In 1961 the Framingham study investigators introduced the term ‘risk factor’ to the medical community and ushered in the era of risk modification, now a dominant strategy for the prevention of diseases. Academic careers have succeeded and private enterprises have flourished on the promotion of this paradigm.
Currently, risk-factor reversal is an established surrogate for quality of care and a cornerstone of most pay-for-performance schemes allegedly designed to improve health outcomes. One particular risk factor, however, stands out by virtue of the unusual treatment it receives from public health advocates.Continue reading “The mother of all risk factors”