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Preventive health care (no health and safety guidance)
Preventive medicine or preventive care refers to measures taken to prevent diseases, (or injuries) rather than curing them or treating their symptoms. The term contrasts in method with curative and palliative medicine, and in scope with public health methods (which work at the level of population health rather than individual health

Levels

Preventive medicine strategies are typically described as taking place at the primary, secondary, tertiary and quaternary prevention levels. In addition, the term "primal prevention" has been used to describe all measures taken to ensure fetal well-being and prevent any long-term health consequences from gestational history and/or disease. The rationale for such efforts is the evidence demonstrating the link between fetal well-being, or "primal health", and adult health. Primal prevention strategies typically focus on providing future parents with: education regarding the consequences of epigenetic influences on their child, sufficient leave time for both parents, and financial support if required.

Simple examples of preventive medicine include hand washing and immunizations. Preventive care may include examinations and screening tests tailored to an individual’s age, health, and family history. For example, a person with a family history of certain cancers or other diseases would begin screening at an earlier age and/or more frequently than those with no family history. On the other side of preventive medicine, some non-profit organizations, such as the Northern California Cancer Center, apply epidemiological research towards finding ways to prevent diseases
.

Prevention levels Doctor’s side
Disease
absent present
Patient’s
side		 Illness absent Primary prevention
(illness absent
disease absent)		 Secondary prevention
(illness absent
disease present)
present Quaternary prevention
(illness present
disease absent)		 Tertiary prevention
(illness present
disease present)
Level Definition
Primary prevention Primary prevention strategies intend to avoid the development of disease. Most population-based health promotion activities are primary preventive measures.
Secondary prevention Secondary prevention strategies attempt to diagnose and treat an existing disease in its early stages before it results in significant morbidity.
Tertiary prevention These treatments aim to reduce the negative impact of established disease by restoring function and reducing disease-related complications.
Quaternary prevention This term describes the set of health activities that mitigate or avoid the consequences of unnecessary or excessive interventions in the health system.

Universal,selective, and indicated

Gordon (1987) in the area of disease prevention, and later Kumpfer and Baxley in the area of substance use proposed a three-tiered preventive intervention classification system: universal, selective, and indicated prevention. Amongst others, this typology has gained favour and is used by the U.S. Institute of Medicine, the NIDA and the European Monitoring Centre for Drugs and Drug Addiction.

Tier Definition
Universal prevention addresses the entire population (national, local community, school, district) and aim to prevent or delay the abuse of alcohol, tobacco, and other drugs. All individuals, without screening, are provided with information and skills necessary to prevent the problem.
Selective prevention focuses on groups whose risk of developing problems of alcohol abuse or dependence is above average. The subgroups may be distinguished by characteristics such as age, gender, family history, or economic status. For example, drug campaigns in recreational settings.
Indicated prevention involves a screening process, and aims to identify individuals who exhibit early signs of substance abuse and other problem behaviours. Identifiers may include falling grades among students, known problem consumption or conduct disorders, alienation from parents, school, and positive peer groups etc.

Outside the scope of this three-tier model is environmental prevention. Environmental prevention approaches are typically managed at the regulatory or community level, and focus on interventions to deter drug consumption. Prohibition and bans (e.g. smoking workplace bans, alcohol advertising bans) may be viewed as the ultimate environmental restriction. However, in practice environmental preventions programmes embrace various initiatives at the macro and micro level, from government monopolies for alcohol sales, through roadside sobriety or drug tests, worker/pupil/student drug testing, increased policing in sensitive settings (near schools, at rock festivals), and legislative guidelines aimed at precipitating punishments (warnings, penalties, fines).

Professionals

Professionals involved in the public health aspect of this practice may be involved in entomology, pest control, and public health inspections. Public health inspections can include recreational waters, pools, beaches, food preparation and serving, and industrial hygiene inspections and surveys.

In the United States, preventive medicine is a medical specialty, one of the 24 recognized by the American Board of Medical Specialties (ABMS). It encompasses three areas of specialization:

  • General preventive medicine and public health
  • Aerospace medicine
  • Occupational medicine

In order to become board-certified in one of the preventive medicine areas of specialization, a licensed U.S. physician (M.D. or D.O.) must successfully complete a preventive medicine medical residency program following a one-year internship. Following that, the physician must complete a year of practice in that special area and pass the preventive medicine board examination. The residency program is at least two years in length and includes completion of a master’s degree in public health (MPH) or equivalent. The board exam takes an entire day: the morning session concentrates on general preventive medicine questions, while the afternoon session concentrates on the one of the three areas of specialization that the applicant has studied.

