Dr. Sandra El Hajj-MSc, N-MD, DHSc
The promotion of health and well-being has always been the goal of medical science—aimed at reducing the ascending burden of morbidity and mortality worldwide, especially when it comes to preventable diseases. According to the Center for Disease Control and Prevention, chronic diseases are the leading cause of healthcare costs in the United States.
Diseases such as cancer, diabetes, stroke, coronary diseases, respiratory diseases and other long-term illnesses are usually associated with suffering, large numbers of deaths, high healthcare costs and reduction of functions. These diseases bring about a long-term effect, and could even extend throughout a person’s lifetime. Interestingly, many of these chronic diseases are actually preventable.
The goal of preventive medicine is to develop and implement practices that promote health in general and prevent the occurrence of disease.
Preventive medicine is an interdisciplinary branch of medicine that primarily focuses on individuals and communities through the advancement of health and well-being. It prevents the occurrence of sickness by protecting, promoting and maintaining all aspects of health.
Preventive medicine does not just investigate the causes of disease, but also focuses on the patient as a whole, taking into account the many factors influencing his or her health. While the medical field sees the cause and effect of diseases, preventive medicine sees beyond physical health. It considers elements of socioeconomics, community settings, health policies, access to health equity, and the disparities among communities and populations.
This is why the implementation of preventive medicine should be focused on the population-based epidemiology of diseases, a person’s socioeconomic status and his or her access to healthcare that can be varied even within a specific population. A strategy that is effective for one group may not be as effective to another, especially when influenced by education and access to care(1).
Preventive medicine can be practiced in both clinical and non-clinical settings.
Preventive medicine covers a broad target which includes the following:
Healthcare industries generate enormous amounts of patient and disease data that has to be analyzed, processed and interpreted to provide insights significant for decision making. Biostatistics holds the key to unlocking the data gathered. It explains the gap that must be reconciled when epidemiologic data are analyzed and interpreted through biostatistics(2).
For example, to prevent the transmission of HIV within a community, preventive medicine either assesses existing programs or promotes methodologies that will lessen the burden. Some of their tools would include how HIV is transmitted, who is at risk, how frequently it occurs and the existing knowledge, attitudes and practices of individuals about the disease gathered through research procedures. Without utilizing such data, the preventive procedures advocated for preventing HIV can be rendered useless and may not prevent HIV spread. Based on the outcome, public health policies and preventive healthcare measures can be developed (3).
The successful implementation of preventive medicine in communities depends on effective health services management and administration. This includes developing, assessing and assuring health policies. It also covers intensive planning, implementing, directing, budgeting and evaluating population health and disease management programs, as well as utilizing legislative and regulatory processes to enhance health as a whole.
To prevent certain diseases, preventive measures must be in place. For example, to prevent the spread of SARS-CoV-2, the causative agent of COVID-19, health authorities carefully planned, developed and implemented preventive measures such as social distancing practices, wearing masks and promotion of hand-washing among the public. Without efficient leadership and management, the transmission of such disease may be uncontrolled.
Preventive medicine looks at environmental factors that may adversely affect the health of individuals and the community as a whole. One key advantage of preventive medicine is its ability to tackle both the seen and unseen causes of diseases that may be attributed to the environment. Some potential environmental factors that may affect health include physical factors such as air, water and land pollution; toxic chemicals such as lead, mercury, pesticides and other chemicals; and biologic sources such as bacteria, viruses, parasites and fungi.
To prevent the incidence of certain diseases, preventive medicine also addresses occupational factors that may adversely affect health and safety, including those that may lead to disability. Policies in place to prevent occupational diseases and accidents are attributed to the implementation of preventive medicine.
For example, health professionals are considered the high-risk group that may acquire COVID-19. At the same time, they’re the most potent group that may transmit the SARS-CoV-2 to the community because of their frequent exposure to the virus. Preventive medicine comes into play to control this, as evidenced by the implementation of standard operating procedures and guidelines to prevent the transmission of the disease to both health workers and the community. These guidelines include proper wearing and disposal of PPEs, the establishment of hospital triage areas, patient isolation, quarantine procedures and correct testing protocols.
Preventive medicine does not just focus on the disease, but also includes measures to promote overall health and prevent the occurrence, progression, and disabilities from disease and injury. This is done while taking into consideration the influences inflicted by social, cultural and behavioral factors, unique to each individual and population.
It’s better to try to keep an unwanted situation from happening than fixing it once it has happened. The proverb, “An ounce of prevention is worth a pound of cure” proves to be one of the most valid explanations of why preventive medicine is important. It is more difficult to manage diseases once they occur than it is to practice preventive measures to avoid them in the first place. This is particularly true for chronic diseases, which are associated with long-term suffering for the patient and family care-provider, large numbers of deaths and high healthcare costs.
Chronic diseases can significantly reduce the quality of life for both patients and their families as well as the involved community. They have a profound impact on the enjoyment of life, relationships, quality of work, and finances. Most chronic diseases are considered preventable diseases.
The Centers for Disease Control and Prevention (CDC) lists the five leading causes of death in the United States as heart disease, cancer, chronic lower respiratory disease, stroke, and unintentional injuries which can be prevented by healthier lifestyle choices, habits and practices(4).
According to the CDC, chronic diseases such as diabetes and heart disease account for seven out of ten deaths, making early screening and detection so critical. This makes preventive medicine very important in avoiding disease burden and premature death.
There are three different types of preventions: primary, secondary and tertiary. Every level has its own characteristics and is essential at a certain level of disease.
Effective implementations of these interventions, combined with positive lifestyle changes, can greatly reduce the incidence of chronic disease as well as the disability and death accompanying many chronic diseases.
The goal of preventive medicine is the absence of disease, either by preventing its occurrence or by halting its progression. This can be advocated by governmental agencies, primary care physicians, and individuals themselves. However, the present challenge of preventive medicine is to motivate individuals and communities to consistently practice a healthy lifestyle and take safe environmental measures.
For prevention to be most effective, it must involve multiple stakeholders and sectors across an individuals’ lifetime. Healthy habits such as eating healthier and nutritious foods, exercising, avoiding toxic chemical exposure from unhealthy products, avoiding tobacco use, and avoiding exposure to pollution can help individuals stay healthy, avoid disease, or reduce the effects of the disease. In the next article of this two-part series on preventative medicine, we’ll discuss the most important preventative tests to be aware of in your lifelong preventative care plan.