Order 995769: Capstone project on physical health, levels of prevention and sampling in research
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module6.1Preventionandhealthservices.pptxIntroduction to Public Health Practice
Prevention Health Services
Program Name
Faculty Name :
Date:
Subject Code:
Module No. 4 – Public Health & Health Systems
School of Public Health
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Objective
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At the end of this module, the students should be able to
Describe the health system as a public health concern
Discuss Natural history of disease
Identify and describe the levels of prevention and modes of intervention
Learning Outcome
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The students will acquire knowledge about the natural history of disease as well as the modes of intervention and will be able to apply this knowledge for the prevention of health problems in the community
Content
Public health system
Natural History of Disease
Levels of prevention
Modes of intervention
Health services pyramid
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Public health system
Relationship between public health and other health activities has never been clear.
Different views prevail among health professionals
Public health is part of the health system or the health system is part of public health?
Most components serve the same ends
The term health system refers to all aspects of the organization, financing and provision of programs and services for prevention and treatment of illness and injury.
The public health system is a component of this larger health system.
Public commonly perceives the health system to include only medical care and treatment aspects of the overall system.
However, public health activities are part of larger set of activities that focus on health, well-being, disease and illness.
Some questions to brainstorm
Does the countries have a rational strategy for investing its resources to maintain and improve people’s health?
Is the current strategy excessive in ways that inequitably limited access to and benefit from needed services?
Is the health system accountable to its end-users and ultimate payers for the quality and results of its services.
The issues of health,
Excess
access,
Accountability
and quality
Make the health system a public health concern
Prevention and Health service
Health and illness are dynamic state that are influenced by a wide variety of biological, environmental, behavioral, social and health services factors acting through an ecological model.
The complex interaction of these factors results in the occurrence or absence of disease or injury.
Which in turn contributes to the health status of individuals and populations.
Prevention and Health services
Before we go to prevention, its necessary to understand the Natural history of disease.
The nineteenth-century revolution in thinking brought about by Koch and Pasteur led to the recognition of distinct stages in the development of a disease.
If left untreated, a disease would evolve through a series of stages that characterize its natural history
But if an intervention is applied, the natural history is modified, producing a typical clinical course for the condition
Natural history of disease
General strategies to maintain health before developing health
Two general strategies that seek to maintain health by intervening prior to the development of disease or injury.
Health promotion
Specific protection
Both involve activities that alter the interaction of the various health-influencing factors in ways that contribute to either averting or altering the likelihood of occurrence of disease or injury.
Health promotion and Specific Protection
Health promotion activities attempt to modify human behaviors by increasing the ability to resist disease or injury- including factors, thereby reducing or neutralizing risks to health.
Examples of health promotion activities include interventions such as nutrition counseling, genetic counseling, family counseling, and the myriad activities that constitute health education
Health promotion and Specific Protection
Health promotion also properly includes
Provision of adequate housing
Employment
Recreational conditions
Community development activities
It is somewhat ironic that activities that focus on the state of health and that seek to maintain and promote health are not commonly perceived to be “health services.
Specific protection activities provide individuals with resistance to factors (such as microorganisms like viruses and bacteria) or modify environments to decrease potentially harmful interactions of health-influencing factors (such as toxic exposures in the workplace).
Examples of specific protection
Use of protective equipment for asbestos removal)
Immunizations
Occupational
Environmental engineering,
Regulatory controls
Activities to protect individuals from environmental carcinogens
Exposure to second-hand or side-stream smoke
Toxins
Early Case Finding and Prompt Treatment, Disability Limitation, and Rehabilitation
Early detection and prompt treatment reduce individual pain and suffering and are less costly to both the individual and society
Interventions to achieve early detection and prompt treatment include
Screening tests
Case-finding efforts
Periodic physical exams
Screening tests, Case-finding efforts and Periodic physical exams
Screening tests are increasingly available to detect illnesses before they become symptomatic.
Case-finding efforts for both infectious and noninfectious conditions are directed at populations at greater risk for the condition on the basis of criteria appropriate for that condition.
Periodic physical exams
Strategy targeting disease is disability limitation through effective and complete treatment.
Efforts largely aim to arrest or eradicate disease or to limit disability and prevent death.
The final intervention strategy focusing on disease—rehabilitation—is designed to return individuals who have experienced a condition to the maximum level of function consistent with their capacities
Link with Prevention
Prevention in relation to the stage of the disease or condition.
