Sie sind auf Seite 1von 33

Golden Lecture of Prevention

Building a Global Prevention Network to Share Knowledge and Wisdom Updated November 2009

Life Expectancy Map

From Wikipedia

Hygeia In Greek mythology The goddess of health. Hygiene The science that deals with the preservation & promotion of health.

Importance of Hippocrates Teaching for public health and medicine of today


This lecture is dedicated to a man who is currently recognized as the father of medicine. Its because of his work, healers became doctors instead of sorcerers. Hippocratic oath is administered during the graduation ceremonies of all modern medical schools.

Objectives
1. To define prevention and highlight its importance in global health. 2. To discuss the importance of network in the context of the Supercourse and to begin to organize the internet based globalization for prevention

3. To further distribute the golden lecture to faculty, students and professionals all over the world

Definition of Prevention
Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability. The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention
A Dictionary of Epidemiology, Fourth Edition Edited by John M. Last

Public Health and Sanitation


Achievements of the 20th century: Improvements in hygiene practices Improvements in food handling (refrigeration) Improvement in Water and sewage treatment Vaccination practices

Rising Life Expectancy

Source: United Nations (U.N.) Population Division, Demographic Indicators, 1950-2050 (The 1996 Revision) (U.N., New York, 1996).

Historical Examples of Global Prevention Activities

Koch identified tubercle bacillus

Death rate for Tuberculosis, 1860-1960, United States, Source: US Bureau of the Census, Historical Statictics of the United States; Colonial Times to 1970 (Washington, D.C.:Government Printing Office, 1975), Part 1 pp58,63. Note: Data between 1860 and 1900 for Massachusetts only.

Streptomycin introduced Vaccination available

The Sanitary Revolution and the Ascendancy of Public Health


1. The sanitary revolution produced the greatest transformation in the pattern of disease that the world had known since nomadic hunter-gatherers settled in permanent villages, and ultimately developed modern urban industrial communities

Death Rates for Measles in Children Under Age 15, England and Wales, 1850-1970

Source: Thomas McKeown, The Modern Rise of Population (Academic Press, San Francisco, 1976), pp. 93, 96.

Epidemiologic Transition in Mexico

Cuba: The Story of Success in the Area of Prevention

Example of successful prevention program in Cuba


VACCINATION PROGRAM RESULT
POLIO DIPHTHERIA NEWBORN TETANUS CONGENITAL RUBELLA MENINGITIS POST MUMPS MEASLES WHOOPING COUGH RUBELLA MUMPS ELIMINATED SINCE 1962 ELIMINATED SINCE 1969 ELIMINATED SINCE 1972 ELIMINATED SINCE 1989 ELIMINATED SINCE 1989 ELIMINATED SINCE 1993

TRANSMISSION INTERRUPTED SINCE 1994 TRANSMISSION INTERRUPTED SINCE 1995 TRANSMISSION INTERRUPTED SINCE 1995

MORBIDITY
MENINGOCOCCICAL DISEASE TYFHOID FEVER B HEPATITIS REDUCTION REDUCTION REDUCTION 93% 75% 52%

Leading Causes of Death Around the World (WHO data)


World Deaths in millions % of deaths

Coronary heart disease Stroke and other cerebrovascular diseases

7.20 5.71

12.2 9.7

Lower respiratory infections


Chronic obstructive pulmonary disease Diarrhoeal diseases HIV/AIDS Tuberculosis Trachea, bronchus, lung cancers Road traffic accidents Prematurity and low birth weight

4.18
3.02 2.16 2.04 1.46 1.32 1.27 1.18

7.1
5.1 3.7 3.5 2.5 2.3 2.2 2.0

750

Death Rates for Coronary Heart Disease by Country Men Ages 35-74, 1970 and 1993 (Rate/100,000)

CAN 500

FI AUS US N SCOT T A NZ

SING 250 JPN H CHN K 0

USSR SP N

ITY
FRAN

Advances in Cancer Care and Cancer Prevention will Arise From


Genetics, genomics, proteomics Cell biology and immunology Molecular Epidemiology/biomarkers Bioinformatics Behavioral Sciences

Lifestyle Factors
Genes load the gun. Lifestyle pulls the trigger
Dr. Elliot Joslin

Relation Between CHD Events and LDL-C in Recent Statin Trials


30 25 20 4S-Rx 4S-PI 2 Prevention

% with LIPID-Rx 15 CHD event LIPID-PI 1 Prevention CARE-Rx CARE-PI 10 WOSCOPS-PI AFCAPS/TexCAPS-PI 5 WOSCOPS-Rx AFCAPS/TexCAPS-Rx 0 90 110 130 150 170 190 210 Mean LDL-C level at follow-up (mg/dL)

PI=placebo; Rx=treatment .

Methods: Supercourse model

Teacher in Alexandria

Teacher in
UAE- Sharjah

Teacher in Tanzania

Teacher in Pittsburgh

Teacher in Paris

Teacher in Moscow

Over 4600 Lectures

Conclusions
Increased life expectancy in the past century was achieved through the improvement of sanitation and prevention Successful prevention in the past and in the future needs to be rooted in the networking of health professionals around the world to share their knowledge Internet based Information sharing is the key to prevention and a golden world

What is the future of prevention?


Globalization of Prevention Networking of people in prevention Sharing of data, knowledge and wisdom

Please forward the Golden Lecture to faculty, students and health professionals in your country

Review Questions (Developed by the Supercourse team)


What caused the dramatic shift in life expectancy over the course of the 20th century? What are the major levels of prevention? Give an example of successful prevention activity that had a big influence on increasing life expectancy.

Das könnte Ihnen auch gefallen