Judy Monroe, MDIndiana State Health Commissioner

June 19, 2009

Primary Prevention - means it never occurs

Secondary Prevention – detect and prevent progression of conditions before they are symptomatic

Tertiary Prevention - prevent the progression and complications of disease and symptoms already occurring

Primary Prevention – largely the domain of public health (community prevention – aimed at the population)

Secondary Prevention – largely the domain of primary care (clinical practice – aimed at the individual)

Tertiary Prevention – largely the domain of subspecialists

Primary Prevention - $ immunizations weight control and exercise to prevent type

2 diabetes folic acid to prevent neural tube defects in

newborns

Secondary Prevention - $$ control hypertension – prevent stroke control cholesterol – prevent heart disease mammograms

Tertiary Prevention - $$$$$$$ intensive care treatment for complications

of pneumococcal pneumonia to prevent death

intensive treatment of diabetes to prevent an amputation

surgery to prevent complications of a neural tube defect

Tertiary Prevention - $$$$$$$ rehabilitation of a stroke victim to prevent

being wheel chair bound management after a myocardial infarction

to prevent another infarction treatment of later stage breast cancer after

delayed diagnosis

Program Savings for Every $1 Spent

Chronic disease $5.60

Immunizations $27

Smoking Cessation for Pregnant Women

$6

Tuberculosis screening and Isoniazid

$1.20

Water Fluoridation $38

Women, Infants, and Children $1.92 - $4.21

Healthy workforce benefits business more productive workers less absenteeism less injuriesHealthcare is the most expensive benefit paid

by U.S. employers

INShape Indiana nutrition, physical activity, and tobacco control

Indiana Workplace Wellness PartnershipIndiana Hospital AssociationState Employee Wellness – One Care StreetHealthy Indiana PlanWellness Tax CreditLactation Support in the Workplace (IC-22.2-

14.1)