Tony Biglan, Co-Director of the PNRC, has written this timely message for our Journal.
Recent Institute of Medicine reports on prevention and treatment1-3 document the extensive progress made in prevention of most mental, emotional, and behavioral disorders. Exponential growth in the number of randomized controlled trials over the past 15 years has delineated programs and policies to prevent depression; anxiety disorders; antisocial behavior; academic failure; tobacco, alcohol, and other drug use and abuse; premature or unsafe sex; inadequate exercise; schizophrenia; and poor dietary habits. Interventions are available throughout the lifespan from the prenatal period through adolescence. They effectively target the major social-environmental influences on problem development—families, schools, and peers. This knowledge could significantly reduce the prevalence of these common, costly problems in entire populations. Estimates of the annual US costs of these problems range from $247 billion1 to $435 billion.4
What typically fails to gain attention is the benefit that preventing these problems would have for reducing the burden of physical illness in the US. Depression; academic failure (and its attendant poverty); tobacco, alcohol,
and other drug use and abuse; delinquency; premature or unsafe sex; inadequate exercise; and poor dietary habits account for a large proportion of the cases of cardiovascular disease (CVD) and cancer, which the Centers for Disease Control indicate are the two leading causes of death in the US. For example, the INTERHEART study of risk factors for heart disease found that psychosocial factors such as depression and stress have a population attributable risk of 32% for myocardial infarction, slightly less than that for smoking, but greater than for hypertension and obesity.5
- NRC & IOM. 2009. Preventing mental, emotional, and behavioral disorders among young people: progress and possibilities. Washington, DC: National Academies Press.
- NRC & IOM, 2007. Ending the tobacco problem: A blueprint for the nation. Washington, DC: NAP.
- NRC & IOM. 2009. Depression in parents, parenting, and children. Washington, DC: NAP.
- Biglan A, Brennan P, Foster S, Holder H. 2004. Helping adolescents at risk. New York: Guilford.
- Sheps DS, Frasure-Smith N, Freedland KE, Carney RM. 2004. The INTERHEART Study: Intersection between behavioral and general medicine. Psychosomatic Medicine 66, 797-798.