Preventive Corrective actions: Any action taken to prevent the occurrence of undesired event is called Preventive action and any action, taken after commencement of such undesired event, in order to prevent the reoccurrence of same or, similar event, is called Corrective action. The former action is taken by choice and latter is taken under compulsion.
The preventive healthcare means (PHC) taking all precautionary measures before occurrence of any probable disease which, the body is prone to, to keep the body fit. PHC includes immunizations, lab tests, physical examinations, diagnostic services as prescribed by the Doctor to better understand the symptoms and diagnose the illness.
The body undergoes different physiological dynamic processes which may affect the body adversely before an individual realize. Hence, the preventive actions should be taken on regular basis. The preventive healthcare strategies are categorized as primal, primary, secondary, and tertiary preventions.
Primal prevention: The purpose of this type of prevention is to help the future parents by providing them adequate attention and secure physical and affective environments for conception to first baby. The concept of primal prevention is very recent and it deals with the Epigenetics (study of changes in organism, caused by change of gene’s expression rather than alteration of the genetic code.
Primary prevention: This prevention is meant to avoid occurrence of disease either through eliminating disease causing agents or, by increasing immunity to disease. The immunization against disease, maintaining a healthy diet and regular exercise are few examples.
Secondary prevention: It deals with an existing disease prior to the appearance of symptoms. The examples include treatment of hypertension (a risk factor for many cardiovascular diseases), cancer screenings etc.
Tertiary prevention: This prevention is meant to reduce the harm of symptomatic disease, such as disability or death, through rehabilitation and treatment. The examples are surgical procedures to prevent the spreading or, progression of disease.
As mentioned above, there are several methods for prevention of disease. It is advisable for adults and children to visit doctor for regular check-ups, even if they feel healthy in order to identify risk factors for diseases, discuss tips for a healthy and balanced lifestyle, stay up to date with immunizations, boosters etc.
The investigations and screenings are required for many diseases like Hypertension, Hyperglycemia, Hypercholesterolemia, Colon Cancer, Depression, HIV and other common types of Sexually transmitted diseases e.g: Chlamydia, Syphilis & Gonorrhea, Mammography, Colorectal Cancer, Pap smear, Osteoporosis etc.
Other genetic tests are also required to be done for probability of ‘Mutation’ which may cause genetic disorders like cancer of breast or, Ovary in later stage. However, these tests are costly for effective preventive healthcare.
The PHC providers are basically medical professionals like Physician, Cardiologist, Gastro-enterologist, Nephrologist, Psychologist, Ophthalmologist, Dentist, Oncologist, Neurologist etc. for providing primary, secondary and tertiary care.
Preventive methods for different diseases:
Obesity: It is a major risk factor for cardiovascular diseases, hypertension, certain cancers, and type 2 diabetes. In order to prevent obesity, it is recommended that such persons should strictly follow consistent exercises along with nutritious and balanced diet. The habit of routine exercise and healthier diets plays a vital role in reducing the risk for type 2 diabetes which is the main cause of kidney failure, limb amputation and new-onset blindness.
Oral Health: The oral cavity, or the mouth, harbors a plethora of microorganisms. These are considered as normal commensals of the oral cavity and cause harm only when any natural balance is altered. The most commonly occurring disease that is prevalent in individuals is Dental caries, or tooth decay. It can be prevented at an early stage by various methods such as regular and meticulous tooth-brushing with fluoridated toothpastes, using dental floss to remove debris from areas between the teeth which cannot be accessed by the toothbrush. In children, at an early age, other preventive measures may be taken like Fluoride application. It is done at pre-decided intervals, if the patient is more prone to caries, and this assessment is done by a dentist during regular check-ups. A technique known as ‘Oil Pulling’ is undergoing a lot of research. It implies swishing of a vegetable oil, such as coconut, sesame or sunflower oil, in the mouth for about 10-15 minutes, and then spitting out when it turns milky white. It is to be done once daily in the morning before breakfast and even brushing. It is known to flush out toxins from the oral cavity and cleanse the entire area, reducing the microbial load to a great degree. By these suggested mechanisms of actions, it reduces halitosis, prevents caries and other disease such as gingivitis. It is also known to be a good teeth-whitening solution and is practiced by celebrities like Gwyneth Paltrow and Shailene Woodley. There are no known side effects and the oils used are readily available and cost effective. However, this technique should not replace the regular cleaning aids and mechanical removal of plaque and debris with a toothbrush is necessary.
