1.1 What is prevention?
Prevention can be divided into three categories:
- Primary: the promotion of health and the prevention of illness, for example, immunisation and making physical environments safe
- Secondary: the early detection and prompt intervention to correct departures from good health or to treat the early signs of disease, for example, cervical screening, mammography, blood pressure monitoring and blood cholesterol checking
- Tertiary: reducing impairments and disabilities, minimising suffering caused by existing departures from good health or illness, and promoting patients’ adjustment to chronic or irremediable conditions, for example, prevention of complications (Figure 1).
Figure 1. Primary, secondary and tertiary prevention and the natural history of disease
In the context of general practice, a 'preventive approach' incorporates the prevention of illness, injury and disease, rehabilitation of those with chronic illness and the reduction in the burden of illness in a community. A preventive approach recognises the social, cultural and political determinants of health and is achieved through organised and systematic responses. It includes both opportunistic and planned interventions in the general practice setting.