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Health promotion and disease prevention through population-based interventions, including action to address social determinants and health inequity

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Operational definition

This function includes disease prevention and health promotion.

Disease prevention

Disease prevention, understood as specific, population-based and individual-based interventions for primary and secondary (early detection) prevention, aiming to minimize the burden of diseases and associated risk factors.

Primary prevention refers to actions aimed at avoiding the manifestation of a disease (this may include actions to improve health through changing the impact of social and economic determinants on health; the provision of information on behavioral and medical health risks, alongside consultation and measures to decrease them at the personal and community level; nutritional and food supplementation; oral and dental hygiene education; and clinical preventive services such as immunization and vaccination of children, adults and the elderly, as well as vaccination or post-exposure prophylaxis for people exposed to a communicable disease). 

Secondary prevention deals with early detection when this improves the chances for positive health outcomes (this comprises activities such as evidence-based screening programs for early detection of diseases or for prevention of congenital malformations; and preventive drug therapies of proven effectiveness when administered at an early stage of the disease).

It should be noted that while primary prevention activities may be implemented independently of capacity-building in other health care services, this is not the case for secondary prevention. Screening and early detection is of limited value (and may even be detrimental to the patient) if abnormalities cannot be promptly corrected or treated through services from other parts of the health care system. Moreover, a good system of primary health care with a registered population facilitates the optimal organization and delivery of accessible population based screening programs and should be vigorously promoted.

Health promotion

Health promotion is the process of empowering people to increase control over their health and its determinants through health literacy efforts and multisectoral action to increase healthy behaviors. This process includes activities for the community-at-large or for populations at increased risk of negative health outcomes. Health promotion usually addresses behavioral risk factors such as tobacco use, obesity, diet and physical inactivity, as well as the areas of mental health, injury prevention, drug abuse control, alcohol control, health behavior related to HIV, and sexual health.

Disease prevention and health promotion share many goals, and there is considerable overlap between functions. On a conceptual level, it is useful to characterize disease prevention services as those primarily concentrated within the health care sector, and health promotion services as those that depend on intersectoral actions and/or are concerned with the social determinants of health.

Scope of the function

Disease prevention

  • Primary prevention services and activities include: 

Vaccination and post-exposure prophylaxis of children, adults and the elderly;

Provision of information on behavioural and medical health risks, and measures to reduce risks at the individual and population levels; 

Inclusion of disease prevention programmes at primary and specialized health care levels, such as access to preventive services (ex. counselling); and

Nutritional and food supplementation; and

Dental hygiene education and oral health services.

  • Secondary prevention includes activities such as: 

Population-based screening programmes for early detection of diseases; 

Provision of maternal and child health programmes, including screening and prevention of congenital malformations; and

Provision of chemo-prophylactic agents to control risk factors (e.g., hypertension)

Health promotion

  • Policies and interventions to address tobacco, alcohol, physical activity and diet (e.g.,  FCTC , DPAS , alcohol strategy and NCD best-buys)
  • Dietary and nutritional intervention should also appropriately tackle malnutrition, defined as a condition that arises from eating a diet in which certain nutrients are lacking, in excess (too high in intake), or in the wrong proportions
  • Intersectoral policies and health services interventions to address mental health and substance abuse
  • Strategies to promote sexual and reproductive health, including through health education and increased access to sexual and reproductive health, and family planning services
  • Strategies to tackle domestic violence, including public awareness campaigns; treatment and protection of victims; and linkage with law enforcement and social services.

Support mechanisms for health promotion and disease prevention

  • Multisectoral partnerships for health promotion and disease prevention 
  • Educational and social communication activities aimed at promoting healthy conditions, lifestyles, behavior and environments (see EPHO VII)
  • Reorientation of health services to develop care models that encourage disease prevention and health promotion 
  • Risk communication.