Preventive Medicine

April 2, 2003

In the past, providers of health care were primarily concerned with diagnosing and treating existing diseases in patients. The quantity and quality of health professionals services were the primary determinants of patient’s health. Nowadays, this view has been reviewed and replaced by more comprehensive vision of health that places a focus on prevention. Evidence of this change comes from two main sources:

First, a critical study of the history of disease shows that major infectious diseases such as plague and leprosy, which were the leading causes of death in societies at the turn of this century, began to decline long before the introduction of effective therapy.

Second, the evaluation of today’s major causes of death and disability are the real eye opener. For example, unprotected use of intravenous syringes constitutes the major cause of death in homeless or street people, which is largely the result of self-imposed risks and lifestyle habits. Further, deaths caused by practising un-protected sex cannot be reduced by traditional forms of medical treatment, but rather by changes in behaviour. Measures such as increased caution, sobriety, and the use of sterile syringes in case of intravenous drug intake, are more effective in reducing deaths than medical treatment. Therefore, a concept of health must include prevention factors in addition to traditional medicinal interventions.

Following is the summary of factors that contribute significantly towards the deterioration of Canadian’s health:

LIFESTYLE AND BEHAVIOURAL RISK FACTORS:

Lifestyle and behavioural risk factors are the ones that can easily be avoided and changed without undergoing traditional forms of medical treatment (Shah, 1998, pg 87). Examples of these factors are:

:: Stress ::

Chronic stress has a tremendous effect on Canadian health, and women tend to suffer more than men. Stress is commonly found in working parents, for example, and as it increases, family dysfunction increases with it. During stress our bodies go through physiological changes that include, increased metabolism, heart rate, blood pressure and muscle tension (Bensen & Stuart, p.177).

:: Substance abuse ::

This refers to the problems linked with the excessive use of alcohol, tobacco, drugs and illicit drugs eg. cocaine. Heavy drinking is more likely to occur among those in the workforce, who have a high income and higher education. According to the author of Public Health And Preventive Medicine In Canada (Shah), “48% of Canadians take some type of medication in any given 48 hour period, but only 60% do so on the advice of a physician.”

:: Nutrition ::

A healthy diet helps to maintain not only good health but it also boosts the body’s immunization response to disease. Canadians have been shown to have increased their vegetable intake over a past two decades but mostly by using potatoes (as french fries). Poultry and red meat remain the most popular choices among canadians. (Shah, p.90; Bensen & Stuart, p.129)

:: Physical Activity and fitness :: (Shah, p.93)

Physical activity is crucial to the health of the heart, joints etc. According to Public Health and Preventive Medicine in Canada (Shah), “in 1994, over half the population (56%) reported that they were inactive.“ Most of the leisure time was spent watching television.

OCCUPATIONAL HEALTH AND DISEASE

Occupational health is defined as the maintenance of health in the work place. Most of us spend a huge amount of time at our work place that can expose us to hazards that are physical (radiation, temperature and humidity), chemical (poison and volatile solvents), mechanical (repetitive strains), ergonomic (Carpal Tunnel syndrome), and biological (viruses). Some of these can cause immediate problems while others develop over extended periods of time – e.g. workers at industrial mills can develop noise related problems, while those who work in the health professions are exposed to numerous germs (Shah, p.246).

Legislations allow workers to refuse dangerous work, and also ensures their right to know the nature of their work.

MEANS OF PREVENTION

There are three levels of prevention. The choice of which kind of prevention tactic to use depends upon the population at risk, their location and the suspected agent (disease or host) (Shah, p.16; Bensen & Stuart, p.25).

Primary prevention, aims at preventing disease before it starts – e.g. sex education is considered a primary prevention toward the spread of HIV/AIDS.

Secondary Prevention involves the early detection of disease – e.g. cervical and breast cancer screenings fall into this category.

Tertiary Prevention stresses treatment and rehabilitation to keep an existing health problem from recurring – e.g. drug rehabilitation centres for former drug abusers, or meditation as a relaxation method in order to reduce stress, are both tertiary preventions.

PREVENTIVE HEALTH PRACTICES

Preventive health initiatives can not always be imposed by Government health sector. We are responsible and accountable for our daily lives, and by simply taking steps like washing our hands before a meal, or using seat belts, we can make a huge difference in preventing death or disease. Following are some basic preventative measures that can vastly improve the health of Canadians” (Shah, p.94).

:: Immunization ::

Immunization helps in the prevention of infectious diseases, such as Measles, Rubella, Influenza and Hepatitis B (Shah, p.199).

:: Blood Pressure ::

For both males and females blood pressure monitoring should increase with age. High blood pressure is one of the major risk factors for getting cardiovascular disease, coronary heart diseases and stroke. The good news is, it can be monitored and regulated by diet, exercise and medication (Shah, p.94).

:: Cervical Cancer And Breast Cancer Screening ::

According to a population Health Survey, “85% of Canadian women over the age of 15 reported that they have had a pap test at some point in their life.” This is important, because cervical cancer can easily be prevented but due to late detection it is taking so many lives. This deadly disease can be prevented by going through regular screening. Breast cancer is also very common in women and early detection through mammography can help in curing breast cancer and fast recovery. http://www.hhs.gov/news/press/2000pres/20001012a.html

CONSEQUENCES OF NEGLECTING PREVENTION

Economic burden

Mortality (death) and morbidity (illness) not only affect patients but also the whole nation. According to Public Health and Preventive Medicine in Canada, “the total burden of ill health and mortality on Canadian society was estimated to be $156.9 billion.” This toll includes illness, disability and premature death.

Cardiovascular diseases, injuries and violence, cancer, and arthritis were responsible for half of the total cost, while overall chronic conditions accounted for the major economic burden (Shah, p.121).

Clearly prevention is a key factor in maintaining good health, but too many patients rely on doctors to treat illnesses after the fact. The outcome of this approach, however, is often poor. Prevention means that patients must take their health in to their own hands, rather than relying on medications and other interventions in order to maintain health. Education is the only way to encourage people to take this important step.

Bibliography:

Chandrakant P.Shah; 1998. Public Health and preventive Medicine in Canada. University of Toronto press: Canada.

Herbert Bensen, M.D., Eileen M. Stuart, R.N., M.S.; 1993. The Wellness Book. Simon & Schuster: New York.

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