Prevention of Disease
Disease prevention can be defined as measures that seek to avert the occurrence of disease (including injury), arrest its progress, and reduce its consequences once it is established. Disease prevention can be classified into levels: primordial, primary, secondary, and tertiary prevention. Preventive interventions aim at interrupting the web of causality leading to one or more aspects of ill-health. They are directed at different phases in the development of disease, aiming at eradicating, eliminating, or minimizing its impact, or if none of this is feasible, retarding the progress of disease and disability.
Successful prevention depends upon –
- Knowledge of causation
- Dynamics of transmission
- Identification of risk factors and risk groups
- Facilities for these treatment procedures
- Evaluation and development of these procedures
- Early detection and treatment measures
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Disease prevention by regular physical activity has become more and more important. Its significance has been shown in various studies. Epidemiological and naturalistic as well as experimental studies demonstrate the risk-reducing and health-enhancing effects of regular physical activity. In particular, Yoga, aerobic and Zumba training seems to be effective in preventing cardiovascular diseases. The psychological benefits of physical activities are decreasing negative emotional states (e.g., anxiety) and increasing positive emotional states (e.g., vigor).
Whereas the effect of exercise on physical health can be explained by adaptation processes of the metabolic and cardiovascular system, the effects on mental health remain unexplained. Different kinds of hypotheses assume physiological (e.g., thermoregulation, endorphins), psychological (e.g., attention distraction, states of flow), or rather unspecific mechanisms (e.g., effort justification). Further research is needed to enlighten these mechanisms. However, it can be stated that physical exercise is an appropriate means for health promotion in most cases.
Health promotion and disease prevention along with effective patient education are essential components of practice for PAs in all settings. Providers should perceive all interactions with patients as potential opportunities to implement positive behavioral change of unhealthy behaviors. Starting with a meticulous history and physical examination that identify an individual’s risk or evidence of preventable disease, PAs should develop a strategy to implement all recommended interventions that are appropriate for the patient’s age and gender. Behavioral modification and patient education should consider unique circumstances and the patient’s readiness to adopt healthier lifestyles within a continuum of change.
Motivational interviewing strategies should be implemented to improve behavioral change outcomes. Health promotion and disease prevention strategies should be directed not only at individual patients but also at the community as a whole. Working with community groups and organizations to help provide a consistent message to the public on health promotion topics will provide reinforcement to the individual patient. Increasing exercise, appropriate diet, and smoking cessation along with immunizations, targeted screening histories, and examinations represent the mainstay of any successful health-promotion and disease-prevention effort.
Health promotion and disease prevention programs typically focus on enhancing wellness within one or more of these three health domains. Wellness becomes a philosophy of life that utilizes health promotion and disease prevention strategies to achieve the goal of optimal aging. Optimal aging implies maximizing one’s ability to function across physical, psychological, and social domains to one’s satisfaction and despite one’s medical conditions. The three overarching domains of physical, psychological, and social health are often further divided into dimensions. Frequently quoted view of wellness as a process with six interconnected wellness dimensions: physical, emotional, spiritual, social, occupational/vocational, and intellectual Wellness is generally accepted as a multidimensional entity, with inclusion of factors associated with physical, psychological, and social health making intuitive sense.
Even when exposure risk is minimal, it’s always a good idea to take reasonable precautions to help prevent the spread of disease in the workplace, at home and in the community at large.
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Pathogens can be transmitted through various means: airborne through coughing or sneezing, contaminated food sources, bodily fluids and secretions, and physical or sexual contact. Sanitary and sterile conditions are paramount in places where food is prepared and in medical offices or hospitals. It’s vital to remain personally vigilant against illness and infectious disease. You may want to reduce your silent inflammation that we all have to prevent disease and go for a health screening as well. In the meantime, here are several ways to reduce the odds of contracting sickness:
- Regularly wash hands with clean, warm to hot water.
- Maintain good hygiene with bathing and toilet habits.
- Smell-test and examine food before enjoying your meal. When in doubt, throw it out.
- Be familiar with foods that are recalled from store shelves due to link to infectious disease and know how to discard them from your home.
- Wash foods for cooking before enjoying them, including: vegetables, fruits and poultry, such as, chicken.
- Take the right over-the-counter medicines (OTC), get rest and drink plenty of fluids when sick. If obtaining OTC’s, it’s best to ask your physician or pharmacist for their recommendation.
- Avoid contact if at all possible with people who have symptoms or signs of illness.
- Stay home if you are sick.
- Do not delay in seeing your physician if your symptoms or signs get worse or don’t abate.
