Health Promotion

Disease Prevention

Pascale Gehy-Andre

A systematic approach to health improvement

Healthy People 2010

National

Community

Role PlayersClinicians

Businesses

Scientists

Communities

Individuals

Clinician RoleDiagnosis and TreatmentEmpathy

Cure sometimesRelieve oftenComfort always

Secret of care is caring for the patientPREVENTION BY EDUCATING

HistoryHealthy People Surgeon General 1979

Health Promotion Disease Prevention

Healthy People 2000 1990 Infant Mortality Life expectancy

Healthy People 2010 2000Rate of AdvancementQuality of Life

Preventive MedicinePrimary Prevention

Secondary Prevention

Tertiary Prevention

PRIMARY PREVENTIONRemoves or Reduces diseases risk factors.

ImmunizationH flu reduced 95% since first conjugate vaccine

Smoking cessationImproved sanitation

Secondary preventionPromotes techniques to early detection of disease or precursor states

Pap Smear

Tertiary PreventionMeasures aimed at limiting the impact of established disease

Partial mastectomy and radiation therapy.

Healthy People 2010Population growing older Increase quality and years of healthy life

Diversity of populationEliminate health disparities.

Improving health of each individualHealth of the communityHealth of the nation

Systematic ApproachFour key elements:

Goals Focus\Direction

Objectives Determinant of health

Determinants of health Physical\Social

Health status Ultimate Measure

Goalsquality and years of healthy life

Life Expectancy Beginning 20th century 47.3 yrsToday 77 yrs?? Substantial differences among

different population groups in the US.

Eliminate Health Disparities

Life Expectancy By Country

FemaleCountryYrs of

Life expectancyJapan 82-9France 82.6Switzerland 81.9Sweden 81.6Spain 81.5Canada 81.2Australia 80.9Italy 80.8Norway 80.7Netherlands 80.4Greece 80.3Finland 80.3

MaleCountryYrs of

Life expectancyJapan 76.4Sweden 76.2Israel 75.3Canada 75.2Switzerland 75.1Greece 75.1Australia 75.0Norway 74.9Netherlands 74.6Italy 74.4England and Wales 74.3France 74.2

Life Expectancy By Country Contd

Female

Country Yrs of Life

expectancyAustria 80.1Germany 79.8Belgium 79.8England & Wales 79.6Israel 79.3Singapore 79.0United States 78.9

MaleCountryYrs of

Life expectancySpain 74.2Austria 73.5Singapore 73.4Germany 73.3New Zealand 73.3Northern Ireland 73.1Belgium 73.0Cuba 73.0Costa Rica 73.0Finland 72.8Denmark 72.8Ireland 72.5United States 72.5

Quality of LifeEncompasses all aspects of life including:

Health BeliefsRecreation AspirationsCultureRightsValues

Tools to measure Quality of Life

1- Global AssessmentsPoor FairGood Very GoodExcellent

2- Healthy Days

3- Years of healthy life

Eliminate Health Disparities

Eliminate differences that occur by:1- Gender 2- Race 3- Ethnicity4- Education 5- Income 6-Disability7- Geographic location8- Sexual orientation

Achieving EquityHealthy people 2010 is firmly dedicated to the principle that regardless of health disparities, every person in every community across the nation deserves equal access to comprehensive, culturally competent, community-based health care systems that are committed to serving the needs of the individual and promoting community health.

ObjectivesMonitored through 467 objectives in 28 focus areas.Focus of objectives:

Intervention to eliminate illnesses Improving access to quality health careStrengthening public health servicesImproving the availability and dissemination of health-related information.

Determinant of HealthBehavior and environmental factors Individual biology and behaviors Policies and interventions Access to quality health careHealth Status

Leading Causes of Death, 1997

Leading Causes of Death, 1900*