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Prevention and the elderly: public health issues and strategies.

Prevention of disease and promotion of health, singularly appropriate areas of concern for public health, have been receiving intensified attention in recent years. In policy, practice, research, and teaching, prevention and promotion increasingly are identified as priorities. This is not a new venture for the field. The provenance of preventive and health promotional activities can be traced to early "hygiene" and environmental control movements that reflected early concerns about the "public's health" (14, 68). Currently, beginning with the publication of Healthy People (59) and Promoting Health and Preventing Disease (60), unprecedented activity has been taking place in this area; however, recognition of the appropriateness and feasibility of the older population (i.e. 6S and over) as a target group for preventive care is a recent phenomenon. As prevention in general has become an activity to be nurtured, developed, and monitored, and as the nature of the country's population changes, older people are now being included in both the statement of overall objectives for prevention as well as in specific aims. This is reflected in the extension of objectives of Healthy Older People (63) and in the recent Surgeon General's workshop on health promotion in the elderly (58). In considering prevention and the elderly, it is crucial to address two basic issues. The first is to arrive at a working definition of prevention and health