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Prevention: Primary, Secondary, and Tertiary

The term prevention refers to planning for and taking action to avoid the occurrence of an undesirable event. As it relates to health, prevention aims to hinder the development of diseases or illnesses or avoid injuries. Prevention can be divided into three levels: primary, secondary, and tertiary. The entry discusses each of these levels of prevention and presents examples applied to both communicable and noncommunicable diseases as they relate to individual as well as community efforts.

The importance of prevention in improving health cannot be overlooked. Though the death rates have been decreasing in the United States, preventive actions could further lower these rates. Approximately one third of Americans live with a chronic disease, and almost 70% of the deaths that occur each year are the result of chronic diseases. Furthermore, approximately one third of all U.S. deaths are related to three modifiable health-damaging behaviors—tobacco use, lack of physical activity, and poor eating habits. Establishing healthy habits and making lifestyle changes, which are critical prevention efforts, can significantly decrease the morbidity and mortality rates of Americans.

Levels of Prevention

The first level of prevention, primary prevention, sometimes just referred to as prevention, is aimed at stopping any occurrence of disease or illness before the disease process begins or taking measures to avoid injury. Thus, many primary prevention activities focus on health education and health promotion programs that are aimed at changing individuals’ health behavior and lifestyle.

Injury and illness cannot always be avoided. Some chronic diseases, such as cancer or heart disease, can develop and cause damage before being detected and treated. In such situations, the sooner medical intervention can occur, the greater the chance of preventing death or limiting disability. Secondary prevention, sometimes referred to as intervention, is aimed at health screening and detection activities that lead to early diagnosis and prompt treatment of a disease or an injury before the disease becomes advanced or the disability becomes severe.

Tertiary prevention, often referred to as treatment, is aimed at retraining, reeducating, and rehabilitating the individual who has already incurred a disability. Tertiary prevention measures are applied after the disease, disability, impairment, or dependency has already occurred.

Application of Prevention Principles

The principles of the various levels of prevention can be applied to both communicable and noncommunicable diseases. Furthermore, these principles can be applied to the actions undertaken by single individuals or entire communities.

Prevention of Communicable Diseases

Stopping the spread of communicable diseases in apopulationisbasedonstoppingthetransmissionof the pathogens causing the diseases. Successful application of primary, secondary, and tertiary strategies to communicable diseases, particularly primary prevention, resulted in unprecedented declines in both morbidity and mortality during the 20th century. Examples of primary prevention activities undertaken by individuals to stop the spread of communicable diseases include hand washing, proper cooking of foods, and getting immunized against specific diseases. To these can be added community primary prevention measures, including laws dealing with food handling and safety, chlorination of the water supply, the proper collection and disposal of solid waste, and the control of vectors and rodents.

Secondary preventive actions against communicable diseases for individuals can include the self-diagnosis or diagnosis by a physician and treatment of the disease with either over-the-counter medications or those prescribed by a physician. Secondary prevention measures that communities can use are usually aimed at the spread of the disease once it is present in a group of people. Such activities may include case findings and treatment and the reporting of notifiable diseases (those that physicians, clinics, and hospitals are legally requiredtoreporttotheirlocalhealthdepartment). Less commonly, communities may isolate or quarantine those infected or exposed, respectfully.

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