From The Mail in the Sept. 1&8, 2025 New Yorker Magazine:
Medical Trials
Siddhartha Mukherjee, in his piece on early-stage cancer detection, presents a convincing argument concerning the perils of screening ("Early Warnings," June 23rd). He also suggests that the bio-medical model, which finds disease, is being privileged over the public-health model, which seeks to prevent illness and can do so effectively given enough resources. Clean air and water, quality food, adequate housing, safe workplaces, education, and vaccination contribute far more to the health of a population than catching disease early. But biomedicine is where the money is, and screening brings in a significant share. Mammography alone is an eleven-billion-dollar industry.
Burden Lundgren, M.P.H., Ph.D., R.N.Norfolk, Va.
It is much cheaper preventing disease than treating it once it starts and is detected. However, prevention, by its very nature, does not lead to the manifestation of a problem, and if there is no problem, why spend resources to prevent it from occurring in the future? "We'll cross that bridge if and when we come to it is an easier political sell than spending resources up front to prevent a problem that may not occur.
An ounce of prevention is worth a pound of cure.
A stitch in time saves nine.
"Be prepared!" (Old Boy Scout motto.)
Proper Planning Prevents Piss-Poor Performance
I appreciate very much the letter that Burden Lundgren sent in to the New Yorker about the importance of the public health model as compared to the biomedical model when we consider the best ways to enhance community health. Unfortunately, under the Republican administration public health programs have been decimated and it will be years to recover from the predictable negative effects in coming years. Consider the social policies of candidates about community health the next time you vote.
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