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Modern aspercts of preventiv medicine

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1. Structure of mortality. The main causes of population deaths.
2. Methodology, model and principles of health promotion.
3. Types of prevention. Federal Program in Russia.

Published in: Health & Medicine
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Modern aspercts of preventiv medicine

  1. 1. DEPARTMENT FOR HEALTHCARE AND PUBLICDEPARTMENT FOR HEALTHCARE AND PUBLIC HEALTHHEALTH
  2. 2. Problems for discussion 1. Structure of mortality. The main causes of population deaths. 2. Methodology, model and principles of health promotion. 3. Types of prevention. Federal Program in Russia.
  3. 3. «Future belongs to preventive medicine» N. Pirogov
  4. 4. Expected changes in the mortality structure for 120 years Main cause of death 1900 2000 Prognosis for 2020 Trend infectious diseases 20% 1,7% 1% ↓ 20 times diseases of the circulatory system 15% 56% 60% ↑ 4 times cancer 5% 12% 25% ↑ 5 times 20 15 56 60 5 12 25 0% 50% 100% 1900 2000 2020 infectiousdiseases diseasesofthe circulatorysystem cancer others
  5. 5. The main causes of population death in the world 4% 16% 12% 21% 48% diseases of circulatory system neoplasms chronic pulmonary disease diabetes mellitus others
  6. 6. E urope 52 19 2,4 4 4 18,6 diseases of circulatory system neoplasms injury, poisoning… diseases of the digestive system pulmonary disease others Rus s ia 56,8 14,4 10,7 4,5 3,7 9,9 diseases of circulatory system neoplasms injury, poisoning… diseases of the digestive system pulmonary disease others The main causes of population death
  7. 7. The main causes of population death Rus s ia 56,8 14,4 10,7 4,5 3,7 9,9 diseases of circulatory system neoplasms injury, poisoning… diseases of the digestive system pulmonary disease others
  8. 8. Diseases of the circulatory system
  9. 9. Medical care Healthy lifestyle Diseases of the circulatory system
  10. 10. Measures for prevention of mortality due to diseases of circulatory system are able to increase the average life expectancy by 10 years!
  11. 11. Cancer 1. The 12th place in the structure of prevalence among adults; 2. Increasing trend in primary morbidity (+28,5% during 10 years). 3. More than 400 000 new cases each year, including 2500 children under 14. 4. The total prevalence 2029 cases per 100 000 people.
  12. 12. Leading localizations of cancer (both sexes) 12,6% 11,1% 10,7% 3,7% 6,5% 5,1% 50,3% s kin c anc er breas t c anc er lung c anc er s tomac h c anc er c olon c anc er pros tate c anc er others
  13. 13. Leading localizations of cancer (among men and women) men 18,9% 11,9% 11,5% 9,1% 48,6% lung c anc er pros tate c anc er s kin c anc er s tomac h c anc er others women 20,4% 14,7% 7,4% 7% 50,5% breas t c anc er s kin c anc er hys teroc arc inoma c olon c anc er others
  14. 14. 5. The 2d place (15,4 %) in the structure of deaths in Russia. 6. 300 000 deaths every year. 7. The 2nd place (22,9%) in the structure of causes of disability among adults. 8. Economic damage about 170 billion rubles. Cancer
  15. 15. Measures for prevention of mortality due to malignant tumors are able to increase the average life expectancy for 8 years!
  16. 16. Keys of NCD prevention Most NCDs are preventable.  Population based approach. Health promotion is the most cost-effective and sustainable way to improve public health
  17. 17. Methodology, model and principles of health promotion
  18. 18. Main factorsMain factors responsible forresponsible for healthhealth statusstatus 18% 20% 10% 52% lifestyle medical care environment heredity
  19. 19. Health promotion is the process of enabling people to increase control over and to improve their health WHO, 21 November 1986, The Ottawa Charter for Health Promotion
  20. 20. 8th Global WHO Conference on health promotion - “Health in all policies” From Ottawa to Helsinki (June 2013)
  21. 21. Model of health promotionModel of health promotion Reorienting the health services Building healthy public policy Strengthening community action Creating supportive environments Developing personal skills Ottawa Charter for Health Promotion WHO, 1986