- Keep your living quarters and work space clean and disinfected.
- Avoid contact with common vectors of infectious disease: including flies, mosquitos, and ticks.
- If you notice flu-like symptoms, know that these symptoms are also linked to food borne illness which may lead to an infection. Be particularly mindful of this if you are ill, elderly or immune system compromised.
Vaccination: When a certain percentage of the population is immunized against a contagious disease (like the flu), everyone benefits from herd or community immunity, including those who are not candidates for immunization. Preventable diseases that seem to have largely been eradicated re-emerge when vaccination rates drop. Researchers are also looking into possible declines in vaccine potency.
Respiratory hygiene: This includes:
- Covering one’s mouth and nose when coughing or sneezing and promptly disposing of soiled tissues
- Keeping a distance of at least 3 feet from someone with symptoms such as sneezing, coughing, fever or vomiting
- Wearing surgical masks and personal protective equipment (PPE). For example, in certain workplaces (e.g., health care, hazardous waste cleanup and disposal, emergency response), PPE such as gloves, face pieces, respirators and body suits are used to prevent the spread of infection.
Additional recommended practices include:
- Disinfecting surfaces such as counter tops, phones and door handles
- Training, practice and observation related to donning and doffing PPE
Universal precautions include:
- Flushing mucous membranes immediately after contact with blood or OPIM or PPE removal
- Not eating, drinking, smoking, applying cosmetics or lip balm, or handling contact lenses in areas where there is a reasonable likelihood of occupational exposure to blood or OPIM
- Placing all intact needles and sharp objects in puncture-resistant, labeled, leak-proof containers
- Disposing any potentially contaminated waste in sealable bio-hazardous waste bags and containers
Standard precautions are based on the principle that all blood, body fluids, secretions and excretions (except sweat), non-intact skin and mucous membranes may contain transmissible infectious agents. Similar to universal precautions, standard precautions include hand hygiene, gloves, gown, mask, eye protection, total face shield and safe injection practices.
Gloves should be worn whenever there is the likelihood of contact with blood, non-intact skin, mucous membranes or OPIM, and when handling or touching contaminated items or surfaces. Disposable gloves and mouthpieces should not be washed or decontaminated for reuse.
Some of these measures may be perceived as an over-abundance of caution. However, if everyone does their part to help prevent the spread of disease, personal well-being, work and school absence rolls, over-burdened health care facilities, and cost-benefit analyses should reflect favorable results.
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- Activities designed to protect patients and other members of the public from actual or potential health threats and their harmful consequences.
- Disease prevention covers 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
Levels of Prevention :-
The concept of prevention is best defined in terms of levels of prevention.
- Primordial prevention
- Primary Prevention
- Secondary prevention
- Tertiary prevention
- Quaternary prevention
- Primordial Prevention –
It consists of actions and measures that inhibit the emergence and establishment of environmental, economic, social and behavioral conditions, cultural patterns of living known to increase the risk of disease
- Mainly associated with chronic diseases
- Intervention – Individual and mass education
- Has to start in childhood when health risk behavior begins
Examples of Primordial prevention –
National program and policies on :
- Food and Nutrition
- Against smoking and drugs
- To promote regular physical activity
Responsibility of Primordial prevention –
- Parents, Teachers and Peers group: Imparting health education
- Government : Legislating and enacting laws
- Professional and nonprofessional organizations
- Hospitals, Health practitioners and health care workers
- Primary Prevention –
- Action taken prior to the onset of disease, which removes the possibility that a disease will ever occur
- Intervention – Pre-pathogenesis stage of disease
- Concept of positive health – An acceptable level of health that will enable every individual to lead a socially and economically productive life
- Approaches for primary prevention for chronic diseases :
Population (mass) strategy –
Directed at whole population irrespective of individual risk levels
Directed towards socio-economic, behavioral and lifestyle changes
High risk strategy –
To individual at special risk
Population approach –
High risk approach –
Achievements of primary prevention –
Controlling disease like cholera, typhoid, plague, dysentery, and T.B., by raising standard of living
Modes of intervention :
- Health promotion
- Specific protection
Health promotion –
Process of enabling people to increase control over and to improve health
Not directed against any particular disease
Intervention in this area :
- Health education
- Environmental modifications
- Nutritional interventions
- Lifestyle and behavioral changes
Values in health promotion :
- Equity and social justice
- A holistic definition of health
- Covers a full range of health determinants
- Recognizes influence of environment on health
- Seeks to enhance people’s social participation
- Involves inter-sectoral Collaboration
- Secondary prevention –
- Action which halts the progress of the disease at tis incipient stage
- Intervention – early pre-prognosis stage
- It is the domain of clinical medicine
- Modes of intervention :
- Early diagnosis
- Adequate / prompt treatment
- Seeks out unrecognized disease
- Provides treatment before irreversible changes occur
- Reverses communicability of infectious disease
- Protects community
- Tertiary Prevention
All measures available to reduce or limit impairments and disabilities, minimize sufferings caused by existing departure of good health and to promote the patients adjustment to irremediable conditions.
