The continuously rising cost of medical care and the recognition that these increased expenditures do not seem to be accompanied by commensurate gains in the health status of the population have helped to focus our attention on disease before it happens, ie, on prevention. At the same time, we have learned a great deal about the factors that produce or are associated with the leading causes of death and disability. Evidence mounts to implicate personal behavior and the physical and socioeconomic environment as prime determinants of health and disease; hence, the rising interest in health policy discussions.
I shall broadly sketch the objectives, scope, problems, and challenges in the types of programs of prevention now emerging.1
Levels of Prevention
Prevention measures are either primary or secondary. Primary prevention consists of those actions that prevent a disease from occurring. Secondary prevention consists of activities designed to detect disease before it