NEW DIRECTIONS FOR HEALTH: DISEASE PREVENTION

Most documents that discuss health promotion typically include the term disease prevention. What does this term really mean? Historically, three major types of prevention have been described in the health literature. In a general sense, prevention means taking positive actions now to avoid becoming sick later. Getting immunized against diseases such as polio, never starting to smoke cigarettes, practicing safer sex, and similar preventive actions constitute primary prevention - actions designed to reduce risk and avoid health problems before they start. Secondary prevention (also referred to as intervention) is the recognition of health risks or early problems before they lead to actual illness and taking action to prevent, or intervene, to stop the behavior or reduce risk before the disease gets a foothold. Getting a young smoker to quit or reduce the number of cigarettes smoked during the early stages of smoking behavior through some form of behavioral program is an example of an intervention, or secondary prevention. Because two of every three deaths and one of every three hospitalizations in the United States are linked to preventable lifestyle behaviors, such as tobacco use, sedentary lifestyle, alcohol consumption, and overeating, primary and secondary prevention offers our best hope for reducing the incidence (number of new cases) and prevalence (number of existing cases) of disease and disability.

It is clear that we need to move from a mind-set of tertiary prevention (treatment and/or rehabilitation after the person is already sick and typically offered by medical specialists) and focus more on the role of prevention specialists and prevention programs. Health educators in U.S. schools and communities offer an affordable and effective delivery of prevention and intervention programs. Certified Health Education Specialists (CHES) make up a trained cadre of public health workers with special credentials and competencies to plan, implement, and evaluate prevention programs that offer scientifically sound, behaviorally based methods to help you and members of the community increase the likelihood of success. As a nation that historically spends little on prevention (less than 5 percent of our total national funding for health goes to prevention), however, such a shift has been and will continue to be difficult.

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