Lecture 33: Prevention Flashcards
What part of the definition of epidemiology related to prevention?
… the application of this knowledge to control relevant health problems
Define public health
the science and art of preventing disease, prolonging life and promoting health through organised efforts of society
What are the three levels of prevention?
- primary
- secondary
- tertiary
What is meant by a primary level intervention?
Interventions that attempt to prevent disease from occurring ie. they reduce the incidence of disease
What is meant by secondary level of prevention?
reducing the impact of disease by shortening its duration, reducing severity or preventing recurrence for people who already have the disease
What is meant by tertiary level prevention?
reducing the number of impact of complications; improve rehabilitation
Give three examples of primary prevention
- sleeping babies on their backs to prevent SIDS
- immunisation to prevent measles
- excise tax on alcohol to reduce the incidence of cancer, domestic violence, liver disease
What does secondary prevention cure or stop, and what may it involve?
- it cures or stops progression once the condition has been initiated
- it may involve an earlier diagnosis and treatment
Give two examples of tertiary stroke rehabilitation
- specialist stroke rehabilitation
- diabetes monitoring and treatment programs
What could be a primary prevention for myocardial infarction?
education and opportunities to exercise more and eat less salt and saturated fat
What could be a secondary prevention for myocardial infarction?
treatment of blood pressure, lipids and clotting in people who have had a heart attack
What could be a tertiary prevention for myocardial infarction?
assistance with getting back to work
What could be some factors to address primary prevention of car crash injuries? Give examples of preventions to do with each of these factors
- alcohol related factors such as lowering the legal blood alcohol concentration
- the roads themselves as a factor such as improving the road engineering
- seatbelt laws
- rules about new drivers
What could be a secondary prevention for car crash injuries?
compulsory alcohol treatment after drink driving crash
What could be a tertiary prevention of car crash injuries?
psychological support
What are the two strategies for primary prevention?
- high risk/individual strategy
- population/mass strategy
What is the difference between individual and mass strategies?
individual strategy identifies individuals who are at risk then the prevention intervention is applied to them whereas mass strategy aims to reduce risks of the entire population
What would be a population approach to prevent myocardial infarction?
increasing the price of tobacco
What would be a population approach to prevent car crash injuries?
lowering the legal blood alcohol concentration limit
What would be an individual approach to prevent myocardial infarction?
targeted education and opportunities to exercise more eat less salt and saturated fat
What would be an individual approach to prevent car crash injuries?
loss of licence for speeding/drink driving
What are some advantages of mass strategy?
- radical
- large potential for whole population
- behaviourally appropriate
What are some disadvantages of mass strategy?
- small benefit to individuals
- poor motivation of subject
- benefit-to-risk ratio may be low for individuals
What are some advantages of individual strategy?
- appropriate to individuals
- subject motivation
- clinician motivation
- favourable benefit-risk ratio for individuals
What are some disadvantages of individual strategy?
- need to identify individuals
- might be against population norms
- can be hard to sustain behavioural change
Define prevention paradox
A large number of people at small risk may give more rise to more cases of the disease than the small number of people who are at high risk. This means a preventive measure that brings large benefit to the community may offer little to each individual
