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Public Health Focus: Effectiveness of Disease and Injury Prevention

Public health practice is based on scientifically sound strategies for improving the quality of life and reducing morbidity and premature mortality. To maximize the health benefits of available resources, public health decision-makers require information on the effectiveness, as well as the economic and social impact, of disease and injury prevention strategies (1). This report introduces a monthly series of articles to be published in MMWR (weekly) that highlight prevention effectiveness.

The development of prevention technology begins with researchers in the basic public health and biomedical sciences identifying potentially effective technologies that can be used to reduce unnecessary morbidity and premature mortality. Applied research under carefully controlled conditions may then determine whether such techniques are efficacious (e.g., the effect of smoking cessation on lung cancer). As these techniques are applied at the community level, their impact and cost can be assessed first in demonstration settings and then in routine community settings, and improvements in techniques can then be incorporated into prevention strategies.

Important considerations in the assessment of disease and injury prevention strategies (i.e., the scientific method for evaluating the effectiveness of prevention strategies) include identification of efficacious and effective strategies to reduce morbidity and premature mortality and improve the quality of life; characterization of the social, legal, and ethical impact of these strategies; estimation of the economic impact of prevention strategies; determination of optimal methods for implementing those strategies; and evaluation of the health impact of prevention programs. Each report in the monthly series will highlight the knowledge base regarding a specific prevention strategy and will address related considerations, including efficacy, effectiveness, safety, and economic factors. Topics have been selected based on their inclusion in the national health objectives for the year 2000 (2), CDC and other public health program efforts, and the availability of data. In particular, the reports will present specific examples of disease and injury prevention strategies and illustrate approaches to evaluating the effectiveness of such strategies. Reported by: Office of Program Planning and Evaluation, Office of the Director; Office of the Director, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: Public health officials and policy makers at all levels require a scientific framework for assessing the effectiveness of disease and injury prevention as a basis for establishing priorities, selecting prevention strategies, and allocating resources. The success of prevention activities can be defined by whether they delay or avert morbidity and mortality. However, the ability to evaluate objectively many prevention techniques with randomized controlled trials is often limited by fiscal, ethical, or other constraints. The MMWR Recommendations and Reports issue, "A Framework for Assessing the Effectiveness of Disease and Injury Prevention" (1), focuses on the challenges of assessment that arise as a consequence of these constraints. Reports in the MMWR (weekly) series will describe examples of how prevention effectiveness can be assessed.

Because public health programs sometimes may begin to implement preventive measures before appropriate assessments are completed, gaps may exist in knowledge of the efficacy, effectiveness, safety, or economic impact of specific prevention strategies. The series of reports in MMWR (weekly) will characterize many of these gaps and describe how they have been addressed. In addition, the reports in this series are intended to

  1. provide decision-makers with information about the potential impact of these interventions on the health of their communities;

  2. suggest approaches suitable for adaptation to public health practice; and 3) encourage further examination of these topics and stimulate additional systematic efforts by public health professionals to assess and enhance the effectiveness of public health programs.


  1. CDC. A framework for assessing the effectiveness of disease and injury prevention. MMWR 1992;41(no. RR-3).

  2. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives--full report, with commentary. Washington, DC; US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50212.

Disclaimer   All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

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