Merck Manual

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Professional Version

Public Health Foci of Prevention

By

Donald L. Noah

, DVM, DACVPM, College of Veterinary Medicine and DeBusk College of Osteopathic Medicine, Lincoln Memorial University;


Stephanie R. Ostrowski

, DVM, MPVM, DACVPM, Department of Pathobiology, College of Veterinary Medicine, Auburn University

Last full review/revision May 2015 | Content last modified Jun 2016

When considering opportunities and methods to address health problems, three stages of prevention are generally recognized:

1) Primary prevention—focuses on avoiding development of a disease by preventing it before exposure. Examples of primary prevention strategies include immunization programs, health education, and smoking cessation interventions. Because disease is largely avoided by these strategies, primary prevention is generally regarded as the most cost-effective form of prevention.

2) Secondary prevention—focuses on early disease detection and intervention, ideally before the onset of clinical signs. Examples include screening programs against various forms of cancer (eg, breast, colon, prostate, etc), postexposure rabies prophylaxis, tuberculosis skin tests, and infectious disease contact investigations.

3) Tertiary prevention—focuses on the treatment and rehabilitation of individuals with disease(s). Examples include antimicrobial therapies, hypertension drugs, and heart attack and stroke rehabilitation. Because this stage focuses its efforts after a disease is established, tertiary prevention has proved the most expensive form of prevention.

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