Is Frevesdve Medfc$sae TaldsIg Off at Last?

Last winter I delivered a lecture at the Center for D~ase Control (CDC) in Atlanta, Georgia. I During my stay there, I learned that CDC is broadening its horizons by becoming a national center for preventive medicine. Severaf years ago I suggested something very sirniiar. z At that time, my plan involved the establishment of an Institute for Health Care Systems Research, to be financed by insurance companies. Unfortunately, despite meetings with government officials and the heads of five Blue Cross companies, nothing ever came of my idea. In the last few years, however, there has been increasing support in both the medical and popular literature for organizations and institutions that would emphasize preventive, rather than cumtive, medicine. Preventive medicine is defined as “that branch of study and practice which aims at the prevention of dwease.”j As such, preventive medicine can take many forms. An educational program designed to teach teenagers about the problems of VD, for example, is a form of preventive medicine. Vaccinating children against polio, and teaching women to perform breast seM-examinations for early detection of cancer, are also forms of preventive medicine. Reflecting the interest in preventive medicine, CDC, which is a federal agency under the Department of Health and Human Services (HHS) (formerly Health, Education, and Welfare), was recently reorganized to shift its focus from disease control to disease prevention. This is a result of efforts by both CDC and the US Surgeon General, Julius B. Richmond. Larry Sparks, CDC’S Washington special assistant, explains that CDC’S role in national health programs has been evolving for some time toward health promotion. The new organization provides official recognition of that change.4 Whh its new organization CDC effectively becomes a national operating center for preventive mdcine, with its function the active promotion of health through preventive medicine. Whale this is certainly a vital function, it only covers half the problem. Another institution-perhaps within the National Institutes of Health (NIH)-should be established to handle the research aspects of preventive medicine. Although both CDC and the NH currently do much preventive medicine-related research, there is no US institute devoted to preventive medicine. The combined efforts of a research center and an operating agency would result in a comprehensive national program of preventive medicine. CDC has long been a preventionoriented institution. Established during the Second World War, CDC was originally an office for malaria control. It has grown steaddy since then, continually adding the control of more and more d~eases to its i-esponsibilities.s In 1970 it was officially named the Center for Disease Control, and in 1973 it became an agency within the Public Health Ser-