Preventative healthcare


Preventive healthcare consists of measures taken for disease prevention.



It is recognized disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices.



These are dynamic processes which begin before individuals realize they are affected. 



Disease prevention is categorized as primal, primary, secondary, and tertiary prevention.



About half of all deaths are  due to preventable behaviors and exposures.



The leading causes of death include: cardiovascular disease, chronic respiratory disease, unintentional injuries, diabetes, and certain infectious diseases.



It is estimates that 400,000 people die each year in the United /States due to poor diet and a sedentary lifestyle.



Epigenetics, demonstrates the importance of environmental conditions – both physical and affective on the organism during life.



Primordial prevention refers to measures designed to avoid the development of risk factors in early in life.



Primary prevention to avoid disease either through eliminating disease agents or increasing resistance to disease: immunization against disease, maintaining a healthy diet and exercise regimen, and avoiding smoking.



Secondary prevention detects and addresses  diseases prior to the appearance of symptoms:


treatment of hypertension, and cancer screenings.



Tertiary prevention intends to reduce the harm of symptomatic disease, such as disability or death, through rehabilitation and treatment, surgical procedures that halt the spread or progression of disease.



Quaternary prevention refers  to mitigate or avoid results of unnecessary or excessive interventions in the health system.



Primordial prevention refers to measures to prevent the development of risk factors early in life,and even preconception.



Primordial prevention refers to actions and measures to inhibit the emergence and establishment of adverse environmental, economic, and social conditions.



Primary prevention consists of health promotion and specific protection recommendations: eating healthy meals and exercising daily to prevent disease and create a sense of overall well-being. 



By preventing disease and creating well-being, results in prolonged  life expectancy.



Food is the most basic tool in preventive health care. 



Difficulty with paying for food, medicine, or both is a problem facing 1 out of 3 Americans. 



Scientific advancements in genetics has facilitated evaluation of carriers of a disease gene or have an increased predisposition to a specific disease. 



Protective measures:water purification, sewage treatment, personal hygiene routine efforts, such as regular hand-washing, and safe sex have decreased the rates of communicable diseases.



Secondary prevention attempts to prevent an asymptomatic disease from progressing to symptomatic disease.



Primary prevention addresses the root cause of a disease or injury process.



Secondary prevention aims to detect and treat a disease early on: early diagnosis and prompt treatment to contain the disease , and prevent potential future complications and disabilities from the disease.



Tertiary prevention attempts to reduce damage caused by symptomatic disease.



Tertiary prevention maximizes the remaining capabilities and functions of an already disabled patient.



Tertiary prevention focuses  on mental, physical, and social rehabilitation. 



Goals of tertiary prevention include: preventing pain, further disease damage, halting complications from disease, and restoring the health and functions of the individuals affected by disease.



The leading cause of death in the United States is tobacco.



Poor diet and lack of exercise may soon surpass tobacco as a leading causes of death. 



Leading causes of preventable deaths in the United States:



Tobacco smoking



Poor diet 



Physical inactivity



Alcohol consumption



Infectious diseases






Traffic collisions



Firearm incidents



Sexually transmitted infections



Drug abuse



Leading causes of preventable death worldwide: 









High cholesterol






Sexually transmitted infections



Poor diet



Overweight and obesity



Physical inactivity






Indoor air pollution from solid fuels


Unsafe water and poor sanitation



Child mortality- about 64% are due to infection including diarrhea, pneumonia, and malaria.



About 40% of childhood  deaths occur in neonates (children ages 1–28 days) due to pre-term birth complications.



The highest number of child deaths occur in Africa and Southeast Asia.



Child mortality is related to  by poverty, environmental hazards, and lack of maternal education.



Leading preventive interventions reducing deaths in children 0–5 years old worldwide:






Insecticide-treated materials 



Complementary feeding






Clean delivery 



HBV vaccine



Water, sanitation, hygiene



Antenatal steroids



Newborn temperature management


Vitamin A



Tetanus toxoid



Antibiotics for premature rupture of membranes



Measles vaccine



Antimalarial intermittent preventive treatment in pregnancy



Obesity is a major risk factor for:  cardiovascular diseases, hypertension, certain cancers, and type 2 diabetes. 



Obesity prevention: adhere to a consistent exercise regimen, and a nutritious and balanced diet. 



To prevent obesity diet should aim for acquiring 10% of their energy from proteins, 15-20% from fat, and over 50% from complex carbohydrates, while avoiding alcohol as well as foods high in fat, salt, and sugar.



Adults should aim for at least half an hour of moderate-level daily physical activity and eventually increase to include at least 20 minutes of intense exercise, three times a week.



Ninety to 95 percent of people with diabetes have type 2 diabetes. 



Diabetes is the main cause of kidney failure, limb amputation, and new-onset blindness.



Sexually transmitted infections (STIs), are preventable with safe-sex practices. 



Condoms are highly effective at preventing disease, and can prevent STIs.



Post-exposure antiviral prophylaxis, started within 72 hours after exposure to high-risk fluids, can also protect against HIV transmission.



Thrombosis affects thousands, usually older persons undergoing surgical procedures, women taking oral contraceptives and travelers. 



Prevention can include: exercise, anti-embolism stockings, pneumatic devices, and pharmacological treatments.



Primary prevention of cancer can reduce over one third of all cancer cases. 