Sexually transmitted infections (STIs): These are common infections, occurred in our society. It is difficult to self-diagnose during the early stage of some STIs, hence, it is imperative that primary and secondary prevention methods are used. Condom and other barrier use prevent the transmission of many STIs. But, for others such as syphilis, condom use will only protect a user when the syphilitic sore is located on the penis or in the vagina. Unfortunately, chancres (Painless ulcer) can be found not only on the external genitals but on the anus, in the vagina or rectum, and on the lips or inside the mouth. Due to this, prevention should focus not only on condom use, but on abstinence, picking a safe and reliable partner, and on regular screenings.
Cancer: The Cancer is a global problem. The primary prevention of cancer and knowledge of cancer related risk factors can reduce over 1/3rd of all cancer cases and can also prevent other diseases both communicable and non-communicable that share common risk factors with cancer.
Lung cancer: It is the leading cause of cancer-related deaths. Tobacco is an environmental carcinogen and the major underlying cause of lung cancer. Between 25% and 40% of all cancer deaths and about 90% of lung cancer cases are associated with smoking the tobacco. Other carcinogens include asbestos and radioactive materials. Both smoking and second-hand exposure from other smokers can lead to lung cancer and eventually death. Therefore, prevention of tobacco use is utmost requirement to prevent lung cancer.
Lung cancer and tobacco smoking are increasing worldwide, especially in China. China is responsible for about 1/3rd of the global consumption and production of tobacco products.
Skin cancer: It is most commonly found in Australia & USA. In US, alone, around 50,000 deaths are caused by Skin Cancer. The childhood prevention is very important there because a huge exposure to the ultraviolet radiation from Sun occurs during childhood and adolescence and can subsequently lead to skin cancer in adulthood.
Australians have higher knowledge of sun protection and skin cancer as compared to other countries. The Sun protection cream is widely used among children, adolescents, and adults. So many adolescents use this sunscreen purposely with a low sun protection factor (SPF) in order to avoid a tan. Many Australian adults do not use the cream in proper way and many apply sunscreen after their initial sun exposure and fail to reapply when necessary. The sunscreen with SPF >15 should be used.
Cervical cancer: It is most commonly found in women of Latin America, Africa and parts of Asia. The study of Cervical cytology helps to detect abnormal lesions in the cervix. The preventive care alerts woman to take necessary treatment prior to the development of cancer. A high quality screening and follow-up care help to reduce cervical cancer rates by up to 80%. The sexually active women should go for a PAP test every 3–5 years.
Colorectal cancer: This is also called Colon, Bowel or, Rectal cancer. It is globally the second most common cancer in women and the third-most common in men and the fourth most common cause of cancer death after lung, stomach, and liver cancer. This Cancer is preventable by taking preventive health care. About 80% of colorectal cancers begin as benign growths, commonly called polyps, which can be easily detected and removed during a colonoscopy. Other methods of screening for polyps and cancers include fecal occult blood testing. Lifestyle changes that may reduce the risk of colorectal cancer include increasing consumption of whole grains, fruits and vegetables, and reducing consumption of red meat.
Health disparities and barriers to accessing care: The preventive health care services are unequal as the quality of care received, depends. The health disparities are very common worldwide. The elderly adults (>65 years) receive worse care and have less access to healthcare than their younger counterparts. The same trends are seen when comparing low-income people to high-income people. The uninsured people do not seek healthcare until their diseases progress to chronic and serious states.
The common barriers worldwide include lack of availability of health services and healthcare providers in the region, great physical distance between the home and health service facilities, high transportation costs, high treatment costs, and social norms and stigma toward accessing certain health services.
The health economics of preventive care: The cost-effectiveness of preventive care is a highly debated topic. Some economists argue that preventive care is valuable and potentially cost savings and others believe that it is an inefficient waste of resources. The preventive healthcare is mostly composed of annual doctor’s check-ups, annual immunization, and wellness programs.
Health insurance and Preventive Care: Healthcare insurance companies are willing to pay for preventive care despite the fact that patients are not acutely sick in hope that it will prevent them from developing a chronic disease later on in life.
Overview: There is no general consensus as to whether or not preventive healthcare measures are cost-effective, but, definitely, they increase the quality of life. There are different views on what constitutes a Good investment. Some argue that preventive health measures should save more money than they cost, when considering the treatment costs in the absence of such measures.