Prevention is better than cure – what the vernacular has known for a long time has also become an increasingly important topic in health and social policy in recent years. Whether it’s health insurance companies with bonus programs, additional training for medical professionals or the draft for a prevention law – prevention is taking up an increasingly broad space in public discussion. Life expectancy is rising steadily, especially in industrialized countries. However, people can only really benefit from this if their quality of life does not decline. This is the crux of the matter: the older people get, the more likely they are to suffer from chronic diseases. In addition, our lifestyles have changed dramatically in recent decades – an unbalanced diet, too little exercise, smoking and alcohol, stress at work and in everyday life are often our unhealthy companions. As a result, more and more people are becoming chronically ill. A development that is also of some political and economic relevance. For example, a European survey estimates that Member States incur follow-up costs of 20 billion euros for work-related stress alone.
Saving costs in the healthcare system through prevention
In Germany, many billions of euros are spent annually on the treatment of chronic cardiovascular, skeletal and muscular diseases – a figure that could be greatly reduced with targeted prevention, according to health experts. Prevention of cardiovascular diseases alone could save an estimated seven to eight percent of costs in the healthcare system. Premature retirement from the workforce due to illness could also be counteracted.
What does prevention mean?
Prevention and health promotion are closely intertwined. The term “prevention” is synonymous with “precaution.” It encompasses all precautions that can be taken to prevent or at least delay illnesses, disabilities, need for care and accidents. The focus is primarily on specific risk factors and contributing conditions, as well as on strategies to reduce them. This can be achieved by changing the behavior of individuals (behavioral prevention) or by changing the conditions that surround them (situational prevention). The latter is often achieved through government measures; in the case of behavioral prevention, experts also differentiate according to where corresponding measures are applied:
- Universal prevention is aimed at the population as a whole or at subgroups such as pregnant women or adolescents,
- Selective prevention to risk takers such as the chronically ill, smokers or children from migrant families,
- The indicated/indicative prevention to people with risky behavior, for example, adolescents who have become conspicuous for drug use.
In addition, prevention measures are also classified according to where they take place – for example, legislative measures are distinguished from family-based, school-based or community-based prevention. Probably the most common classification is according to when prevention takes place:
- Primary prevention: this makes it its goal to eliminate harmful factors before they can even take effect. So that it can be used, therefore, not only harmful influences must be researched, but also – for example, in educational campaigns – made known.
- Secondary prevention: it involves the detection of diseases and their treatment at the earliest possible stages – an example is cancer screening.
- Tertiary prevention: this takes effect when the disease has already occurred and tries to prevent its aggravation, complications and secondary diseases. Important mainstay here are rehabilitation measures. The boundary to therapeutic measures is fluid here, however.
Accordingly, preventive medicine deals with measures that serve to monitor and maintain health. The term health promotion focuses on health, according to the World Health Organization (WHO) the state of complete physical, mental and social well-being. All measures that lead to this state or increase the degree of self-determination over it are summarized under the term. This includes both the development of individual skills and health-promoting structures.The boundary with prevention cannot always be clearly drawn – for example, measures in kindergartens and schools that promote children’s life skills (life skills) in order, for example, to prevent later violence or drug use are also included under prevention measures, although they certainly serve to maintain health.
