Preventive medicine

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Preventive medicine or preventive care refers to measures taken to prevent illness or injury, rather than curing them. It can be contrasted not only with curative medicine, but also with public health methods (which work at the level of population health rather than individual health). This takes place at primary, secondary and tertiary prevention levels.

Contents 1 Universal, selective, and indicated 2 Professionals 3 Leading cause of preventable death 4 References 5 External links

1. Primary prevention avoids the development of a disease. Most population-based health promotion activities are primary preventive measures.
2. Secondary prevention activities are aimed at early disease detection, thereby increasing opportunities for interventions to prevent progression of the disease and emergence of symptoms.
3. Tertiary prevention reduces the negative impact of an already established disease by restoring function and reducing disease-related complications.

Simple examples of preventive medicine include hand washing and immunizations. Preventive care may include examinations and screening tests tailored to an individual's age, health, and family history. For example, a person with a family history of certain cancers or other diseases would begin screening at an earlier age and/or more frequently than those with no family history.

[edit] Universal, selective, and indicated

Gordon (1987) in the area of disease prevention, and later Kumpfer and Baxley (1997) in the area of substance use proposed a three-tiered preventive intervention classification system: universal, selective, and indicated prevention. Amongst others, this typology has gained favour and is used by the U.S. Institute of Medicine, the NIDA and the European Monitoring Centre for Drugs and Drug Addiction.

1. Universal prevention addresses the entire population (national, local community, school, district) and aim to prevent or delay the abuse of alcohol, tobacco, and other drugs. All individuals, without screening, are provided with information and skills necessary to prevent the problem.
2. Selective prevention focuses on groups whose risk of developing problems of alcohol abuse or dependence is above average. The subgroups may be distinguished by characteristics such as age, gender, family history, or economic status. For example, drug campaigns in recreational settings.
3. Indicated prevention involves a screening process, and aims to identify individuals who exhibit early signs of substance abuse and other problem behaviours. Identifiers may include falling grades among students, known problem consumption or conduct disorders, alienation from parents, school, and positive peer groups etc.

Outside the scope of this three-tier model is environmental prevention. Environmental prevention approaches are typically managed at the regulatory or community level, and focus on interventions to deter drug consumption. Prohibition and bans (e.g. smoking workplace bans, alcohol advertising bans) may be viewed as the ultimate environmental restriction. However, in practice environmental preventions programmes embrace various initiatives at the macro and micro level, from government monopolies for alcohol sales, through roadside sobriety or drug tests, worker/pupil/student drug testing, increased policing in sensitive settings (near schools, at rock festivals), and legislative guidelines aimed at precipitating punishments (warnings, penalties, fines).

[edit] Professionals

Professionals involved in the public health aspect of this practice may be involved in entomology, pest control, and public health inspections. Public health inspections can include recreational waters, pools, beaches, food preparation and serving, and industrial hygiene inspections and surveys.

In the United States, preventive medicine is a medical specialty, one of the 24 recognized by the American Board of Medical Specialties (ABMS). It encompasses three areas of specialization:

• General preventive medicine and public health
• Aerospace medicine
• Occupational medicine

In order to become board-certified in one of the preventive medicine areas of specialization, a licensed U.S. physician (M.D. or D.O.) must successfully complete a preventive medicine medical residency program following a one-year internship. Following that, the physician must complete a year of practice in that special area and pass the preventive medicine board examination. The residency program is at least two years in length and includes completion of a master's degree in public health (MPH) or equivalent. The board exam takes an entire day: the morning session concentrates on general preventive medicine questions, while the afternoon session concentrates on the one of the three areas of specialization that the applicant has studied.

In addition, there are two subspecialty areas of certification:

• Medical toxicology (MT)
• Undersea and hyperbaric medicine (UHB), formerly "undersea medicine"

These certifications require sitting for an examination following successful completion of an MT or UHB fellowship and prior board certification in one of the 24 ABMS-recognized specialties.

[edit] Leading cause of preventable death

The examples and perspective in this section may not represent a worldwide view of the subject. Please improve this article or discuss the issue on the talk page. (June 2009)

Leading causes of preventable deaths in the United States in the year 2000.^[1]

Cause	Number of deaths resulting
Smoking	435,000 deaths or 18.1% of the total deaths
Overweight and Obesity	365,000 deaths or 15.2% of the total deaths.
Alcohol consumption	85,000 deaths or 3.5% of the total deaths.
Infections	75,000 deaths or 3.1% of the total deaths.
Toxic agents	55,000 deaths or 2.3% of the total deaths.
Motor vehicle collisions	43,000 deaths or 1.8% of the total deaths.
Incidents involving firearms	29,000 deaths or 1.2% of the total.
Sexually transmitted infections	20,000 deaths or 0.8% of the total.
Illicit use of drugs	17,000 deaths or 0.7% of the total deaths.

[edit] References

This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (August 2008)

Specific references:

General references:

[edit] External links

• Association of Preventive Medicine Residents
• US Preventive Medicine
• The Prevention Plan
• American College of Preventive Medicine
• American Board of Medical Specialties
• American Board of Preventive Medicine
• American College of Veterinary Preventive Medicine

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