This is note on Preventive Health based on Pokhara University Syllabus (BPH Fourth Semester- IPH II)

1. UNIT II:
Preventive Health
(BPH Fourth Semester, Pokhara University Syllabus)
Isha Karmacharya
MPH (PHSM)
Lecturer
CiST College

2. Preventive Care versus
Preventive Services
• What is Care?
– attention that is given to something or someone, so
that they are looked after, protected, or dealt with
in the right way
• What is Services?
– a government system or private organization that
is responsible for a particular type of activity, or
for providing a particular thing that people need
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3. Preventive Care versus
Preventive Services
Preventive Care
• The goal of preventative
care is to help individuals
safeguard against health
problems in the first place
and to catch illnesses in the
early stages of development
for easier treatment.
Preventive Services
• The goal of preventive
services is to fulfill the
people health need/demand
for reducing death and
disability through
preventive measure (e.g.
specific protection, early
diagnosis and treatment) and
improving the Nation’s
health.
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4. Preventive Care versus
Preventive Services
Preventive Care
• Preventative care is to help
individuals avoid becoming ill
in the first place.
• Preventive care focuses on
evaluating individuals current
health status when they are
symptom free.
• E.g. Wellness visits and
standard immunizations.
Screenings for blood pressure,
cancer, cholesterol, depression,
obesity, and Type 2 diabetes.
Preventive Services
• Preventive service(s) are
provided to help [the member]
avoid becoming sick in the
first place.
• Preventive tests and services
are performed when the
member has no signs or
symptoms, no indications that
they are not healthy.
• E.g. cancer screening services
covered by Medicare,
Medicaid, and many private
insurance plans under the
Affordable Care Act
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5. Preventive Care/Preventive services
• Preventive care is a term that refers to health
care services, like tests and screenings, which
are performed to check your health status and
keep you healthy.
• Preventive care includes things like cancer
screenings, diet and obesity counseling, testing
for sexually transmitted infections, and birth
control.
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6. • Preventive care focuses on evaluating your current health
status when you are symptom free.
• Preventive care allows you to obtain early diagnosis and
treatment, to help avoid more serious health problems. Even if
you’re in the best shape of your life, a serious condition with
no signs or symptoms may put your health at risk.
• Through a preventive exam and routine health screenings, your
doctor can determine your current health status and detect
early warning signs of more serious problems. Your preventive
care services may include immunizations, physical exams, lab
work and x-rays. During your preventive visit your doctor will
determine what tests or health screenings are right for you
based on many factors such as your age, gender, overall health
status, personal health history and your current health
condition.
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7. • Preventive Care is a pattern of nursing and medical
care that focuses on disease prevention and health
maintenance.
• It includes early diagnosis of disease, discovery and
identification of people at risk of development of
specific problems, counseling, and other necessary
intervention to avert a health problem. Screening
tests, health education, and immunization programs
are common examples of preventive care. (Mosby 2 )
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8. • Preventive service(s) are provided to help [the
member] avoid becoming sick in the first
place.
• Preventive tests and services are performed
when the member has no signs or symptoms,
no indications that they are not healthy.
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9. Public Health versus preventive medicine,
community medicine, Clinical medicine,
social medicine and community health
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10. • What is Health?
“a complete state of physical, mentaland social well-
being not merely the absence of disease or injury.”
• What is Medicine?
“the science or practice of the diagnosis, treatment, and
prevention of disease.”
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11. Public Health
In 1920, C-E.A. Winslow defined public health
as
“the science and art of preventing disease,
prolonging life and promoting health through
the organized efforts and informed choices of
society, organizations, public and private,
communities and individuals.”
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12. In a modern interpretation of Winslow's
definition, Beaglehole and Bonita (1997)
identified the following essential elements of
modern public health:
• collective responsibility;
• prime role of the state in protecting and
promoting the public's health;
• partnership with the population served;
• emphasis on prevention;
• recognizing underlying socio-economic
determinants of health and disease
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13. WHO Expert Committee defined as
• “Public Health is the science and the art of preventing
disease, prolonging life, and promoting physical health
and efficiency through organized community efforts for
the sanitation of the environment, the control of
community infections, the education of the individual in
principles of personal hygiene, the organization of
medical and nursing service for the early diagnosis and
preventive treatment of disease, and the development of
the social machinery which will ensure to every
individual in the community a standard of living
adequate for the maintenance of health; organizing these
benefits in such fashion as to enable every citizen to
realize his birthright of health and longevity.”
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14. Preventive Medicine
• Preventive medicine is a branch of medicine distinct to
public health.
• It is by definition applied to healthy people.
• It is the interface between public health and medical
practice
“Medical practices that are designed to avert and avoid
disease. For example, screening for hypertension and
treating it before it causes disease is good preventive
medicine. Preventive medicine takes a proactive approach
to patient care.’
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15. 15
Preventive medicine
• “Art and science of health promotion and
disease prevention”
• By definition preventive medicine is
applied to “healthy” people.
• Its primary objective is prevention of
diseases and promotion of health.

16. • These practitioners combine population-based
public health skills with knowledge of primary,
secondary, and tertiary prevention-oriented
clinical practice in a wide variety of settings.
• Preventive Medicine specialists have populations
rather than individual people as their patients.
• They assess and measure the health status of the
population and develop effective interventions at
the population level in order to improve health.
• They are leaders, advocates, and collaborators in
public health.
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17. • Preventive medicine ranges far beyond the
medical field.
• Modern preventive medicine has been defined
as “the art and science of health promotion,
disease prevention, disability limitation and
rehabilitation”.
• In sum, preventive medicine is a kind of
anticipatory medicine.
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18. 18
Social Medicine
• Defined as “The study of man in his social
environment and study of social factors
affecting health and disease”.
• Jules Guerin –first used this term and,
importance of social factors in the etiology of
disease was stressed.