Between 25% and 40% of all cancer deaths and about 90% of lung cancer cases are associated with tobacco use. 



Both smoking and second-hand exposure from other smokers can lead to lung cancer.



 The prevention of tobacco use is paramount to prevention of lung cancer.



90% of adults in the US who have ever smoked did so prior to the age of 20. 



Cancer screening programs for lung cancer are advantageous.



Lung cancer and tobacco smoking are increasing worldwide, especially in China. 



China is responsible for about one-third of the global consumption and production of tobacco products.



Actions to reduce tobacco use include: decreasing tobacco supply, increasing tobacco taxes, widespread educational campaigns, decreasing advertising from the tobacco industry, and increasing tobacco cessation support resources.



Skin cancer is the most common cancer in the US.



Childhood prevention of skin cancers is particularly important: ultraviolet radiation exposure from the sun occurs during childhood and adolescence and can subsequently lead to skin cancer in adulthood. 



The CDC recommends: limiting sun exposure between 10 AM and 4 PM, when the sun is strongest, wearing tighter-weave natural cotton clothing, wide-brim hats, and sunglasses as protective covers, using sunscreens that protect against both UV-A and UV-B rays, and avoiding tanning salons.



Cervical cancer ranks among the top three most common cancers among women in Latin America, sub-Saharan Africa, and parts of Asia. 



Cervical cytology screening shown to reduce cervical cancer rates by up to 80%, most developed countries now encourage sexually active women to undergo a Pap test every 3–5 years. 



Colorectal cancer is globally the second most common cancer in women and the third-most common in men, and the fourth most common cause of cancer death after lung, stomach, and liver cancer.



Colorectal cancer is  highly preventable; about 80 percent of colorectal cancers begin as benign polyps, which can be easily detected and removed during a colonoscopy. 



Methods of screening for polyps and cancers include fecal occult blood testing. 



Lifestyle changes to reduce the risk of colorectal cancer include:  increasing consumption of whole grains, fruits and vegetables, and reducing consumption of red meat.



In the United States, elderly adults receive, worse care and had less access to care than their younger counterparts. 



All racial minorities  compared to white patients, and low-income compared people to high-income people receive less care: lack of income and education, language barriers, and lack of health insurance. 



Disadvantaged groups should have regular access to a primary care provider, receive immunizations, or receive other types of medical care.



Uninsured people tend to not seek care until their diseases progress to chronic and serious states and they are also more likely to forgo necessary tests, treatments, and filling prescription medications.



Decades of gaps exist in life expectancy between developing and developed countries. 



Japan has an average life expectancy that is 36 years greater than that in Malawi.



Low-income countries also tend to have fewer physicians.



Barriers to health care  include lack of availability of health services,  healthcare providers, great physical distance between the home and health service facilities, high transportation costs, high treatment costs, and social norms and stigma.



Americans spend over three trillion a year on health care but have a higher rate of infant mortality, shorter life expectancies, and a higher rate of diabetes than other high-income nations because of negative lifestyle choices.



Very little is spent on prevention for lifestyle-caused conditions in comparison. 



Chronic illnesses predominate as a cause of death.



Treating chronic illnesses are complex and multifaceted, suggesting prevention is a best approach to chronic disease.



To assess the cost-effectiveness of prevention: the cost of the preventive measure, savings from avoiding morbidity, and the cost from extending the lifespan are considered.



Prevention leads to savings only if the cost of the preventive measure is less than the savings from avoiding morbidity and the cost of extending the life span. 



Preventive measures that aid a large portion of the population to bring about cumulative and widespread health benefits at a reasonable cost is the goal.



Obesity in childhood impairs cognitive achievement and academic performance. 



Obese children tend to become obese adults with associated increased risk for a chronic condition such as diabetes or hypertension.



Preventive care can lead to improved health outcomes and cost savings.



Preventive care is applicable to people of every age. 



The use of preventive services are about half the recommended rate due to cost-sharing: deductibles, co-insurance, copayments, also reduce the likelihood that preventive services will be used.



Preventive care services mainly focus on chronic disease.



Chronic diseases such as heart disease, stroke, diabetes, obesity and cancer are  the most common and costly health problems in the US.



Chronic diseases are among the top ten leading causes of mortality.



Chronic diseases are driven by risk factors that are largely preventable: 


almost half were attributed to preventable behaviors including tobacco, poor diet, physical inactivity and alcohol consumption.



 Heart disease and cancer alone accounted for nearly 46% of all deaths.



Childhood immunizations are largely responsible for the increase in life expectancy in the 20th century. 



Health disparities are increasing in the United States for chronic diseases such as obesity, diabetes, cancer, and cardiovascular disease. 



Without targeted preventive healthcare interventions medical costs from chronic disease inequities will become unsustainable. 



Recommendations from the Institute of Medicine suggest that concerted action be taken: physical activity, food and beverage, marketing and messaging, healthcare and worksites, and schools, government, business and industry, child care, urban planning, recreation, transportation, media, public health, agriculture, communities, and home,  in order for obesity prevention efforts to truly be successful.



Vaccinations form part of the standard preventative health initiatives: diphtheria tetanus pertussis poliomyelitis, measles, mumps, rubella, haemophilus influenzae type b, hepatitis B, influenza, and pneumococcal infections.





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