In this blog post, I will be summarizing the article, "Global Noncommunicable Diseases - Where Worlds Meet" by NEJM. Then, I will be discussing my thoughts and opinions on this matter.
This article basically shows the increasing importance of preventive care for noncommunicable diseases. Noncommunicable diseases, such as heart disease, cancer, and diabetes, are becoming increasingly prevalent. According to the article, six of the top ten risk factors of all deaths are associated with noncommunicable diseases. Non-communicable diseases, unlike most communicable diseases, affect countries of all income levels. The reason for this is that as developing countries become more developed, they are becoming more urbanized. This results in demographic and lifestyle shifts that introduce bad habits such as eating excessively, which increases the chance of heart disease. This is quite a paradox because globalization is key to economic development and the improvement of health, but it also causes a higher incidence of noncommunicable diseases. There are multiple causes for noncommunicable diseases and these diseases can have lifelong impacts. In addition, monetary incentives for industries and interest groups hinder policy makers' effectiveness in dealing with the control of the risk factors behind noncommunicable diseases. This problem can be dealt with by a combined proactive intervention plan from all areas of society nationally and globally. It is surprising that there is a great overlap between the leading risk factors for death in both the richest and poorest countries. For example, the causes of high blood pressure, such as smoking and obesity, are usually applied to rich countries. It is hard to imagine citizens of poor countries having enough money to buy tobacco when there are definitely more pressing concerns. However, this may be likely the case because since most poor countries do not have a stable agricultural infrastructure or meat industry, they rely on foods rich in fats and oils, which are usually cheaper than agricultural goods or fresh produce. Therefore, the accumulation of these oils and fats into the blood vessels ultimately results in high blood pressure.
An example of a chronic disease is Epilepsy, a brain disorder that causes clusters of nerve cells to signal sudden motions. Primary prevention avoids the development of a disease by eliminating the risk factors associated with the disease. In this case, primary prevention deals with genetic screening and prenatal diagnosis in the pregnant mother for the genes that cause Epilepsy. Secondary prevention deals with preventing a disease from occurring among those who are at risk. In the case of Epilepsy, secondary prevention includes wearing seat belts, bicycle helmets, or anything that prevents head injury. Tertiary prevention is preventing a disease from worsening for those who already have the disease. In this case, various medications would be used for those who have epilepsy. The effectiveness of these prevention strategies would be more effective in more developed countries because there are more vehicles (more opportunity for head injury) and money for medications in developed countries whereas developing countries may not have as many risk factors or enough money for tertiary prevention. Also, in more developed countries, motor safety and bike riding policies may be easier to implement with an organized government rather than a government yet fully established, as in the case with most developing countries.
Good summary and discussion of the article. But your definitions of primary and secondary prevention are off. Primary prevention is about preventing someone from developing a disease. Secondary prevention is about early detection of a disease (i.e. screening tests). Your definition of tertiary prevention is correct, though. So for epilepsy, you could consider measures to prevent head injury as a primary preventive measure (although severe head injury is kind of an uncommon cause of epilepsy). Regarding secondary prevention, there are actually no secondary prevention measures for epilepsy because once you develop it you have seizures, which are (mostly) quite visible and distinct. So there are no "screening tests" for epilepsy. An example of a secondary prevention measure for another disease would be a routine mammogram to detect breast cancer before it causes any symptoms.
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