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In this issue, as we near the end of 10 years' of editing this journal it must be time for some reflection on what we've seen, not just during this period but during our professional working lives. A significant proportion of the Editorial Board fall loosely into the category of baby‐boomers now looking forward to really changing the world, freed from the constraints of institutional employment.
Perhaps the most important contribution this month, in the light of the above remarks, is Heather MacDougall's offering in public health past and present. She comments on A new perspective on the health of Canadians, the seminal Canadian Green Paper published by Marc Lalonde in 1974, was such a tipping point in the movement to the new public health. MacDougall explores the experience of Canada, the UK and the USA in the light of Lalonde, and concludes that, as was the case with the sanitary idea, new ideas such as germ theory, health education and centrally‐funded preventive services take time to be adopted. She suggests that perhaps the greatest impact of A new perspective lay in challenging the hierarchical dominance of the biomedical model, and that by demonstrating the limitations that this posed for prevention the Canadian document enabled the international public health movement to reinvent its role for the 21st century.
See page 955
Also appropriate is the choice of cannabis prevention as the target for a critique of social marketing in an editorial by Harry Sumnall and Mark Bellis. This approach enjoyed some fashionability after the mid‐70s and is now being re‐launched somewhat uncritically, not least in the UK. A personal communication from Lowell Levin first time around, entitled “Social marketing: buy the whole package?”, concludes that social marketing should not be—but often is—confused with health development and health promotion strategies. He goes on to stress that the community must have the capability and the opportunity to pose the problems, determine causation, select options for solution and act. This emphasis would shift the weight of the contribution of social marketeers from pacification to emancipation; from reducing risk to reducing barriers to effective social action.
See page 930
As our 10 years have gone by, contributors have increasingly begun to bring out the policy and practice relevance of research. This is reflected in the increasing number of papers in our section on continuing professional education. This month, continuing professional education offers us the following: a simple guide to chaos and complexity; a systematic review of Antonovsky's sense of coherence scale; and the first part of a systematic review of organisational‐level interventions that aim to increase employee control.
See pages 933, 938 and 945
Findings for evidence‐based policy and practice include:
See pages 960, 966, 972, 978, 984 and 990
And from research reports we have the finding that the effect of childhood socioeconomic position relative to adulthood varies by cause of death; and that mental ability risk factor gradients in a study of the 1970 British Cohort may offer some insights to the apparent link between low pre‐adult mental ability and premature mortality. Meanwhile, in theory and methods, John Nicholl explores the constant risk fallacy in case‐mix adjustment.
See pages 997, 1004 and 1010
To conclude an issue looking backwards as well as forwards, there is a review of Julian Tudor‐Hart's new book, The political economy of health care: a clinical perspective. Julian has been a giant on the political Left in looking at health policy issues from the perspective of general practice in a disadvantaged setting, and his new contribution is sure to provide food for thought for those who come after us. It goes well as a pair with speakers' corner, which raises the question when do we know enough to recommend action when questionable, down‐stream interventions are more likely to have some evidence base than good bets upstream?
See page 931 and 1014