ResearchProjects

More people die of preventable disease in the United States than in other wealthy countries, especially among people with lower education or incomes.  Preliminary modeling work suggests that only nine prevention goals are required to attain 40% mortality reduction from 11 conditions, resulting in 20% mortality reduction overall, because of interdependencies and common pathways. For example, alcohol use disorder and/or heavy drinking impacts not only liver failure, but also behavioral consequences such as sexual risk-taking and medication nonadherence. However, attaining 20% mortality reduction would require a radical transformation of preventive care focused on personalization, navigation, and compensation.

Personalization is defined as maximizing individual-level benefit by modulating intensity of screening, frequency of screening, and intensity or duration of response; navigation is reducing barriers posed by fragmentation of health and social systems; and compensation is offsetting dependent care, time costs, and travel costs.

This study is preparatory for testing the hypothesis of 20% mortality reduction from personalization, navigation, and compensation and focuses on alcohol use disorder and heavy drinking, HIV risk, and risk for cardiovascular disease.