INTRODUCTION TO PREVENTIVE MEDICINE, PUBLIC  Definition: “The art and the science of preventing diseases,

HEALTH, AND COMMUNITY MEDICINE prolonging life, promoting health and efficiencies through
organized community effort” – Winslow (1920)

OUTLINE
 As a consequence, programs oriented to prevention become
I. Introduction
more visibly identified with the range of care identified as a
A. Purpose of Medicine
function of public health.
II. Preventive Medicine
1. Public – personal preventive services
A. Types of Prevention
2. Private – personal curative services
III. Public Health
 But prevention is no more the exclusive province of public
IV. Community Medicine
health specialist. On the contrary, prevention should be
incorporated into the practice of physicians and other health
I. INTRODUCTION
care providers
A. Purpose of medicine according to Henry Siegrist  Present:
 Henry Siegrist – is a professor in history of medicine at John 1. Practice of public health is not limited to
Hopkins University. He popularized history of medicine in prevention
America making it more comprehensive and more significant 2. Best identified as a social movement concerned
in human and social terms. with protecting and promoting the collective
 He defined the four major tasks of medicine as: health of the community
o Promotion of health  Problems are viewed within the context of the community
o Prevention of illness as a whole rather than as simply something occurring in a
o Restoration of the sick / Restoring health series of individual.
o Rehabilitation Table 1. Practice of Public Health and that of the Clinician
 Preventive Medicine – focuses on promoting health and
(Leavel and Clark, 1965)
preventing illness
 Curative medicine – Restoring health and rehabilitation
 Four major tasks of medicine are all covered by Community
Medicine

II. PREVENTIVE MEDICINE

 Implies the application of a body of knowledge to the
prevention of disease
 As a discipline, it started with the prevention and control of
communicable diseases, but with the epidemiologic shift
from communicable to non-communicable diseases, as a
result of urbanization and industrialization, the focus of
preventive medicine also shifted from communicable
diseases to non-communicable diseases

 From this extension evolved the assumption that many if not

all health problems were theoretically preventable at some
stage of their evolution and that community-wide control
programs might be of practical use
 Also evolved from specific prevention (immunization) to non-
specific/general prevention (personal hygiene and sanitation)
towards health promotion.
A. Types of Prevention
 Specific Prevention – focus is on the
individual
 General/Non-Specific Prevention – has more
impact to the community, emphasis is on
health promotion, empower people to
participate in their own protection.

 It seeks to empower people to participate in their own

protection and achievement of good health and well being

III.PUBLIC HEALTH

 19th century, even before the discovery of microbes,

through the application of epidemiology, John Snow’s
classic study of cholera gave birth to the modern era of
public health

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 CHECKPOINT!
1. Identified the four major task of medicine
2. What is the focus of preventive medicine?
3. What is the focus of curative medicine?
IV. COMMUNITY MEDICINE
4. What is the start of preventive medicine as a practice?
 The provision of health care in the community, that is the
5. Is community wide control programs effective in
practice of medicine outside the hospital is sometimes preventing illness? True of false.
equated with community medicine. In this context, 6. Give an example of non-specific prevention.
“Community Medicine” is to signify health care focused on 7. Who studied cholera through epidemiology that gave rise
population, groups, rather than individual patient. to modern era of public health?
 Community Medicine is the study of health and disease in 8. Best identified as a social movement concerned with
the population of defined communities or groups in order protecting and promoting the collective health of the
community.
to identify their health needs, and to plan, implement and
9. Community medicine is synonymous to preventive
evaluate health programs to effectively meet these needs – medicine and public health. True or false.
(WHO) 10. What are the main factors that determine a community’s
 Community medicine may be distinguished from other forms health
of personal health care in the community, in that the
interest is centered on the community as a whole and on
the groups in which communities are composed

3. Restoring health

communicable
1. Henry Sigerist

rehabilitation
4. Prevention of
 Not the same as ‘preventive medicine’ or ‘public health’

preventing
health and
Public Health Practitioner Clinician/Private Practitioner

2. Promoting
because it provides comprehensive health services ranging

hygiene,
6. Personal
disease
from preventive, promotive, curative to rehabilitative

illness

5. True
and
services Specialist in preventive “General practitioners” of
 Serves as a link between Clinical and Non-clinical domain of medicine preventive medicine
medicine
Primary concern is disease Treatment of disease and injury

5.
6.
1.
2.

3.

4.
 Community Approach: Main factors that determine a
prevention
community’s health are to be found within the community
itself (e.g. social, cultural, or biological features, or in its Patient is the community Patient is an individual
environment (natural or man-made) – Social Determinants Seeks health procedures Strives to approach perfection in
of Health. which can be applied serving the individual patient,
economically to large number despite expense
- Community medicine is superior to the individually based of people with satisfactory
system because result
o It allows communal needs and problems to be Uses community health Bound by medical ethics not to
assessed education techniques to “advertise” for patients, although
o Priorities are established (through situational persuade individual to avail of individual and family health
analysis and problem prioritization)
health services education is his/her duty
o Resources are rationally allocated and distributed
(equity: group who needs most is given more of Functions through organized Functions as an individual
the resources) community effort and has provider of health services, with
o It permits the deployment and design of services legal backing legal obligations but no legal
and specific interventions
authority except the right to
o It permits the determination of the effect and
practice
effectiveness of the system and the interventions
used (not just implementation but also Financed by funds coming Paid by individual fees
monitoring) largely from taxation
Responsible to the entire Responsible directly to his/her
community in which he/she patient
Figure 1 Dalgren and Whitehead model of practices his/her specialty
determinants of health
“Monopoly” in certain aspects Competition with other
of mass preventive medicine practitioners in his/her geographic
in the geographic area in area
which he/she works

Deals with many His/her administrative problems

administrative problems are minimal since his/her practice
has the characteristics of a small
business

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