Pediatric Prevention: General Prevention

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Key points

  • Prevention may be divided into primary, secondary, and tertiary prevention.

  • Prevention can be an abstract concept: it is therefore useful to consider concepts from the medical social sciences when practicing prevention.

  • The “Prevention Paradox” describes that although high-risk individuals are more likely to experience a given outcome, most cases come from the broader population.

Then came the fifth and final triumph—the prevention of disease.

—William Osler1

The concept of prevention in medicine

Primary, secondary, and tertiary prevention

The standard framework by which to view preventive activities is through primary,2 secondary,3 and tertiary4 prevention. In particular,

  • Primary prevention describes efforts to stop disease from occurring in individuals who have no history, and no current signs or symptoms, of the disease one is attempting to prevent. Importantly, primary prevention attempts to mitigate the risks of developing a disease before it develops. Examples include vaccination of uninfected individuals, lead abatement in

Applying prevention in practice

Several considerations should come into play when considering theprimary-secondary-tertiary (PST) Prevention framing. Perhaps first, and most obviously, once one is considering where a strategy falls along the prevention continuum, it becomes apparent that disease must be considered along a spectrum of progression, as opposed to a binary “sick/not sick” status. The practical ramification of this point is that there is always something that can be done to prevent progression to a next (and

Acknowledgments

The authors are grateful for comments on a draft version of this article provided by Martha Wojtowycz, PhD.

Disclosure

The authors have nothing to disclose.

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References (11)

  • W. Osler

    Chapter VI - the rise of preventive medicine

  • V. Reisig et al.

    Prevention, primary

  • M. Wildner et al.

    Prevention, secondary

  • E. Grill et al.

    Prevention, Tertiary

  • A. Kleinman

    The illness narratives: suffering, healing, and the human condition

    (1988)
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