The Guide to Community Preventive Services What Works to Promote Health?

The guide describes itself as a resource to help readers select interventions to improve health and prevent disease in communities, businesses, health care organizations and schools. It is designed to answer three questions (i) What has worked for others in the field of improving health? (ii) How can the most effective interventions be selected? and (iii) What might the intervention cost and what is likely to be achieved? The book is divided into three parts dealing with changing risk behaviours and addressing environmental challenges, reducing disease, injury and impairment and methodological background. It covers the main topic areas of reducing tobacco usage, increasing physical activity, various child ill health prevention programmes, what works in cancer prevention, diabetes, diseases which can be prevented by vaccines and finally oral health—something of a strange combination in my opinion as obesity, the biggest health problem in the USA neither receives specific mention nor does nutrition. The book has a very American focus but does contain useful information on various recommendations from advisory groups and a brief summary on the methods used to determine economic efficiency of all interventions. But my main complaint is how little mention the workplace gets. It is mentioned in only two areas, cancer prevention and diabetes education and self-management and even then is quite disappointing. On the cancer front, it concludes that there is insufficient evidence to determine the effectiveness of interventions to reduce occupational exposure to UV light and to promote sun-protective behaviours and in diabetes there is insufficient evidence to determine the effectiveness of diabetes self-management in worksite programmes. If I were optimistic, I would conclude that the absence of evidence of the effectiveness of workplace interventions is not the same as evidence of absence of effectiveness but overall the one conclusion I have from reading the book is, and I will apologise in advance, that ‘more workplace research is needed’. Overall, this book is likely to be more of interest to public health than occupational physicians and will have a small (but probably) selective occupational readership. ☆☆ (Reference only)