CANCER PREVENTION THROUGH HEALTH PROMOTION - DEFINING THE ROLE OF PHYSICIANS IN PUBLIC-HEALTH

In recent years a major focus in the delivery of cancer prevention services has been on the actions of physicians in ambulatory care practice. Whereas delivery of these services has increased markedly, it is likely that physician actions overall are not producing expected measurable benefits to whole populations. The level and quality of prevention services will be increased through greater local consensus regarding cancer prevention goals, better organization to provide these services more efficiently, and improved health education in clinics. But the greatest challenge is to increase access for all Americans to these services. Access to health services is not only a medical problem. Social problems of unemployment,poverty, and limited education. significantly influence access to services and good health in poorly understood ways. While encouraging direct approaches to,addressing social problems in the medical community, the agenda for the future in cancer prevention must be concerned with facilitating a public health community responsibility attitude among physicians and with fostering development of hospital/community/physician partnerships in which community organizations have significant ownership. Overall public health indices in cancer can improve only with greater attention to access and the broad societal issues of preventive medicine.