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Commentary |

From Disease Prevention to Health Promotion

Lester Breslow, MD, MPH
JAMA. 1999;281(11):1030-1033. doi:10.1001/jama.281.11.1030.
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Today, the phrase "disease prevention and health promotion" is commonly encountered. The idea of disease prevention alone is quite clear: "Primary prevention means averting the occurrence of disease . . . [and] . . . secondary prevention means halting the progression of a disease from its early unrecognized stage to a more severe one."1

During this century, disease prevention has changed largely from focusing on reducing environmental exposures over which the individual had little personal control, such as providing potable water, to emphasizing behaviors such as avoiding use of tobacco, fatty foods, and a sedentary lifestyle. Although individuals have a choice in these matters, as early as 1952 the President's Commission on Health Needs of the Nation noted that such individual responsibility for health can be fully effective only if society ensures access to necessary education and professional services.2 More recent reviews also have cited the need for social support for individual health initiatives.3

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