Levels of disease prevention

Introduction
• Prevention includes a wide range of activities known as “interventions”
aimed at reducing risks or threats to health. Prevention, as it relates to
health, is about avoiding disease before it starts.
• It has been defined as the plans for, and the measures taken, to prevent
the onset of a disease or other health problem before the occurrence of
the undesirable health event.
Introduction ctd.

• Disease prevention includes measures not only to prevent the

occurrence of disease, such as risk factor reduction, but also to arrest
its progress and reduce its consequences once established.
Why is disease prevention important?

• The purpose of this essential public health operation is to prevent

disease through actions at primary, secondary and tertiary levels.
Most of these actions fall within the role of health professionals and
health care providers in primary care, hospitals and community
services environment.
 Levels of prevention (I)
Levels of Phase of Target
prevention disease
Primordial Underlying Total population
conditions and selected
leading to groups
causation
Primary Specific Total
causal population,
factors selected groups
and healthy
individuals
Levels of prevention (II)

Levels of Phase of disease Target

prevention
Secondary Early stage of Patients
disease
Tertiary Late stage of Patients
disease (treatment,
rehabilitation)
 Primordial prevention
•Primordial prevention is defined as
prevention of risk factors themselves,
beginning with change in social and
environmental conditions in which these
factors are observed to develop, and
continuing for high risk children,
adolescents and young adults.
•Primordial prevention, a relatively
new concept, is receiving special
attention in the prevention of chronic
diseases. For example, many adult
health problems (e.g. obesity,
hypertension) have their early origins
in childhood, because this is the time
when lifestyles are formed.
•Contd.
•General access to energy-dense
diets coupled with typically
sedentary urban lifestyles creates a
trend toward obesity and chronic
disease.
•It is important to change the
behaviours that promotes major risk
factor development. Primordial
prevention calls for changing the
socio-economic status of society. A
better socio-economic status
correlates inversely with lifestyle
factors like smoking, abnormal food
patterns and exercise.
•Primordial prevention begins in
childhood when health risk
behaviour begins. Parents,
teachers and peer groups are
important in imparting health
education to children.
Examples of primordial prevention actions
(I):

National policies and programmes on

nutrition involving the agricultural sector,
the food industry, and the food import-export
sector
Examples of primordial prevention actions
(II):

Comprehensive policies to discourage

smoking
Examples of primordial prevention
actions (III):

Programmes to promote regular

physical activity
 
Primary prevention

• Primary prevention aims to prevent disease or injury before it ever

occurs. This is done by preventing exposures to hazards that cause

disease or injury, altering unhealthy or unsafe behaviours that can

lead to disease or injury, and increasing resistance to disease or injury

should exposure occur.

 Examples include:
• Legislation and enforcement to ban or control the use of hazardous
products (e.g. asbestos) or to mandate safe and healthy practices (e.g.
use of seatbelts and bike helmets)
• Education about healthy and safe habits (e.g. eating well, exercising
regularly, not smoking)
• Immunization against infectious diseases.
Secondary prevention

• Secondary prevention aims to reduce the impact of a disease or injury

that has already occurred.

• This is done by detecting and treating disease or injury as soon as

possible to halt or slow its progress, encouraging personal strategies to

prevent reinjury or recurrence, and implementing programs to return

people to their original health and function to prevent long-term

problems.
Examples include:

• Regular exams and screening tests to detect disease in its earliest

stages (e.g. mammograms to detect breast cancer)
• Daily, low-dose aspirins and/or diet and exercise programs to
prevent further heart attacks or strokes
• suitably modified work so that injured or ill workers can return safely
to their jobs.
Tertiary prevention

• Tertiary prevention aims to soften the impact of an ongoing illness or

injury that has lasting effects.

• This is done by helping people manage long-term, often-complex health

problems and injuries (e.g. chronic diseases, permanent impairments) in

order to improve as much as possible their ability to function, their

quality of life and their life expectancy

 Examples include:
• Cardiac or stroke rehabilitation programs, chronic disease management
programs (e.g. for diabetes, arthritis, depression, etc.)
• Support groups that allow members to share strategies for living well
• Vocational rehabilitation programs to retrain workers for new jobs when
they have recovered as much as possible.
 Responsibilities for disease prevention:

•Government
•Professional and non-governmental
organizations
•Industry
•Hospitals, health clinics, health
practitioners and health-care workers
Note:

• For many health problems, a combination of primary, secondary and

tertiary interventions are needed to achieve a meaningful degree of
prevention and protection.
END