In addition, there are two subspecialty areas of certification:

These certifications require sitting for an examination following successful completion of an MT or UHB fellowship and prior board certification in one of the 24 ABMS-recognized specialties.
Prophylaxis

Prophylaxis (Greek "προφυλάσσω" to guard or prevent beforehand) is any medical or public health procedure whose purpose is to prevent, rather than treat or cure a disease. In general terms, prophylactic measures are divided between primary prophylaxis (to prevent the development of a disease) and secondary prophylaxis (whereby the disease has already developed and the patient is protected against worsening of this process).

Examples

Some specific examples of prophylaxis include:

  • Influenza vaccines are prophylactic.
  • Antibiotics are sometimes used prophylactically: For example, during the 2001 anthrax attacks scare in the United States, patients believed to be exposed were given ciprofloxacin. In similar manner, the use of antibiotic ointments on burns and other wounds is prophylactic. Antibiotics are also given prophylactically just before some medical procedures such as pacemaker insertion.
  • Tricyclic antidepressants (TCAs) may, with caution, be an example of a chronic migraine preventative (see Amitriptyline and migraines’ prevention by medicine).
  • Antimalarials such as chloroquine are used both in treatment and as prophylaxis by visitors to countries where malaria is endemic to prevent the development of the parasitic Plasmodium, which cause malaria.
  • Condoms are sometimes referred to as "prophylactics" because of their use to prevent pregnancy as well as the transmission of sexually transmitted infections.
  • Low-molecular-weight heparin is used as a prophylaxis in hospital patients, as they are at risk for several forms of thrombosis due to their immobilisation.
  • Professional cleaning of the teeth is dental prophylaxis.
  • Risk reducing or prophylactic mastectomies may be carried out for carriers of the BRCA mutation gene to minimise the risk of developing breast cancer
  • Daily and moderate physical exercise in various forms can be called prophylactic because it can maintain or improve one’s health. Cycling for transport appears to very significantly improve health by reducing risk of heart diseases, various cancers, muscular- and skeletal diseases, and overall mortality.
  • Prophylaxis may be administered as vaccine. Prophylactic vaccines include: PEP, nPEP, PREP, or nPREP. PEP stands for post-exposure prophylaxis used in an occupational setting. nPEP is non-occupational post-exposure prophylaxis. nPEP may be used in a recreational setting; for example, during intercourse, if the condom breaks and one partner is HIV-positive, nPEP will help to decrease the probability of spread of infection of HIV. PREP is often used in occupational settings, e.g., in hospital staff to prevent the spread of HIV or Hepatitis C from patient to staff. nPREP is a measure taken before exposure but in a non-occupational setting (non-occupational Pre-exposure prophylaxis); for example, injection drug users may seek nPREP vaccinations.
  • Polypill for prevention of e.g. cardiovascular disease

    Leading cause of preventable death
Main article: List of preventable causes of death

Leading causes of preventable death worldwide as of the year 2001.

Cause Number of deaths resulting (millions per year)
Hypertension 7.8
Smoking 5.0
High cholesterol 3.9
Malnutrition 3.8
Sexually transmitted infections 3.0
Poor diet 2.8
Overweight and obesity 2.5
Physical inactivity 2.0
Alcohol 1.9
Indoor air pollution from solid fuels 1.8
Unsafe water and poor sanitation 1.6

Leading causes of preventable deaths in the United States in the year 2000.

Cause Number of deaths resulting
Tobacco Smoking 435,000 deaths or 18.1% of the total deaths
Overweight and Obesity 365,000 deaths or 15.2% of the total deaths.
Alcohol consumption 85,000 deaths or 3.5% of the total deaths.
Infectious diseases 75,000 deaths or 3.1% of the total deaths.
Toxicants 55,000 deaths or 2.3% of the total deaths.
Traffic collisions 43,000 deaths or 1.8% of the total deaths.
Incidents involving firearms 29,000 deaths or 1.2% of the total deaths.
Sexually transmitted diseases 20,000 deaths or 0.8% of the total deaths.
Drug abuse 17,000 deaths or 0.7% of the total deaths.

See also


From Wikipedia, the free encyclopedia : Preventive health care (no health and safety guidance)
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