TY - JOUR T1 - PReventive medicine AU - Sheps CG Y1 - 1979/03/30 N1 - 10.1001/jama.1979.03290390062041 JO - JAMA SP - 1384 EP - 1385 VL - 241 IS - 13 N2 - The continuously rising cost of medical care and the recognition that these increased expenditures do not seem to be accompanied by commensurate gains in the health status of the population have helped to focus our attention on disease before it happens, ie, on prevention. At the same time, we have learned a great deal about the factors that produce or are associated with the leading causes of death and disability. Evidence mounts to implicate personal behavior and the physical and socioeconomic environment as prime determinants of health and disease; hence, the rising interest in health policy discussions.I shall broadly sketch the objectives, scope, problems, and challenges in the types of programs of prevention now emerging.1Levels of Prevention  Prevention measures are either primary or secondary. Primary prevention consists of those actions that prevent a disease from occurring. Secondary prevention consists of activities designed to detect disease before it SN - 0098-7484 M3 - doi: 10.1001/jama.1979.03290390062041 UR - http://dx.doi.org/10.1001/jama.1979.03290390062041 ER -