Talk:Preventive healthcare

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Karlaaa8a (article contribs).

Page name

Before anyone brings it up, yes, "preventative" is a word, and it is an alternative form of "preventive". However, it is not the correct word for this area of medical specialization. Carl 21:36, 30 October 2005 (UTC)

What's your source for 'preventative' not being correct for this 'area' of medical specialization.

I've taken the liberty of rephrasing the preventative/preventive sentence to avoid the suggestion that 'preventative' is 'not in the dictionary'. I have emphasized that 'preventive' is the preferred form.

Obscene soviet breasts

Inappropriate for the younger readers, i do feel, must be removed to meet universal guidelines and regulations.

I agree, because, in a generally broad subject like this, there are many alternatives available.

I don't think it's obscene, as it is intended to be didactic rather than pornographic. However, the current caption does not make sense. "A 1930 Soviet poster propagating breast cancer?" Can someone who reads Russian provide a better translation or explanation? MlleDiderot 14:14, 12 November 2006 (UTC)

Removed section

I removed the following section because it's far too detailed and off-topic for this article. Perhaps some can be incorporated into Association of Preventive Medicine Residents and American Board of Preventive Medicine Examination. --David Iberri (talk) 04:01, 2 May 2006 (UTC)

Agreed that it is inappropriate material here. It was reinserted, but now once again removed.--cjllw | TALK 13:26, 25 May 2006 (UTC)

Seems like description of a person who practices preventive medicine could be useful information on a "Preventive Medicine" page -- I have reinserted this material and hope it can stay. June 14 2006

I've also removed the section; it's not written in the same tone as anything else on Wikipedia, and a q&a session / personal account is impossible to fact-check or ensure a neutral point of view. If it could be rewritten in the third person, generalising rather than specifying, and making larger claims or descriptions of the nature of preventive medicine, it would be a much better addition. Ziggurat 21:46, 14 June 2006 (UTC)

Abortion

Abortion should be in the list of preventative deaths, the numbers are astonishing for the United States of America alone.

No, as it is not a independent sentient living human.--Doc James (talk · contribs · email) 08:56, 19 February 2009 (UTC)

Deaths from abortions are relatively rare in the US. Much more common in other countries where access to safe and sanitary abortion more limited. (see Unintended pregnancy, Unsafe abortion, Maternal death) But a bit more coverage of preventive benefits of contraception and reproductive health care here wouldn't be amiss here. Zodon (talk) 21:35, 19 February 2009 (UTC)

I think the above editor was referring to the deaths of the fetus.--Doc James (talk · contribs · email) 21:16, 4 March 2009 (UTC)

is suicide considered a preventable death?

and if it is considered within this category - what are the numbers? —Preceding unsigned comment added by Earlypsychosis (talk • contribs) 05:54, 5 March 2009 (UTC)

Don't know about preventability, for stats, consider Suicide#Epidemiology, List of causes of death by rate group G.1 Zodon (talk) 07:27, 5 March 2009 (UTC)

you can't vaccinate against suicide, but early intervention for some psychiatric conditions is considered prevention of suicide - one can argue about whether this is prevention or whether a disorder already exists and 'early intervention' is the appropriate terminology - b - betswiki (talk) 21:46, 16 June 2009 (UTC)

yes primary vs secondary prevention for psychosis (see my user name for my interest !!), but there is also a well developed mental health promotion field and some good examples of extensive suicide prevention projects Earlypsychosis (talk) 18:34, 17 June 2009 (UTC)

Thinking on mental illness prevention has moved on a lot (see e.g. Mental_disorder#Prevention) - we really should have suicide (80%+ of suicides have a mental illness component) and mental illness in here (JCJC777 (talk) 11:12, 23 December 2012 (UTC))

Public health campaigns

This news story says that Salovey has published on the use of positive and negative messages in public health campaigns related to prevention. Positive messages usually (but not always) work better. It might be interesting to see something on this subject in this article. WhatamIdoing (talk) 17:35, 7 January 2011 (UTC)

Lack of Criticism Section = Lack of Critical Thinking

This article reads like propaganda. There is no critique of "Preventative Medicine" techniques or assumptions. Do you believe that medical articles on Wikipedia should have some balance in the form of assessing the efficacy of the reported form of medicine through systematic reviews and reporting of popular criticism?Herbxue (talk) 00:33, 1 September 2011 (UTC)

Not clear that a criticism section would be a helpful way to handle this. Might be clearer to incorporate limitations of the various approaches into the appropriate sections.

