Lecture 32: Prevention

Question 1

What is epidemiology?

Answer 1

The study of the occurrence and distribution of health-related events, states or processes in specified populations, including the study of the determinants influencing such processes and the application of this knowledge to control relevant health problems

Question 2

What is the study of public health?

Answer 2

The science and art of preventing disease, prolonging life and promoting health through organised efforts of society

Question 3

Name the 3 levels of prevention:

Answer 3

Primary
Secondary
Tertiary

Question 4

What is primary prevention? Include an example:

Answer 4

Interventions that attempt to prevent disease from occurring i.e. reduce the incidence of disease
Examples:
* Immunisation to prevent measles
* Excise tax on alcohol to reduce the incidence of cancer, unintentional injury, domestic violence, liver disease

Question 5

What is secondary prevention? Include an example:

Answer 5

Reduce impact of disease by shortening its duration, reducing severity or preventing recurrence
* Cure, or stop progression once condition has been initiated
* May involve earlier diagnosis and treatment
Example:
Cervical cancer screening

Question 6

What is tertiary prevention? Include an example:

Answer 6

Reduce the number or impact of complications; improve rehabilitation
Examples:
* Specialist stroke rehabilitation units
* Diabetes monitoring and treatment programs

Question 7

What are the 2 strategies for primary prevention?

Answer 7

1. High risk (individual) strategy: Individuals in special need are identified.The preventive process controls the level of exposure or provides protection against the consequences of the exposure in this high risk group
2. Population (mass) strategy: Aims to reduce the health risks of the entire population

Question 8

Give an example of a population (mass) approach for preventing car crash injuries:

Answer 8

• Low legal blood alcohol concentration limit
• Random breath testing
• Seat belt law
• Improved engineering of roads
• Median barriers
• Safety standards for cars

Question 9

Give an example of a high risk (individual) approach for preventing car crash injuries:

Answer 9

• Loss of licence for speeding/drink driving
• Ignition interlocks

Question 10

What are the advantages and disadvantages of population (mass) strategy?

Answer 10

Advantages:
* Radical
* Large potential for whole population
* Behaviourally appropriate (i.e. establishes norms)
Disadvantages:
* Small benefit to individuals
* Poor motivation of individuals
* Benefit-to-risk ratio may be low for individuals

Question 11

What are the advantages and disadvantages of high risk (individual) strategy?

Answer 11

Advantages:
* Appropriate to individuals
* Individual motivation
* Clinician motivation
* Favourable benefit-risk ratio for individuals
Disadvantages:
* Need to identify individuals
* Might be against population norms - stigma, discrimination
* Can be hard to sustain behavioural change

Question 12

What is prevention paradox?

Answer 12

A preventive measure that brings large benefit to the community may offer little to each participating individual.

A large number of people at small risk may give rise to more cases of disease than the small number who are at high risk