Intervening earlier is not automatically intervening better: the Harvard PGDA working paper argues that treating intermediate risk factors may be less effective and less cost-effective than primary prevention or than creating social and policy environments that reduce vulnerability, because people with the will to act healthily may live or work in environments that restrict healthy choices.

Evidence 1 passage

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  treating intermediate risk factors may, in turn, be less effective (and less cost-effective) than primary prevention measures or creating favorable social and policy environments to reduce vulnerability to developing disease (Brownell & Frieden, 2009; National Commission on Prevention Priorities, 2007; Satcher, 2006; Woolf, 2009). After all, even those with the will to engage in healthy practices may find it difficult to do so because they live or work in environments that restrict their ability to make healthy choices.

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