Reports of popular criticism would be of dubious value (apt. to be undue weight, news, etc.). Would need clear high quality citations (WP:MEDMOS). Zodon (talk) 01:44, 1 September 2011 (UTC)

That guideline seems to indicate that there is no requirement for articles to be balanced in terms of point of view. Is it not an endorsement of "preventative medicine" to not include both a description and a critique?Herbxue (talk) 02:37, 1 September 2011 (UTC)

As noted in the lead of MEDMOS, it supplements, rather than supplanting the regular manual of style. I was just pointing out the need for high quality sources, especially when dealing with popular criticism. Too often coverage of popular criticism lends undue weight to or perpetuates popular misconceptions.

Certainly covering the limitations of preventive medicine makes sense. Whether to use a criticism section or another format depends on the material to be covered. Again - my comment was relating to form rather than content. Zodon (talk) 23:03, 1 September 2011 (UTC)

Sounds reasonable. So, you would not consider commentary on a website like Quackwatch to be an appropriate source for this article?Herbxue (talk) 02:56, 2 September 2011 (UTC)

In general, Quackwatch is considered a reliable source... so long as the statement is primarily about what Quackwatch's opinions are. There are many better sources available. Systematic reviews are often lovely. There are also some good books that deal with its limitations in various ways. I don't think that even its most ardent supporters believes that it is the solution to all the world's ills. WhatamIdoing (talk) 03:06, 2 September 2011 (UTC)

This thread got me thinking, so I started the limitations section. (Needs more work and additional citations.)

On the financial/profit angle - I expect (hope) there are articles on wikipedia already on that topic, but I don't know what they would be called. Any suggestions for appropriate wikilinks? Zodon (talk) 08:31, 2 September 2011 (UTC)

I'm not quite sure what you mean. Are you thinking about Cost-effectiveness analysis, or the idea that we don't choose to prevent some diseases, because BigCorp makes money off of treating them? If the latter, then you will find an example of that notion described and sourced at Breast cancer awareness#Environmental_breast_cancer_movement. WhatamIdoing (talk) 01:22, 4 September 2011 (UTC)

inexcusable prejudice

The following line refers explicitly to gay and bisexual men using condoms inconsistently with sex with men.

"PrEP is a measure taken daily (before, during, and after) possible exposure; for example, by gay or bisexual men who inconsistently use condoms during sex with men who may have HIV infection."

If a bisexual man uses condoms inconsistently might he not also use them inconsistently with women? The way this is phrased suggests that only male partners might have HIV, but this is obviously false. It also oddly suggests that only gay or bisexual men having sex with a man who might have HIV might get infected. Again false. If one's partner may have HIV then one is at risk, this is true for women as well as men. HIV is not a 'gay' disease. — Preceding unsigned comment added by 121.98.83.53 (talk) 23:13, 29 September 2011 (UTC)

Your logic is sound, but you are assuming that the writer was as thoughtful on this subject as yourself. I would bet $200 that there was no intention to distinguish bisexual male-on-male sex here, but in fact failure to distinguish it. It is incompetence, not discrimination, at work here. Anarchangel (talk) 00:39, 31 May 2014 (UTC)

What are the origins of primary secondary and tertiary prevention?

The originator(s) of this useful concept is/are not given credit. Does anyone know where the concept originated? A reference would be good. The late Dr Wendy Dawson once told me that her step-father, Dr Don Rittey, was the originator. But I do not know if this is so. Dr Rittey was a one-time Permanent Secretary for Health in Zambia (Late 1960s I think) and was a British-trained public health specialist. He taught social medicine at the University of Zimbabwe (called Rhodesia at the time) prior to his death in the late 1970s. — Preceding unsigned comment added by 105.227.185.205 (talk) 14:23, 8 August 2013 (UTC)

Suggested Edits/Restructuring of the Preventive healthcare page

Hello Wikipedia community! I noticed that this page was flagged for several issues and I am editing it as part of a class assignment. According to Wikipedia, this page is currently more opinionated than encyclopedic, lacks adequate citations, and limits the examples and perspective to the United States. The page itself is quite sparse and does not appear to have a specific focus or logical progression of sections. There are several sections which include superfluous information and some of the most important information, the actual preventive methods, is crammed into one unorganized section called “Prophylaxis.” I hope to add more information, create a more academic tone, and reorganize the sections such that the page flows smoothly. I also hope to discuss preventive care in developing nations and will separate my main topics into subtopics titled "United States" and "developing nations." My proposed changes are below and I greatly welcome any suggestions, comments, or feedback.

