Great potential lies in measures that target the area of primary prevention. However, this is also where the crux lies: the effects to be achieved can only be assumed and derived from statistics, and the effects achieved are difficult to measure both in terms of their extent and in terms of timing on an individual basis. How can it be proven that someone is heart-healthy at 60 because he has exercised regularly? Perhaps it is also because he has not smoked or simply has “good genes”? Another difficulty is that the payers for prevention are often different from those for diseases and their social and occupational consequences. And matching different pots of money is a task that should not be underestimated.
Primary prevention
Much of the cost to be saved is in the area of “common diseases,” especially:
- Cardiovascular diseases (for example, high blood pressure, heart attacks),
- Musculoskeletal disorders (especially back problems),
- Osteoporosis,
- Diabetes mellitus and
- Cancer.
Their number is increasing, co-caused by known risk factors that can be prevented. Therefore, in this area lies a great potential of primary prevention. The focus is on regular and proper exercise, adequate and healthy diet and adequate periods of rest. Smoking and alcohol consumption – known risk factors for a variety of diseases – must be stopped or limited, and in the case of trivial ailments, the aim should be to refrain from taking medicines.
Infectious diseases as well as HIV and sexually transmitted diseases can also be contained through vaccinations and appropriate preventive measures. Here, too, it is important to know about them – an important aspect of sexuality education.
Another point is the increase in mental and psychosomatic illnesses. These include:
- Eating disorders,
- Stress-related illnesses and
- Addictions.
Here, too, an important contribution to prevention can be made through educational work and seminars, for example, to learn stress management strategies and relaxation techniques. Not to be forgotten are the counseling of pregnant women and programs to maintain dental health. Here, dentists in particular are called upon to adequately educate and instruct their patients. Group prophylaxis for children, which is anchored in law, has already shown considerable success in dental health over the past 15 years.
Secondary prevention
Examinations of newborns immediately after birth and at regular intervals thereafter is an important measure performed by physicians to detect certain diseases and developmental disorders as early as possible and to treat them appropriately. Within the framework of these examinations, the recommended vaccinations are usually also carried out.
In adults, the general examination of the state of health (“check-up”) and examinations for the early detection of cancer provide the opportunity to detect diseases before they become apparent with symptoms.
Prevention – in whom?
Prevention and health promotion should begin at an age when behavior patterns are learned and lifestyle, exercise behavior and diet can be particularly well influenced. Therefore, prevention programs must already be introduced in children and adolescents – in kindergarten, school, family and other living environments. In this way, the socially determined inequality of health opportunities can also be reduced.
Another area is the world of work. Many work-related illnesses and accidents can be prevented through workplace health promotion and improved occupational safety. Older people are also a large group. Physical and mental capacity is a prerequisite for a self-determined, independent life. Promoting and maintaining this in old age is therefore also an important goal.