Intervention – Late pathogenesis stage
Modes of intervention –
Disability limitation : To prevent or halt the transition of disease of disease process from impairment to handicap
Rehabilitation : The combined and co-ordinated use of medical, educational, social and vocational measures for trainings and re-training the individual to the highest possible level of functional ability
Requires cooperation from different sections of society
The action taken to identify patient at risk of over-medicalisation, to protect him from new medical invasion, and to suggest to him interventions, which are ethically acceptable.
Quaternary prevention is the set of health activities to mitigate or avoid the consequences of unnecessary or excessive intervention of the health system
Quaternary prevention should precedence over any alternative preventive, diagnostic, and therapeutic, as is the practice version ‘primum non nocere’
Intervention types –
- Do not mistake risk factors with disease
- To avoid check ups or unnecessary exams
- To avoid technical interventionism in healthcare
- To avoid the indiscriminate use of antibiotics
- Understanding disease pathology is the first step towards formulating preventive measures
- Prevention can be achieved in any stage of disease
- Primordial or primary prevention is most effective and economical
- Disease control is also a part of prevention which is achieved by means of continuous monitoring and surveillance of disease.
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One of the best ways to maintain your health is by taking care of yourself. If you want to live a healthy lifestyle and enjoy your old age without being injected with several different kinds of shots, then change your daily lifestyle because even the simplest little healthy modification can cause great benefits.
Though it is difficult to put health and fitness as a top priority in this rat race day and age, it’s best to start with baby steps will surely peak your health tremendously.
- Pump up nutrition
- Get outdoors
- Ease Stress
- Stop nose picking
- Stretching is important
- Breathe the right way
- Bathing daily atleast once is good
- Cut your nails regularly
- Avoid sharing personal items
- Say no to sugary items
- Sweat it out
- Stop worrying
- Quit smoking
- Stay safe while having sex
- Respect your body and yourself
- Know your risks
- Maintain a healthy blood pressure
- Monitor your cholesterol
- Limit your calories
- Stay informed about health
- Maintain healthy diet
- Keep your brain active
- Reduce alcohol intake
Recommended medical check up
- Yearly check-up (every other year if no health risks)
- Yearly dental exam
- Skin Check
- Cholesterol Check
- Monthly breast self-exams
- Yearly Pap smear/OBGYN visit after the age of 18 or when sexual activity begins
- Mammogram initially by age 40; high risk by age 35
- Colonoscopy initially by age 40; high risk by age 35
- Bone density test
Super foods that fight disease –
These nutrient-packed foods can help ward off ailments ranging from heart
disease to the common cold. Powerhouse of Fiber, Vitamins, Minerals and Anti oxidants
- Alfalfa Sprouts
- Cranberries / Strawberries / Blackberries
- Sweet Potatoes
- Dairy foods
- Fatty fish
- Dark leafy greens
- Whole grains
- Beans / Black beans
- Nuts – cashews,
- Oats and barley
- Citrus fruits
All above powerhouses are mentioned in our earlier posts / blogs
Myths about disease prevention
Highly publicized disease outbreaks in the last decade have put people on edge, and they look to healthcare facilities for knowledge on how to prevent the spread of disease. Here are some lingering myths about disease prevention that are important to dispel.
Myth #1 – Antibacterial is always better : Antibacterial products are everywhere: from soap to cleaning products, public, private, and professional spaces are inundated with products that claim to kill most to all harmful bacteria on a surface when used. This may sound like the best way to prevent the spread of disease, but can actually cause more problems than it solves.
The first danger is the simple fact that not all infectious diseases are caused by bacteria. Illnesses that are caused by viruses are not affected by antibacterial products at all, and frequent use of these products can create a false sense of security that can backfire in the case of a viral outbreak.
The second, and perhaps most widely known, danger of antibacterial products is their contribution to creating bacterial resistance. Widespread use of antibacterial chemicals allows bacteria to develop resistances more quickly, making it harder to treat infections and illnesses.