First, I will add 2-3 introductory paragraphs that describe what preventive healthcare is, why it is important, the primary diseases to which it applies, and more broadly, how it is implemented. This will only be a very brief summary to give readers an abridged preview of the rest of the page and will not include thorough detail. Next, I will merge the “Definitions” and “Universal, Selective, and Indicated” sections to describe the different levels of prevention. I will define primary, secondary, and tertiary prevention, and include examples based on the individual and population level. I will likely omit the “Tier” section since it is not as commonly cited as primary, secondary and tertiary levels. Someone else noted that it would be important to cite the origins of primary, secondary, and tertiary prevention, and I agree. I will try to track down the original source of this terminology. Next, I will outline the leading causes of preventable death in the United States and worldwide. I will describe the causes of such diseases as well as the behaviors and exposures that lead to the diseases and deaths. However, I will not go into depth about specific preventive methods until the “Methods of Prevention” section. For example, I may state that sedentary lifestyles can lead to cardiovascular disease in the “Leading causes of preventable death” section but I will wait until the “Methods of Prevention” section to describe the recommended duration and frequency of daily exercise needed to prevent disease. For the developing nations section, I will organize my topics in a similar manner. I will also describe other preventive care methods that are important, though they may not fall under the leading causes of death, including birth control/family planning, vaccinations, and dental care among others. Following the methods section, I will discuss currently implemented programs (or the lack thereof) in the United States and worldwide. I will explore several initiatives to demonstrate how governments and organizations implement public health initiatives to prevent disease. Finally, I will discuss the effectiveness of some preventive healthcare programs that have been evaluated in literature. I will talk about the benefits of preventive care (in terms of projected years of life saved, overall health improvement, reduced healthcare expenditures, etc.) as well as ways that these programs can be improved through legislation, grassroots health initiatives, etc. I intend to include examples of countries that have exemplary, moderate, and poor programs of preventive care.

I was wondering if any of you had any advice regarding the structure of my proposed changes. I worry that some of the information I present (especially between the United States and developing nations sections) will be redundant. I also am concerned about how I will choose which developing nations to discuss in order to give a holistic and connected global view of preventive healthcare. Does anyone have any comments or suggestions on how to avoid being repetitive or having an overwhelming amount of disparate information? Below is my proposed outline in a bit more succinct form:

Outline:

1. Levels of Prevention

2. Leading Causes of Preventable Death

2.1 United States

2.2 Developing Nations

3. Methods of Prevention

3.1 United States

3.2 Developing Nations

4. Currently Implemented Programs

5. Effectiveness

7. See also

8. References

9. External links

I am excited to edit this page and look forward to hearing back!

LWang1991 (talk) 19:59, 27 February 2014 (UTC)

Thank you in advance for your efforts!

I think you have appropriately identified some of the challenges in this topic - mainly, that "preventive healthcare" is in some ways just a dictionary definition; "health care that is meant to prevent rather than to treat disease."

Your outline looks quite good. I feel like the only guidance I could give would be to make you aware ahead of time about some of the issues in this topic that you are likely to run into later on:

1. As you go through "Leading causes of Preventable Death," you may find that quite a few of them are problems that fall outside of the purely "medical," especially in developed nations. I don't have a list in front of me, but I anticipate you finding smoking, alcohol, motor vehicle accidents, and violent crimes, to dominate the list. Most cancers and infections, in the developed world, aren't really preventable in the same way that they used to be.

2. As you get into the cost literature, you will find that most preventive health care does NOT save money, which is a popular myth. Very few interventions (vaccines among them), are so cheap and effective that they actually reduce costs down the road. Mammograms, colonoscopies, blood pressure medications, cholesterol medications...they all certainly improve health, but they do so at at cost; it would actually be cheaper to treat the breast cancers and heart attacks later on than to give this preventive care to millions of people.

3. Preventive care in the developing world (some parts of Africa are the exception) is starting to look much more like the developed world. The historic killers (vaccine preventable illness, poor sanitation, etc) are becoming less and less, and rich world problems (diabetes, hypertension) are starting to rise.

Hope this is helpful!

