ANSWER
Prevention encompasses a wide range of activities known as “interventions” that aim to reduce health risks or threats. You have probably heard researchers and health professionals talk about three types of prevention: primary, secondary, and tertiary. What exactly do these terms mean?
Primary defense
Primary prevention aims to prevent disease or injury before it occurs. This is accomplished by reducing exposure to hazards that cause disease or injury, changing unhealthy or unsafe behaviors that can lead to disease or injury, and increasing resistance to disease or injury in the event of exposure. Here are some examples:
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Legislation and enforcement to prohibit or limit the use of hazardous products (for example, asbestos) or to require safe and healthy practices (e.g., use of seatbelts and bike helmets)
education on healthy and safe practices (e.g., eating well, exercising regularly, not smoking)
vaccine against infectious diseases
Secondary safeguards
Secondary prevention aims to lessen the impact of a previously occurring disease or injury. This is accomplished by detecting and treating disease or injury as soon as possible to stop or slow its progression, encouraging personal strategies to prevent reinjury or recurrence, and implementing programs to restore people to their original health and function to avoid long-term problems. Here are some examples:
routine examinations and screening tests to detect disease in its early stages (e.g., mammograms to detect breast cancer)
daily low-dose aspirins, as well as diet and exercise programs, to prevent future heart attacks or strokes
Work that has been modified to allow injured or ill workers to return to work safely
Tertiary prevention seeks to mitigate the long-term effects of an ongoing illness or injury. This is accomplished by assisting people in managing long-term, often complex health problems and injuries (e.g., chronic diseases, permanent impairments) to improve their ability to function, quality of life, and life expectancy as much as possible. Here are some examples:
Programs for cardiac or stroke rehabilitation, as well as programs for chronic disease management (e.g., for diabetes, arthritis, depression, etc.)
Support groups that allow members to share healthy living strategies
When workers have recovered as much as possible, vocational rehabilitation programs are used to retrain them for new jobs.
“Upstream” movement
Consider the following example to help explain the distinction. Assume you are the mayor of a town near a swimming hole popular with children and adults. One summer, you learn that residents develop severe and long-lasting rashes due to a chemical irritant after swimming in the river. You decide to act.
You are engaging in primary prevention if you approach the company upstream, discharging the chemical into the river and forcing it to stop. You are removing the potentially hazardous exposure and preventing rashes from occurring in the first place.
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Secondary prevention is when you ask lifeguards to check swimmers as they exit the river for signs of a rash that can be treated immediately. You are not preventing rashes, but you are reducing their impact by treating them as soon as possible so swimmers can regain their health and resume their everyday lives.
Tertiary prevention is achieved by establishing programs and support groups that teach people how to live with persistent rashes. You are not preventing or treating rashes immediately, but you are lessening their impact by assisting people in living as comfortably as possible with their rashes.
A combination of primary, secondary, and tertiary interventions is required to achieve a meaningful level of prevention and protection for many health problems. However, as demonstrated by this example, prevention experts believe that the further “upstream” one is from an adverse health outcome, the more likely any intervention will be effective.
QUESTION
Communicable Diseases Affecting Your Community
What was the last communicable diseases affecting your community and what were the primary, secondary and tertiary preventions that the community health nurses have undertaken to prevent the spread of the disease?