Talking about public health can be tricky, because so many of the terms we use sound like jargon. When public health professionals are talking to each other, that may not be a problem; but when we’re trying to explain our work to community members or professionals from other sectors, the words we use might be confusing. Because CHNA 20 is deeply committed to growing collaborative relationships with all members of our communities -- not just the public health experts -- we’ll be periodically sharing simple explanations of complicated-sounding jargon we use when we discuss our work. We hope this will help demystify some of the jargon and make our efforts more understandable and accessible to our communities.
What are the types of prevention?
While health care typically deals mainly with diagnosing and treating disease, public health looks at trying to improve a broad spectrum of outcomes related to health and well-being -- ideally, preventing health problems from developing in the first place. That’s the basic idea behind prevention strategies, which can be understood as three types of preventive measures:
Primary prevention refers to efforts to prevent health problems before they occur in the first place. Like damming a river to prevent later floods, primary prevention means looking at the possible root causes of a specific health challenge and working to improve those root causes. Examples of well-known primary prevention efforts include vaccinations, seatbelt and car seat policies, and legislation against hazardous chemicals.
Secondary prevention means trying to lessen the impact of an already-developing problem -- in other words, stopping an identified health challenge in its tracks. Early detection of disease through community screenings, such as skin cancer or blood pressure screening events, is a common example of secondary prevention in action.
Tertiary prevention refers to responsible management of a health challenge that’s already developed. Since it’s obviously not possible to stop every disease, illness or injury before it occurs, tertiary prevention takes steps to manage existing health problems in an effort to stave off further complications. Examples of tertiary prevention include chronic disease management protocols, rehabilitation programs and regular therapies.
You can read more about the different types of prevention from these sources:
CDC
Institute for Work and Health
National Collaborating Centre for Determinants of Health
Do the types of prevention apply to behavioral health as well as physical health? And is there a link between prevention efforts and the social determinants of health?
Yes! Although most of the examples we outlined above are more aligned with physical health and wellness, prevention is vitally important to all aspects of the public health field. Prevention efforts are particularly important in behavioral health, especially substance misuse programming. Well-known initiatives such as mental health first aid training and the placement of culturally competent community health workers are also examples of aligning prevention with behavioral health needs.
The three types of prevention also go hand-in-hand with the social determinants of health, since prevention as a discipline is based in discovering and treating root causes of problems before they can threaten individual or community health. To get a better sense of how prevention and SDoH are related, it’s helpful to think about upstream, midstream and downstream interventions.
Upstream interventions are large-scale efforts, usually at the policy level. These interventions are all about examining the structural social determinants, such as wealth inequities, educational opportunities, and social constructs such as systemic racism, that affect health on a national and even global scale.
Midstream interventions occur at the regional, state and local levels. These interventions look at social determinants such as housing equity, safe working conditions and access to transportation that can impact health disparities. Midstream interventions still operate largely through systemic and policy change.
Downstream interventions deal with the more immediate daily needs of a marginalized population. Helping families access nutrition assistance programs, safe and affordable child care options or culturally competent mental health services are all examples of downstream interventions that deal with social determinants of health through direct services to the people who need them.
Through our work with the Blue Hills RCC, Three Rivers Interlocal Council, the Randolph Community Wellness Plan and many other regional efforts, we consistently employ different types of prevention and intervention strategies to meet community needs. The Blue Hills Community Health Alliance is committed to addressing systemic root causes of public health disparities in our region with the help of our partner organizations. If you’re interested in learning more about prevention frameworks or need tools for use in your work, we encourage you to check out our ever-expanding Resource Library.