A.-M., 115–117 Villani, W., 197 Villanueva, P., 223 Villarreal, P., 117–118 Vincent, C., 115–117, 117b, 126 Vincent, J.-L., 122–123 Visentin, G., 335 Visness, C.M., 53–54 Visser, S.N., 444 Viswanath, K., 352–353 Vogelstein, B., 266 von Bertalanffy, L., 352 Vonk, I.J., 453–454 Vos, T., 396, 398, 409 W Waddington, J.L., 437 Wagener, D.K., 63–64 Wagner, A., 265 Wagner, C., 115–116 Wahlberg, A., 323 Wailoo, A.J., 373–374 Wakefield, M., 389 Walach, H., 345, 418 Wald, D.S., 273 Wald, N.J., 272–273 Walker, A., 399–400 Walker, K., 145 Waller, J., 253 Walsh, A.J., 176 Walsh, T.R., 158–159 Walshe, K., 111–114, 127 Author Index Walt, J.G., 294–295 Wandel, S., 296 Wang, B., 236 Wang, C.F., 142f Wang, E., 415 Wang, L., 14 Wang, T.T., 196 Wang, X., 387 Wanzel, K.R., 115–116 Warburton, D., 403–404, 403b Warburton, D.E., 404 Ward, E.M., 416 Ward, K.J., 182 Wardle, J., 253 Ware, J.E., 324 Warner, K.E., 417, 446–447 Warren, J.B., 235 Warren, R., 258 Wartolowska, K., 302 Wat, D., 157 Wateska, L., 193 Watkins, C., 189 Watkins, L.L., 455 Watson, A.C., 432 Watson, G.L., 444–445 Watson, S., 444–445 Watson, S.M.R., 444–445 Wattendorf, D., 251 Waxler, J.L., 252–253 Wazana, A., 189, 194–195 Webster, J.L., 396–397 Weeks, J., 325 Weiderpass, E., 391–392, 394 Weimer, K., 310, 312–313 Weinehall, L., 346 Weiner, J., 353354 Weiner, M., 121122 Weingaărter, V., 118 Weinmann, S., 437 Weis, B.K., 250–251, 264 Weiss, R.D., 442 Weissman, J.S., 213–214 Welch, B., 363 Welch, H.G., 143–145, 259–260 Wenk, R., 415 Wennberg, D.E., 300 Wente, M.N., 304 Weon, B.M., 60 Wesley, O., 405 Westbrook, A.L., 432 Wester, K., 135–136 Weston, A.D., 246, 249–250, 263–264 Wheeler, E.E., 438–439 507 Whelton, M., 407–408 White, A., 323–324 White, H.L., 184 White, M.M., 389, 401 Whiteford, H.A., 430–431 Whitehead, M., 355 Whitelegg, J., 84–85 Whitmee, S., 354 WHO, 7, 14–16, 28–32, 29t, 31f, 81–86, 83f, 87t, 88–89, 89–91f, 92–93, 153–155, 154f, 159–160, 160b, 167, 260, 298–299, 299f, 340–341, 353, 355, 358–359, 364–365, 373, 380–381, 382t, 389–398, 400–402, 406–408, 412–416, 429–431, 441, 448–455, 451b Whooley, M.A., 455 Wichmann, J., 399 Wieland, D., 323 Wieseler, B., 225–226, 232–233 Wilcken, B., 262 Wilde, G.J., 253 Wiley, V., 262 Wilkinson, E., 347–348 Wilkinson, P., 362–363 Willan, A., 388 Willcutt, E.G., 443–444 Willett, W., 342 Willett, W.C., 397 Williams, G.C., 39 Williams, S.J., 275 Williams-Russo, P., 96–97, 251, 364–365, 369–370 Willis, E.M., 323–324, 326 Wilson, A., 230 Wilson, D.E., 408 Wilson, J.M.G., 253–254 Wilson, K., 154–155, 388 Wilson, R.M., 115–117 Winpenny, E., 352–353 Wise, J., 363 Wisk, L.E., 344 Wissow, L., 448 Witt, C.M., 325 Witt, W.P., 344 Witten, T.M., 60 Wolchik, S.A., 447 Wolcott, J., 134–135 Wolcott, J.A., 118–119 Wolfe, S., 223 Wolman, D.M., 186–187 Woloshin, S., 256 Woloshynowych, M., 115–117, 117b Wolpe, J., 454 Wong, L.Y., 325 508 Author Index Woodward, A., 389 Woodward, M., 408 Woolf, S.H., 185, 200–201, 255–256, 255f Wright, A., 449 Wright, J.M., 178, 271 Wright, N., 272–273 Wrigley, E.A., 9f Wu, T.-Y., 136 X Xu, J., 455 Y Yach, D., 335, 387, 391 Yaffe, K., 455 Yamin, C.K., 391 Yank, V., 218, 233 Yarnall, K.S., 345–346 Yasui, Y., 361 Yates, J.S., 287–288, 323 Yeaw, J., 294–295 Yoder, K.E., 301 Yong, D., 158 Yoon, P.W., 261 You, S.L., 416 Youssef, H.A., 437 Yu, J.B., 45–46 Yuen, C.M., 15 Yun, Y.H., 323–324 Yunger, J.L., 57–58 Yusuf, S., 273 Z Zahar, J.R., 164 Zaletel-Kragelj, L., 64 Zarb, P., 147–149, 149t Zaridze, D., 393 Zatonski, W.A., 342, 392–393 Zavestoski, S., 354 Zealley, B., 58–60 Zegers, M., 115–116 Zeller, T., 251–252 Zeltner, T., 387 Zetterqvist, A.V., 223 Zetterqvist, J., 436–437 Zhang, B., 296 Zhang, H., 14 Zhang, K., 387 Zhou, S., 343 Zimmermann, C., 414 Zimmern, R., 246–248 Ziolkovska, A., 396 Zipkin, D.A., 189 Zoller, H.M., 354 Zomer, E., 272–273 Zuger, A., 199–200 Zwerling, A., 13 ... methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility To the fullest extent of the law, neither the Publisher... exception to the inclination of healthcare authorities to equate human health with the absence of disease is the view promulgated by the peak international authority on health, namely, the World Health. .. determine human health and wellbeing Terms in bold italics are defined in the Glossary Chapter The Origins of Health The health of nations is more important than the wealth of nations (William