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Prevention. Judy Monroe, M D Indiana State Health Commissioner June 19, 2009. The Order of Prevention. Primary Prevention - means it never occurs Secondary Prevention – detect and prevent progression of conditions before they are symptomatic
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Prevention Judy Monroe, MD Indiana State Health Commissioner June 19, 2009
The Order of Prevention Primary Prevention - means it never occurs Secondary Prevention – detect and prevent progression of conditions before they are symptomatic Tertiary Prevention - prevent the progression and complications of disease and symptoms already occurring
Domains of Prevention Primary Prevention – largely the domain of public health (community prevention – aimed at the population) Secondary Prevention – largely the domain of primary care (clinical practice – aimed at the individual) Tertiary Prevention – largely the domain of subspecialists
Examples of Prevention Primary Prevention - $ • immunizations • weight control and exercise to prevent type 2 diabetes • folic acid to prevent neural tube defects in newborns
Examples of Prevention Secondary Prevention - $$ • control hypertension – prevent stroke • control cholesterol – prevent heart disease • mammograms
Examples of Prevention Tertiary Prevention - $$$$$$$ • intensive care treatment for complications of pneumococcal pneumonia to prevent death • intensive treatment of diabetes to prevent an amputation • surgery to prevent complications of a neural tube defect
Examples of Prevention Tertiary Prevention - $$$$$$$ • rehabilitation of a stroke victim to prevent being wheel chair bound • management after a myocardial infarction to prevent another infarction • treatment of later stage breast cancer after delayed diagnosis
Why Prevention is Important to a State’s Effort to Improve Population Health
Why Prevention is Important to Attracting Businesses Healthy workforce benefits business • more productive workers • less absenteeism • less injuries Healthcare is the most expensive benefit paid by U.S. employers
Indiana’s Prevention Programs INShape Indiana • nutrition, physical activity, and tobacco control Indiana Workplace Wellness Partnership Indiana Hospital Association State Employee Wellness – One Care Street Healthy Indiana Plan Wellness Tax Credit Lactation Support in the Workplace (IC-22.2-14.1)