  22. 22. 7 key principles of health promotion, WHO Holistic Inter-sectoral Participative Multi-strategy Sustainable Equitable Empowerment
  23. 23. COMBING PERSONAL AND PUBLIC RESPONSIBILITIES Personal Responsibility ”Nobody can take better care of your health than yourself” Public Responsibility ”Make the healthy choices the easy ones” (Ottawa charter)
  24. 24. 18
  25. 25. •POLICY INTERVENTIONS Vision for the future •The future is in our hands •From what to how •Political will and leadership •From predicting the future to making the future
  26. 26. Codes of health and longevity
  27. 27. PreventionPrevention refers to approaches and activities aimed at reducing the likelihood that a disease or disorder will affect an individual, interrupting or slowing the progress of the disorder or reducing disability.
  28. 28. Principles of prevention programs patient - oriented use of scientific progress multiple communication channels increasing range of preventive services creating a market for preventive and wellness services
  29. 29. Averaged data for the United States, Finland, Great Britain, Holland, New Zealand 55% 37% 8% prevention treatment others Contribution of curative and preventive measures in reductionContribution of curative and preventive measures in reduction of mortality from coronary heart diseaseof mortality from coronary heart disease
  30. 30. Socrates
  31. 31. Types of prevention. Federal Program in Russia.
  32. 32. Types of prevention Condition of an organism Healthy Disfunction Symptoms of pathology Organ failure Duration decades years months Donozological prevention Nozological prevention The purpose of intervention health promotion  correction of disorders,  strengthening adaptive capacity of the organism  earlier detection of the disease,  achieving long- term remission prevention of complications disability mortality primary secondary tertiary
  33. 33. Primary prevention Outcome Objective Activities Target audience Results Prolonged HALY To motivate for healthy lifestyle Social Healthy people  ↑ number of healthy individuals  ↑ index of health  ↑ percentage of people who lead healthy lifestyle  ↑ life expectancy Based on the formation of people's needs to keep healthy lifestyle Based on the formation of people's needs to keep healthy lifestyle
  34. 34. Secondary prevention Outcome Objective Activities Target audience Results Maintaining the health of people in high-risk group Early detection of disorders, strengthening adaptive capacity of organism Medico-social or socio- medical High-risk group • ↓Incidence Based on multi-level screening systemsBased on multi-level screening systems
  35. 35. Tertiary prevention Outcome Objective Activities Target audience Results Prolonged DALY Prevention of disease progression, relapses, decompensated disabilities, lethal outcomes Nosological Patients with chronic diseases •↓ frequency of relapses •↓ frequency of complications •↓temporary disability • ↓ disability rate • ↓ lethal outcomes Based on regular health check-upsBased on regular health check-ups
  36. 36. Coverage of population for different types of prevention
  37. 37. Federal Program: "Promotion of healthy lifestyles and prevention of noncommunicable diseases in the Russian Federation for 2013-2017 " Objective: To increase life expectancy by reducing the premature mortality from NCDs, primarily from cardio- vascular diseases
  38. 38. Ministry of Health Center for preventive medicine Population > 150 000 Population 50 000 -150 000. local hospital rooms of preventive medicine Out-patient clinics Health center departments of preventave medicine rooms of preventive medicine feldsher-midwife station rooms of preventive medicine Research institute of preventive medicine Federal Service for Consumer Rights Protection and Human Welfare Ministry of Education and Science of the Russian Federation Ministry foof Sport, Tourism and Youth Policy of the Russian Federation departments of preventive medicine rooms of preventive medicine City center for preventive medicine PopulationlevelIndividuallevelGrouplevel
  39. 39. Thank you for your attention!

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