AaronM (talk) 14:20, 28 February 2014 (UTC)

That does sound like a lot work. Doing a complete re-write from scratch may not be the best approach. Try improving what is there and adding what is missing if you can. One thing to remember is that others will be watching to see that it meets our policies and guidelines, in particular our Wikipedia:Manual of Style, which as a new editor you are not expected to know completely. To assist those watching it is a good idea to work on one section at a time with an initial major edit. You then might want to come back after a short break of a couple of hours to see if anyone else has improved your addition, to possibly learn something from their changes and then tweak that section yourself or make your own minor corrections before working on the next section and repeating the process. During a break you can type up some notes, type up references for the next section or read a policy page. Of course this is just a suggestion. - Shiftchange (talk) 14:40, 28 February 2014 (UTC)

Beginnings of the project

Hi everyone, I am going to start editing the page today. Throughout the next month and a half, I will be adding and removing sections and continuing to revise what I have added. Thank you everyone for your feedback, I will keep your suggestions in mind during this process. To someone's previous comment, I found the original authors of primary, secondary, and tertiary prevention. I have requested the original publication so it will be here in a few days (I hope) and then I will make the necessary changes.

LWang1991 (talk) 16:04, 16 March 2014 (UTC)

Peer Review

I think you have done a lot of good work on this article. One easy improvement you could make is to enlarge the graphs so they are readable without clicking on them. The disease categories all sound good, but you could additionally add lung cancer, skin cancer, smoking, drug, and alcohol use, and sexual health. Sexual health seems particularly relevant since you mention syphilis prevention earlier in the article. I don't think you necessarily need to go into depth into each topic (someone else will hopefully fill them out later), but just mentioning a few major ways to prevent those specific conditions and how frequently preventative measures are used would be helpful. The other main suggestion I have is to incorporate more of a world view and add information on preventative healthcare in the developing world. You could focus on immunizations, chemotherapy, nutrition, sanitation, and health education. All these are relevant in all regions of the world. Overall, I think the article looks good!Juliannadrew (talk) 07:46, 1 April 2014 (UTC)

Final Edits

Hi everyone. I really appreciate the feedback you have given to me on this page. I am nearing the end of my class assignment and have realized a few things about my page. While I do feel that it is an improvement over the previous page, I definitely was overly ambitious in the scope of material I had originally hoped to cover. Because of this, my section "Preventive Methods for Different Diseases" is much less comprehensive than I had planned. Since I had hoped to give this page both a global and American focus, I was only able to complete a few sections before the deadline. However, the good thing about Wikipedia is that it is a community effort and a continual process. I recommend adding the following sub-sections to my "Preventive Methods" section, but of course you all can pick and choose at your discretion: breast cancer, prostate cancer, heart disease, diabetes, oral/dental health, mental health, STD's, and infectious and communicable diseases. Again, thank you for your feedback and I look forward to seeing how this page grows and expands! LWang1991 (talk) 03:54, 25 April 2014 (UTC)

The original research part

The column have the 4. Quaternary prevention , but all my text book only mention about 1.Primary prevention 2.Secondary prevention 3.Tertiary prevention as the presentation version. can the people who add this into the article,I will removed this part until someone show the reliable reference that really prove this thing existent?
--36.225.99.162 (talk) 03:23, 28 December 2015 (UTC)

U.S. Preventive Services Task Force

An interesting overview appeared here in the Washington Post about the U.S. Preventive Services Task Force. It may be useful. LeadSongDog come howl! 20:47, 7 March 2016 (UTC)

Dr. Carrieri's comment on this article

Dr. Carrieri has reviewed this Wikipedia page, and provided us with the following comments to improve its quality:

The paragraph "Health disparities and barriers to accessing care" does not consider research from European countries. Despite the existence of universalistic health care systems, there is evidence of income-related inequalities in the access to preventive care in many European countries [1,2] and of a significant influence of socio-economic conditions on the demand of preventive care in Europe [3,4].

[1] Carrieri, V., Wuebker, A. Assessing inequalities in preventive care use in Europe, Health Policy, 2013, 113: 247-257. [2] Jusot F, Or Z, Sirven N. Variations in preventive care utilisation inEurope. European Journal of Ageing 2011;9(1):15–25. [3] Schmitz H, Wübker A. What determines influenza vaccination take-up of elderly Europeans? Health Economics 2011;20(11):1281–97.

[4] Carrieri V, Bilger M. Preventive care: under-used even when free. Is there something else at work? Applied Economics 2013;45(2):239–53.

We hope Wikipedians on this talk page can take advantage of these comments and improve the quality of the article accordingly.

We believe Dr. Carrieri has expertise on the topic of this article, since he has published relevant scholarly research:

• Reference : Vincenzo Carrieri & Ansgar Wubker, 2012. "Assessing Inequalities in Preventive Care Use in Europe," Ruhr Economic Papers 0371, Rheinisch-Westfalisches Institut fur Wirtschaftsforschung, Ruhr-Universitat Bochum, Universitat Dortmund, Universitat Duisburg-Essen.

ExpertIdeasBot (talk) 20:27, 1 July 2016 (UTC)