Myth #2 – Hand sanitizer cleans your hands : Across the country due to awareness campaign hand sanitizer usage have increased by healthcare professionals and everyday consumers alike. While alcohol-based hand sanitizers do reduce microbe levels quickly and effectively, they are not the convenient solution to infection control and disease prevention that many people think.
Hand sanitizers do just that – sanitize – and can’t remove dirt, grime, oil, or grease that can harbor infectious microbes. So washing your hands with soap and water is still the best way to eliminate germs on your hands.
Myth #3 – A daily dose of a vitamin C supplement will prevent the onset of the common cold : Researchers have concluded that prophylactic vitamin C does not reduce the incidence of colds in the general population, but may be useful in reducing incidence of colds for people exposed to brief periods of severe physical exercise.
Myth #4 – Sodium Phosphate can detox the kidneys : Sodium phosphate is used to clean out your colon before a test, and pills can be used for constipation. Sodium phosphate is also used in processed foods to keep them fresh. But it certainly doesn’t detox your kidneys! In fact, taking sodium phosphate as a drug can be dangerous for people with kidney disease.
Myth #5 – Hydration is the key to prevent Kidney disease : While drinking enough water is a great way to help your everyday health, it is just one way of keeping your kidneys healthy. Some people think that the more water they drink the better, but there is such a thing as drinking too much water which can lead to low blood sodium levels. So, while drinking water is important to keep your body healthy and happy, don’t overdo it and don’t’ rely on hydration alone.
Myth #6 –If I already have heart disease, I shouldn’t exercise : Exercise has countless health benefits, one of which is strengthening your heart and increasing blood flow throughout the body.
If you have heart disease, talk to your doctor about the safest exercises you can do to maintain your heart health. Walking might be the best option, because it is low-impact but still lowers your risk for high blood pressure, cholesterol and diabetes, some of the main risk factors for heart disease.
Myth #7 – I have a family history of heart disease, so I’m destined to have it too : Genetic factors can increase your risk for heart disease, but that doesn’t mean you’re predestined to experience it. However, it does mean that prevention is more critical.
If you have a family history of heart disease, eating a balanced diet, not smoking, getting regular exercise and regularly checking your blood pressure and cholesterol are all important preventative measures you must take to reduce your risk.
Myth #8 – I’m having chest pain, it must be a heart attack : This is probably one of the most common myths about heart disease. Yes, chest pain is a symptom of heart attacks, but everyone who has a heart attack experiences different symptoms, such as excessive sweating, pain in both arms, the neck or jaw, or even feelings of light headedness and difficulty sleeping. You may experience pain in other body parts because the heart transmits it to these areas, since it doesn’t have as many pain receptors itself.
Myth #9 – I don’t need to worry about my salt intake : Most people’s daily salt intake is five times higher than what they actually need. Processed, canned and restaurant foods typically contain high levels of sodium, which raises your blood pressure and thereby increases your heart disease risk.
Myth #10 – I am young. I don’t need to worry about heart disease : Heart disease is more common among older adults, but how you treat your heart now could have long-term consequences for how it functions later. If you smoke, are overweight or have diabetes, this can increase your risk for heart disease—no matter what age you are. Start practicing health habits today to maintain your heart health for the future.
Myth #11 – Only old people get heart disease : While it’s true most cardiovascular diseases are diagnosed in people above age 45, let me assure you – the heart damage started well before age 45. Fact is heart disease can impact anyone at any age.
Myth #12 – Avoid saturated fat for a healthy heart : The widely held belief that saturated fats lead to coronary artery disease is just plain wrong. Do your own research. You’ll find that saturated fats are good for your heart.
Myth #13 – Surgery “FIXES” your heart : Surgery simply repairs a problem. It does not cure the cause of the problem. Actually nothing is cured. Your heart is not fixed. A problem has been repaired. Stent implant open blockages caused by plaque buildup.It opens the artery, but does not fix the cause of the plaque buildup.
Myth #14 – You can eat what you want if you take your heart medicine : Heart medications, or medications to treat high risk diseases that lead to heart disease, are not cures for the problem. Medications simply regulate symptoms. You must control what you eat to control your health.
Myth #15 – You’ll know if you ever have a heart attack. The chest pain will be unbearable : A lot of people, especially women, don’t have crushing chest pain but rather unusually bad fatigue, jaw or back pain or sleep disturbances instead.
Myth #16 – I don’t have cavities so I don’t have gum disease : Being cavity-free doesn’t ensure you are in the clear where gum disease is concerned. That’s because gum disease is painless and many people have no idea they have it. Gums that bleed easily or are red, swollen or tender is a sign of gingivitis, the earliest stage of gum disease and the only stage that is reversible.