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Sick individuals and sick populations: 20 years later
  1. Y G Doyle1,
  2. A Furey2,
  3. J Flowers3
  1. 1South East London Strategic Health Authority and European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, UK
  2. 2South East London Strategic Health Authority, UK
  3. 3Eastern Region Public Health Observatory, Institute of Public Health, Cambridge, UK
  1. Correspondence to:
 Dr Y Doyle
 South East London Strategic Health Authority, 1 Lower Marsh, Waterloo, London SE1 7NT, UK; Yvonne.doyle{at}


Twenty years after Geoffrey Rose published his classic paper, the central messages remain highly relevant to modern public health policy and practice. The individual and population approaches are fundamentally different but both are needed. Recent examples of powerful population approaches prove Rose’s point that norms can change benefiting the most deprived. Individual approaches have also succeeded but their protection of the most deprived communities is limited. Consumerism in health and over-reliance on individual approaches risk widening health inequalities.

  • incidence of disease
  • clinical epidemiology
  • preventative health care

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  • Funding: none.

  • Conflicts of interest: none declared.

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