Preventive intervention strategies are considered
Primary
Secondary
Tertiary
Primary prevention
Here the goal is to protect healthy people from developing a disease or experiencing an injury in the first place through reducing risk factor levels.
For example:
education about good nutrition, the importance of regular exercise, and the dangers of tobacco, alcohol and other drugs
education and legislation about proper seatbelt and helmet use
regular exams and screening tests to monitor risk factors for illness
immunization against infectious disease
controlling potential hazards at home and in the workplace
Secondary Prevention
These interventions happen after an illness or serious risk factors have already been diagnosed. The goal is to halt or slow the progress of disease (if possible) in its earliest stages; in the case of injury, goals include limiting long-term disability and preventing re-injury.
For example:
telling people to take daily, low-dose aspirin to prevent a first or second heart attack or stroke
recommending regular exams and screening tests in people with known risk factors for illness
providing suitably modified work for injured workers
Tertiary prevention
This focuses on helping people manage complicated, long-term health problems such as diabetes, heart disease, cancer and chronic musculoskeletal pain. The goals include preventing further physical deterioration and maximizing quality of life.
For example:
cardiac or stroke rehabilitation programs
chronic pain management programs
patient support groups
Prevention strategies in relation to population disease status and effect on disease incidence and prevalence.
Primary prevention aims to reduce the incidence of conditions,
Secondary and tertiary prevention seek to reduce prevalence by shortening duration and minimizing the effects of disease or injury
Relationship of health promotion and specific protection to levels of prevention
Primary, secondary and tertiary
Relationship with Health promotion and specific protection are primary prevention strategies seeking to prevent the development of disease.
Early case finding and prompt treatment represent secondary prevention, because they seek to interrupt the disease process before it becomes symptomatic
Disability limitation and rehabilitation are considered tertiary-level prevention in that they seek to prevent or reduce disability associated with disease or injury.
Links with Public Health and Medical Practice
Its allocation of responsibilities for carrying out the various interventions.
Three practice domains can be roughly delineated:
Public health practice
Medical practice
Long-term care practice
Public health practice
Primary goal: health promotion, specific protection and early case finding.
The concept of public health practice here is a broad one that accommodates the activities carried out by many different types of health professionals and workers, not only those working in public health agencies
Public health practice occurs in voluntary health agencies, as well as in settings such as schools, social service agencies, industry, and even traditional medical care settings.
Health Care Pyramid Levels
Primary, Secondary and Tertiary medical care
Primary medical care
Focuses on the basic health needs of individual and families
First contact health care in the view of the patient
Provides 80% of necessary care, includes comprehensive array of services,
Onsite referral, health promotion and disease prevention
Curative services
Secondary care
Specialized care serving the major share of remain 20% of need beyond scope of primary care.
Physicians or hospitals provide secondary care , generally on referal from primacy care
Tertiary medical care
Highly specialized and technologically sophisticated medical and surgical care
For complex conditions
Provided in large medical centers or academic health centers.
Long-term care practices
Long-term care is appropriately classified separately because of the special needs of the population requiring such services and the specialized settings where many of these services are offered.
This, too, is changing as specialized long-term care services increasingly move out of long-term care facilities and into home settings.
Everyone should be served by population-wide public health services, and nearly everyone should be served by primary medical care.
However, increasingly smaller proportions of the total population require secondary - and tertiary-level medical care services
Health services pyramid
Primary prevention
Secondary prevention
Tertiary prevention
Tertiary health care
Secondary health care
Primary health care
Population-based public health services
Public Health and Medical Practice Interfaces
Public health and medical practice are presented as separate domains of practice, there are many interfaces that provide a template for either collaboration or conflict.
Public health practitioners have traditionally deferred to medical practitioners for providing the broad spectrum of services for disease and injuries in individuals
Medical practitioners have generally acknowledged the need for public health practice for health promotion and specific protection strategies
Summary
Generally, primary preventive services are community-based and are targeted toward populations or groups rather than individuals.
Early case-finding activities can be directed toward groups or toward individuals
Long-term care involves elements of both community-based service and individually oriented service.
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References
Principles of Public Health Practice, 3rd Edition, F. Douglas
Developing Practice for Public Health and Health Promotion E-Book, 3rd Edition, Naidoo & Wills
Park’s Textbook of Preventive and Social Medicine, 20th Edition, K. Park
Community Medicine with Recent Advances, 3rd Edition, AH Suryakantha
http://www.jblearning.com/samples/0763745251/45251_CH03_049_072.pdf
www.ashp.org/DocLibrary/Bookstore/P1725-Chapter9.aspx
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