19. Social Medicine
The field of social medicine seeks to implement social care through:
• understanding how social and economic conditions impact health,
disease and the practice of medicine and foster conditions in
which this understanding can lead to a healthier society.
 Social medicine as a scientific field gradually began in the early
19th century, the Industrial Revolution and the subsequent
increase in poverty and disease among workers raised concerns
about the effect of social processes on the health of the poor.
 The field of social medicine is most commonly addressed today
by public health efforts to understand what are known as social
determinants of health
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20. Over time the term “social medicine” took on
varied meanings as it was adapted to differing
societies and diverse social conditions.
Nonetheless, certain common principles underlie
the term:
1. Social and economic conditions profoundly
impact health, disease, and the practice of
medicine.
2. The health of the population is a matter of
social concern.
3. Society should promote health through both
individual and social means.
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21. • Firmly based in the medical profession, Social
Medicine reflected a concern with the role of
social factors in the etiology of disease, which
can be known as ‘social pathology’ and the
need for government action in the areas of
disease prevention and medical care.
• Social medicine tells human is not only a
biological animal, but also a social being, and
disease has social causes, social consequences,
and social therapy.
• So it stands on two pillars – medicine and
sociology
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22. Community Medicine
• Community Medicine have became prevalent as a
substitute for ‘social medicine’, since the latter term
sounds too much like “socialism”.
• Community medicine is a new comer.
• It is has burrowed heavily from the concepts,
approaches, and methods of public health,
community health, preventive and social medicine.
• It focuses on health of the community as a whole
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23. Continue…
• The Faculty of Community Medicine of the Royal College of
Physicians has defined community medicine as “that
speciality which deals with populations…. and comprises
those doctors who try to measure the needs of the population,
both sick and well, who plan and administer services to meet
those needs, and those who are engaged in research and
teaching in the field.”
• WHO study group stated that since health problems vary from
country to country, each country should formulate its own
definition of community medicine in the light of its traditions,
geography and resources.
• As of date, there is still confusion and conflict about the roles,
tasks and professional identities in the service as well as the
academic worlds of community medicine.
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24. Community Medicine may be defined as:
“The art and science of application of technical
knowledge and skills to the delivery of healthcare to a
given community, designed in collaboration with related
professions as well as human and social sciences on the
one hand, and community on the other.”
Goals of Community Medicine
• Focus shift from treatment of sick
• Prevention of Diseases
• Promotion of health
• Quality of life improvement for individuals & groups
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25. 20
“J M Last” defined Community
Medicine…
• Study of health & diseases in population of a
defined community.
• Goals are…..
- To identify health problems & needs.
(Community Diagnosis)
- To plan & implement measures.
(community health care/ services)
- To evaluate extent of effectiveness.
( health care evaluation)
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26. 26
• Ultimate goal of community medicine is -
-to prevent the disease.
-to promote the health.
-to prolong the life.
Ultimate goal of CM

27. 27
Branches of Community medicine
• Epidemiology
• Environmental health
• Rural /Urban health
• Communicable diseases
• Non-communicable diseases
• Vital statistics
• Occupational health
• Health planning & management…

28. Community Health
• A community is a group of individuals sharing an identity,
culture, and operates through common institutions and
organizations.
• Community health is a field of public health, a discipline that
concerns itself with the study and betterment of the health
characteristics of communities.
 While the term community can be broadly defined, community
health tends to focus on geographic areas rather than people
with shared characteristics. In some instance, it is used as a
synonym for ‘environmental health’.
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29. Understanding a Community
 In order to evaluate one’s community, one must
understand the factors that effect the health of a
community. The three main factors and determinants
of community health are as follows:
1. Physical Factors
2. Social and Cultural Factors
3. Individual Behaviors
(Source: McKenzie, Pinger, Kotecki, 2012)
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 Community Health: is the status of a defined group
of people and the actions and conditions to promote,
protect, and preserve their health.

30. Factors of Community Health
 Physical Factors: Examples:
 Geography Dry,Tropical
 Environment Smoggy, (polluted)
 Community Size 244,000
 Industrial Development Metropolitan, Rural
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31. Factors of Community Health Contd….
 Social and Cultural Factors:
– Traditions, prejudices, beliefs
– Economy
– Politics
– Socioeconomic Status
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32. Clinical Medicine
• "Clinical" as a term refers to the medical care of
real patients.
• Clinical medicine is the study and practice of
medicine by direct examination of the patient.
• The primary objective of the clinical medicine is
removal of disease from the patient (rather from
the mass).
• It employs various modalities to accomplish this
objective, e.g., diagnostic techniques, treatment
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33. Clinical medicine and community medicine
Clinical Medicine Community
Medicine
Objective Patient cure Health improvement
Information Complaint,
history and
related factors
morbidity, mortality
Investigations Laboratory tests, X-
ray, other tests
Survey studies
Diagnosis Differential
diagnosis
Community diagnosis
& priority setting
Resources Available therapy Health & Health
related services
Management Treatment Health programs
Evaluation status Follow-up of patient Assessment of health
of community
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34. THANK YOU
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