Prevention Is Better Than Cure Example


Prevention Is Better Than Cure Example
Which public health intervention do you think should be introduced to address the health inequalities that currently blight Britain? Theresa Marteau explores ideas on health inequality for the 2019 Bennett Prospect prize. Prevention is better than cure. For example, about 75 per cent of Type 2 diabetes could be prevented if the causes were effectively addressed. Done equitably, this would go some way towards reducing the eight-year gap in life expectancy between the rich and the poor, and the 19-year gap in years lived in good health.

The fiscal case for prevention is also strong given that, to use the same example, Type 2 diabetes accounts for around £1 in £11 of the NHS budget. Successive Health Secretaries have recognised this reality. Yet the governments they serve have generally failed to prioritise prevention. Is the repeated failure because we don’t know what could work? Or are the political costs of implementation too high? Or maybe it’s both? Clearly, fresh thinking is needed, so this year’s Bennett Prospect Prize is asking the question: Which single public health intervention would be most effective in the UK? Smoking, unhealthy diets, alcohol and physical inactivity are the leading causes of premature deaths in England.

These behaviours are more common amongst those living in areas of high deprivation, thereby contributing to inequalities in health. Changing these behaviours at scale requires many interventions at different levels, targeting the “causes of the causes”—including poverty, education and housing—as well as the more direct causes themselves.

  1. Priority needs to be given to interventions with the greatest chance of the largest equitable effects.
  2. But which are they and how are they most effectively introduced? Predictive Prevention is one approach that has captured the attention of, amongst others, the current Secretary of State for Health, Matt Hancock.

This enthusiasm is born of an expectation that informing individuals of their risks of disease and how to reduce them—such as increasing physical activity to reduce the risk of Type 2 diabetes—changes their behaviour. The evidence, however, does not support these expectations.

  1. While personalised predictions can increase people’s motivation to change, they have (at best) minimal impact on how people actually behave.
  2. As attested by almost a century of evidence from the psychological and behavioural sciences, much of our behaviour is shaped more powerfully by the multiple, overlapping environments in which we live—physical, economic, social, digital and commercial—often without our awareness.

In short, changing environments is more effective in changing our behaviour than any form of persuasion. Interventions in economic environments provide one important example: targeting the affordability of products that harm health, whether that be tobacco, alcohol, foods high in fat, sugar and salt, or fossil-fueled transport.

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In spite of this, however, the recent “Health Taxes to Save Lives” report co-chaired by Mike Bloomberg and Larry Summers identified such effective fiscal interventions as underused by governments worldwide. Their report also noted affected industries making false or misleading statements about the effectiveness of such taxes and their impact on the poor.

Such misleading statements were also expressed by our own Prime Minister, Boris Johnson, when rallying against “sin taxes” in his successful campaign to lead the Tory Party. All of this adds up to a clear case of missed potential—but, equally, the chance to propose innovative solutions that can meet urgent public policy needs.

  • Ten years ago, Michael Marmot’s “Fair Society, Healthy Lives” sounded a call for intervention.
  • How might interventions in the domains he outlined—from early child development to lifelong learning, and from minimum incomes to good working conditions—be translated into policy? Which public health intervention do you think should be introduced to address the health inequalities that currently blight Britain? The closing date for entries to this year’s Bennett Prospect Prize is 31 December 2019 with the winning essay published online in Prospect.

How to enter To be eligible an applicant should be within five years either of having submitted their PhD or of starting work in a policy-focused career. Applicants should not be in possession of a tenured academic position. Click here for full details of the prize.

What is the mean of prevention is better than cure?

It is better to stop something bad from happening than it is to deal with it after it has happened.

What is always better than cure?

Promotion of healthy lifestyles and the prevention of ill health is a fundamental principle behind public health and improving the public’s health. The phrase ‘prevention is better than cure’ is often attributed to the Dutch philosopher Desiderius Erasmus in around 1500.

  1. It is now a fundamental principle of modern health care and inherent within health and social care strategies across the UK (See: England, Northern Ireland, Scotland, Wales ).
  2. Prevention is about tackling the upstream causes of ill health, this in itself is not controversial.
  3. The challenge is how it is paid for.
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See: King’s Fund – Prevention is better than cure, except when it comes to paying for it, The results are not easily measured, because it is not easy to see where illness has not occurred. The UK has a rich history of focusing on prevention, from Edward Jenner’s smallpox vaccine in 1796 to John Snow using data analytics to determine the cause of the cholera outbreak in 1854.

While there has been huge progress across many public health trends, life expectancy in the UK has stalled and in some parts of the UK, has even decreased. There are worrying trends in health inequalities, with an unprecedented reversal in life expectancy for some groups and stark inequalities between healthy life expectancy between the most and least deprived areas.

Increasing rates of alcohol and drugs-related deaths and hospitalisations, STIs, and obesity and a shift in the pattern of ill health towards multiple health conditions are also indicative of the need for action. Nursing is essentially about providing quality evidence-based care and support to individuals and populations to improve health and well-being throughout life.

In the past, public health has been seen as a niche specialty far removed from the typical image of nursing and only practiced by those with very specific qualifications. Nursing and midwifery staff are now increasingly recognised as instrumental in improving and supporting the public’s health at an individual, community and population level.

All nursing and midwifery staff are well placed to do this and need to embrace the contribution they can make to prevention. The ongoing challenge is having enough staff with the skills and time to make this essential contribution. The RCN have been campaigning for many years for a greater focus on prevention with adequate funding.

This is particularly pertinent in England, following the transfer of funding for public health to local authorities in 2013 and thereafter significant year on year cuts to local authority budgets and to the public health grant. The RCN welcomed the announcement in the recent 2019 spending review of a real terms increase to the public health grant, which we see as a step in the right direction.

However, indications are that the increase will likely fall short of the amount needed to offset the years of cuts and is not based on an assessment of population need. Improving public health and preventing ill health is about more than health services; and requires action to address the wider determinants of health, for example, education, transport and employment, which need to be addressed alongside health services in a more systematic way and with cross-government action and investment.

The RCN’s commitment is for a properly funded cross-government prevention strategy with a nursing workforce who are able to deliver this. We are calling for a long term sustainable investment in public health and prevention, which is based on assessment of population need and an understanding of health inequalities.

The RCN has key alliances with a number of organisations to support lobbying on public health. For example we are members of the Alcohol Health Alliance who have recently called for £1 billion spent in tax to alcohol industry to be spent on funding 40,000 nurse vacancies.

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What diseases will never be cured?

Prevention Is Better Than Cure | Andrew Kok Wai Yun | TEDxAIMSTUniversity

Main Digest – Our incomplete list of incurable diseases also include rare diseases which are often genetic in nature. Incurable diseases are considered to be disorders of both infectious and non-infectious, neoplastic, autoimmune, genetic, or metabolic in nature that have no known current cure.

  1. Terminal illnesses include conditions such as late stage cancer, AIDS and some forms of heart disease.
  2. Although many incurable diseases are often terminal, there are also many incurable conditions that that a person can live with all their life.
  3. Medical conditions such as diabetes, asthma, Alzheimer’s and other forms of dementia, cannot be “cured,” but they can be managed.

In the past, medical treatment was all about treating the disease, but these days, many doctors have shifted their focus to the patient themselves, rather than just the disease. (Article continues below image.) Illustration of hospital symbols, medicine, health care, disease, doctor and two nurses. (Continued.)

What level of prevention is the most effective?

Primary prevention – Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur. Examples include:

legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets) education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking) immunization against infectious diseases.