Chapter 12

Health Promotion and Disease Prevention

Teri KampwerthTara McKean

Improve and control overall health Promote general well-being through a

healthy lifestyle Differentiate between primary, secondary

and tertiary disease prevention Responsibility for intervention

Key Points

Prevalence Causes Complications How health care professionals can help Cultural Competence

Health Literacy

Protect, maintain, and restore

Promotion of good health practices

Health Promotion

World Health Organization (WHO) Promoting development Fostering health security Strengthening health systems Harnessing research, information and

evidence Enhancing partnerships Improving performance

Goal 1: ◦ Increase Quality and Years of Healthy Life 

Goal 2: ◦ Eliminate Health Disparities

Focus Areas

Healthy People

Exercise and fitness; Diet, nutrition, and eating right; Healthy lifestyle; Vaccination and immunization; Health screenings; Family planning; Mental health and mental disorders; Educational and community-based

programs

Lifestyle Objectives

Cancer Heart Disease Alcohol and Drug Use Cardiovascular and Cerebrovascular Diseases

Effects of Negative Lifestyles

Montana Meth Project

The Fun Theory

The Campaign to End Obestity

Self-awareness Aggressiveness

Availability & Utilization

Occupational safety and health; Environmental health; Food safety; Oral health

Health Protection

Healthy people living in every stage of life Healthy people in healthy places Healthy people in a healthy world People prepared for emerging health threats

Health Protection Goals

U.S. Preventive Services Task Force◦ Screening◦ Counseling◦ Preventive medication

Availability & Utilization

Overseeing the maintenance of safe living and working environments such as:◦ pure water;◦ clean air;◦ safe food;◦ drug products;◦ appropriate waste disposal;◦ elimination of hazardous situations; and◦ reduced risk of automobile accidents

Cont’d.

Primary

Secondary

Tertiary

Disease Prevention

Who offers disease prevention?

How are prevention strategies being used?

Availability and Utilization

Cynical of outcome Suspicious about pricing

Skepticism and Cost-Effectiveness

1. Applying Existing Knowledge2. Assigning Responsibility3. Addressing the Issues

Issues with the 3 P’shealth PROTECTION, disease PREVENTION, health PROMOTION

Americans receive enough information◦ Media◦ Peers◦ Healthcare Professionals

Applying Existing Knowledge

Who should be held accountable for taking action?

Dietician Society Individual Physician Government

= The Individual

Assigning Responsibility

Epidemiologic transition

• 1970’s = communicable/contagious diseases• Today = epidemic disorders

Addressing System Issues

Reorientation toward primary care

Specialist versus Generalists

Allergy/ Immunology - $158,000 Ambulatory - $  80,000 Anesthesiology: General - $207,000 Anesthesiology: Pain Management - $315,000 Cardiology: Interventional - $290,000 Critical Care - $187,000 Dermatology - $ 195,000 Emergency Medicine - $192,000 Endocrinology - $171,000 FP (w/o OB) - $161,000 FP - Sports Medicine - $ 152,000FP - Urgent Care - $ 128,000Gastroenterology - $265,000 Medicine/Pediatrics - $139,000Medical Oncology - $198,000Neonatal Medicine - $286,000 Nephrology - $191,000 Neurology - $180,000

Addressing System Issues

Obstetrics/Gynecology - $211,000 Maternal/Fetal Medicine - $286,000 Occupational Medicine - $139,000 Ophthalmology - $138,000 Ophthalmology Retina - $280,000 Orthopedic Surgery - $256,000 ORS - Hip & Joint Replacement - $330,000 ORS - Spine Surgery - $398,000 Pathology - $169,000 Pediatrics - $135,000 Podiatry - $128,000 Radiation Oncology - $241,000 Radiology - $201,000 Rheumatology - $179,000 Surgery - General - $226,000 Surgery - Cardiovascular - $336,000 Surgery – Neurological - $354,000 Surgery - Plastic - $237,000 Urology - $261,000   SOURCE: Allied Physicians, Inc.,  Los Angeles Times and Rand McNally.  Updated  June, 2006

Technologic advances

◦ Human Genome Project 13 years project Completed in 2003

Addressing System Issues

Managed care Improves a person’s immediate health status Averts more serious problems later in life

Addressing System Issues

Level of intervention

◦ Individual

◦ Community

◦ Social

Addressing System Issues

Insurance Coverage for Preventive Services

◦ Large variation among coverage

Addressing System Issues

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Questions