Introduction:

Chronic preventable diseases are a major cause of disability and premature death among Canadians. Research suggests that each year, 150,000 Canadians die due to preventable diseases that account for 65% of all deaths in Canada. According to the Public Health Agency of Canada, 44% of Canadians over 20 have at least 1 of 10 common chronic health conditions. Healthcare professionals believe that most chronic health issues are preventable as they share a common set of avoidable risk factors such as smoking, excessive alcohol use, sedentary lifestyle, poor nutritional choices, second-hand exposure to cigarette smoke, and unhealthy body weight. Reducing the disease burden of preventable diseases by practising preventive medicine can directly help reduce the economic burden of chronic diseases in Canada. 

What is Preventive Medicine?

Preventive Medicine is a speciality of science that promotes preventive practices among individuals, families, and communities to improve overall health and wellbeing. The goal is to either prevent the disease from occurring or reverse/ halt the disease process to minimize the risk of complications (such as disability and death). 

Preventive Medicine practitioners are licensed healthcare professionals such as Doctors of Osteopathy (DO) and Medical Doctors (MD), who are skilled in various healthcare disciplines such as Epidemiology, Biostatistics, Healthcare Management, Clinical Research and Evaluation & Planning of healthcare services. Individuals and primary care physicians can also adopt simple tools and techniques to improve the overall quality of life. 

Why Is Preventive Medicine Important? 

Preventive Medicine interventions aim to prolong life and reduce disability and death. Improvement in the quality of life and advancement in medicine and technology has greatly improved the median age of death around the globe. According to 2019 statistics, the average life expectancy in Canada is 82 years. Data suggests that the overall life expectancy can be increased to 90 years by addressing the top 3 causes of death in the elderly under 85 years. These are:

• Cancers
• Heart disease
• Other diseases involving blood vessels, such as stroke 

 The goal of preventive medicine is also to watch out for medical conditions and health issues that are on the rise to avoid the risk of an outbreak. 

All medical professionals perform some form of preventive care when treating the patient’s primary illness to minimize the risk of complications. On the other hand, preventive care professionals focus more on the preventive aspect to devise strategies and policies to promote health and wellness among the communities. 

For example, preventive specialists advise screening tests, perform physical and medical examinations, devise treatment plans after diagnosing the illness, evaluate public health policies and programs and utilize diagnostic tools to help individuals and masses. In addition, they also help in addressing risky habits to prevent diseases or delay the onset of complications, such as:

• Quit smoking programs
• Weight-loss initiatives for obese/ overweight individuals
• Reduce alcohol use 
• Reduce dependence on drugs 
• Educating people on living a healthy, dynamic lifestyle 

Types of Preventive Medicine

Preventive medicine encompasses a wide range of measures or interventions that can reduce the threat to health and wellbeing. Based on the intervention stage, there are four types of Preventive Medicine.

 

Primordial Prevention:

Primordial prevention precedes primary prevention and involves reducing the risk factor of the entire community or population by devising helpful policies or laws. Primordial prevention focuses on understanding the process of disease development and relies on improving the environmental or social conditions that lead to the disease. For example:

• Improving sanitary conditions in the urban neighborhoods to prevent infectious diseases
• Ensuring access to safe sidewalks to promote healthy physical activity, which is in turn, preventive against heart diseases, diabetes, and stroke 

Primary Prevention:

Primary Prevention refers to strategies and interventions that aim to prevent the disease before it occurs. It includes modifying the risky behaviours or activities that cause injury or disease, limiting exposure to hazardous environmental or physical agents linked to a health issue and taking measures to increase protection or offer resistance in case the exposure occurs.

Examples include:

• Enforcement of laws and regulations to ban or control the use of harmful chemicals (such as asbestos) 
• Mandating safe and healthy practices such as the use of seat-belts & helmets 
• Educating masses about safe and healthy practices such as eating a balanced diet, maintaining a dynamic lifestyle, and quitting smoking)
• Introducing vaccinations against infectious diseases

Secondary Prevention:

Secondary prevention aims to reduce the intensity or impact of injury or illness that has already occurred. Secondary prevention is achieved by early detection and diagnosis of illness, prompt management to allow complete recovery, using interventions to prevent a recurrence and devising strategies to allow early rehabilitation and return to normal functions to prevent disability and other long-term complications. 

Examples include:

• Screening and physical tests to detect the disease in its early stages (such as colonoscopy for colon cancer, mammograms to detect breast cancers)
• Low dose daily Aspirin intake in people with a history of heart disease 
• Occupational therapy or modification of work for injured individuals to allow an easy return to work

Tertiary Prevention:

Tertiary prevention includes interventions that can decrease the impact of an ongoing illness or disease that has long term effects. This is achieved by helping affected individuals manage their long-term symptoms to maintain the optimal quality of life. 

For example:

• In patients suffering from chronic diseases such as arthritis, diabetes, or depression, a variety of rehabilitation interventions can be introduced that allow these individuals to maintain their day-to-day activities. Don’t forget to check out some easy interventions here to adequately control your diabetes.  
• Support groups for chronic illnesses also serve as a valuable resource for affected individuals to share their daily struggles in a safe and non-judgmental environment and learn more about coping skills.
• Retraining programs for recovered individuals who are looking to reenter the workforce. 

 

To understand the difference, imagine there is a town where adults and kids swim in a pond during the summers. You are appointed as the mayor of that town, and it is brought to your attention that individuals swimming in that pond are developing serious rashes and reactions in response to the hazardous toxic wastes in the water. As a mayor, you decide to intervene.

If you stop the influx of toxic wastes into the pond water, this would be primary prevention as you are removing the source of rashes. 

If you employ lifeguards on-site to check every individual for signs of rashes or reaction (so early treatment can be warranted), you are practising secondary prevention. In this case, the source of the problem is not removed but you are adopting measures to treat the disease before it gets problematic by early detection.

If you set up support groups or rehabilitation programs that would allow affected individuals to live with their rashes, you are practising tertiary prevention where you are neither preventing the problem from occurring nor taking emergent action to detect or treat the issue. You are taking measures to soften the after-effects of health issues to make it easier for affected individuals to go on with their life. 

 

A combination of primary, secondary, and tertiary intervention is needed to accomplish meaningful prevention against most health issues. 

Conclusion:

Preventive medicine helps individuals of all ages by improving the quality of life and reducing the economic cost of healthcare services. It is important to identify tools and interventions that can reduce your risk of developing serious health problems. It is strongly advised to speak to your primary care provider to evaluate your health. Check out some tips to pick out your first primary care provider in Canada. You can also speak to a virtual care specialist at Mednow from the comforts of your home. All Mednow Virtual Care doctors are licensed Canadian physicians and can offer medical advice, diagnosis and prescribe, online or on the phone.

This article offers general information only and is not intended as medical or other professional advice. A healthcare provider should be consulted regarding your specific situation. While the information presented is believed to be factual and current, its accuracy is not guaranteed, and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the authors as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products, or services is expressly given or implied by Mednow or its affiliates.

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