High Risk Strategies Disadvantage

High risk strategies ●​ Seeks for high risk-susceptible individuals ○​ Then offer individual protection ○​ has advantage on intervention appropriate for individuals ○​ Cost effective ●​ Disadvantages also lies ○​ socially inappropriate ○​ Limited potential for population ○​ Limited potential for individuals ●​ Most Down syndrome in low risk group ○​ women under 30 have the lowest individual risk of 0.7 per 1000 birht ○​ 51% of cases occur form this group ●​ High risk group contributes to fewer total cases ○​ Risk increase with age ■​ 13.1(40-44) ■​ 34.6(above 45) ○​ But has low birth rate ■​ 40-44 ●​ 0.95% ■​ Above 45 ●​ 0.05% of births down syndrome cases ○​ Only contributes to 13% of total ■​ however in individual level it is shown to have this group has the highest risk ●​ Screening only high risk mothers may leave out majority of cases ●​ Flaw ○​ It may be just because the sample is larger ■​ More baby is form the sample of under 30 mothers ■​ Individual risk is low ●​ but majority of births are from this group also ●​ Therefore having larger % of down syndrome ex) 10,000 women under 30 give birth with 0.7 individual risk( mathematically, will have 7 cases 100 women over 45 give birth with individual risk of 34.6=3-4 cases Even with older women having 50 times the risk, younger women give out more total cases because they are mothers of more babies. If I'm a mother of under 30 (individual) I do not need to be much worried about having down syndrome offspring. However, in an individual over 45, I should be. From the view of the public health service, I should not be looking at risk strategies to focus care, because even with low individual risk, mother under 30 still covers the majority of the birth mothers.