The universal GP Training website for everyone, not just Bradford.   Created in 2002 by Dr Ramesh Mehay

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and looking at Chronic Disease Management + Co-morbidity

What is Health Promotion & Disease Prevention? And why bother?

Health promotion and disease prevention programs focus on keeping people healthy.  In medicine, too many of us get bogged down with treating actual disease when it happens that we forget about try to prevent it in the first place (disease prevention).  And often, we are so concerned with getting those medically unstable to a stable position that we forget about those who are stable but will go back to being unstable and develop other disease processes if we don’t help them to look after THEIR OWN HEALTH CONDITION (health promotion & further disease prevention).

Health promotion aim to engage and empower individuals and communities to choose healthy behaviors, and make changes that reduce the risk of developing chronic diseases and other morbidities. Defined by the World Health Organization, health promotion is: “The process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions.”

Disease prevention differs from health promotion because it focuses on specific efforts aimed at reducing the development and severity of chronic diseases and other morbidities.

Wellness is related to health promotion and disease prevention. Wellness is described as the attitudes and active decisions made by an individual that contribute to positive health behaviors and outcomes.  Health promotion and disease prevention programs often address social determinants of health, which influence modifiable risk behaviors. Social determinants of health are the economic, social, cultural, and political conditions in which people are born, grow, and live that affect health status. Modifiable risk behaviors include, for example, tobacco use, poor eating habits, and lack of physical activity, which contribute to the development of chronic disease.

Primary, Secondary and Tertiary Prevention

Primary prevention

Primary prevention aims to prevent disease before it ever occurs. This is done by preventing exposures to hazards that cause disease, altering unhealthy or unsafe behaviours that can lead to disease , and increasing resistance to disease should exposure occur. Examples include: immunising people (increasing resistance), statin in patients with high QRISK but no PMH of IHD.

Secondary prevention

Secondary prevention aims to reduce the impact of a disease that has already occurred. This is done by detecting and treating disease as soon as possible to halt or slow its progress, encouraging personal strategies to prevent or recurrence, and implementing programs to return people to their original health and function to prevent long-term problems. Examples include: mammography to detect breast Ca early, clopidogrel for patients already had a stroke, low dose aspirin patients already had an MI

Tertiary prevention

Tertiary prevention aims to soften the impact of an ongoing illness that has lasting effects. This is done by helping people manage long-term, often-complex health problems  (e.g. chronic diseases, permanent impairments) in order to improve as much as possible their ability to function, their quality of life and their life expectancy. Examples include: cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes, arthritis, depression, etc.)

To help explain the difference, take this example. Let’s say you are the Public Health Consultant of a town near a swimming hole used by kids and adults alike. One summer, you learn that citizens are developing serious and persistent rashes after swimming as a result of a chemical irritant in the river. You decide to take action.

If you approach the company upstream that is discharging the chemical into the river and make it stop, you are engaging in primary prevention. You are removing the hazardous exposure and preventing rashes in the first place.

If you ask lifeguards to check swimmers as they get out of the river to look for signs of a rash that can then be treated right away, you are engaging in secondary prevention. You are not preventing rashes, but you are reducing their impact by treating them early on so swimmers can regain their health and go about their everyday lives as soon as possible.

If you set up programs and support groups that teach people how to live with their persistent rashes, you are engaging in tertiary prevention. You are not preventing rashes or dealing with them right away, but you are softening their impact by helping people live with their rashes as best as possible.

For many health problems, a combination of primary, secondary and tertiary interventions are needed to achieve a meaningful degree of prevention and protection. However, as this example shows, prevention experts say that the further “upstream” one is from a negative health outcome, the likelier it is that any intervention will be effective.

Source: At Work, Issue 80, Spring 2015: Institute for Work & Health, Toronto 

More Examples

It’s not just about stopping smoking, not doing drugs, getting fitter, not drinking alcohol much and eating more healthily.   There are lots of other types of health promotion and disease prevention activities.   Don’t limit your mind – you might come up with something innovative and transformative.  Here are a few more examples.

Typical activities for health promotion, disease prevention, and wellness programs include: 

  1. Communication: Raising awareness about healthy behaviors for the general public. Examples of communication strategies include public service announcements, health fairs, mass media campaigns, and newsletters.
  2. Education: Empowering behavior change and actions through increased knowledge. Examples of health education strategies include courses, trainings, and support groups.

Examples of effective health promotion activities for child and family health

  • Promoting breastfeeding
  • Promoting child and family nutrition
  • SIDS prevention and education
  • Injury prevention
  • Promoting physical activity
  • Smoking cessation programs such as ‘quit’ activities and ‘brief interventions’
  • Promoting early literacy
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Bradford VTS was created by Dr. Ramesh Mehay, a Programme Director for Bradford GP Training Scheme back in 2001. Over the years, it has seen many permutations.  At the time, there were very few resources for GP trainees and their trainers so Bradford decided to create one FOR EVERYONE. 

So, we see Bradford VTS as  the INDEPENDENT vocational training scheme website providing a wealth of free medical resources for GP trainees, their trainers and TPDs everywhere and anywhere.  We also welcome other health professionals – as we know the site is used by both those qualified and in training – such as Associate Physicians, ANPs, Medical & Nursing Students. 

Our fundamental belief is to openly and freely share knowledge to help learn and develop with each other.  Feel free to use the information – as long as it is not for a commercial purpose.   

We have a wealth of downloadable resources and we also welcome copyright-free educational material from all our users to help build our rich resource (send to

Our sections on (medical) COMMUNICATION SKILLS and (medical) TEACHING & LEARNING are perhaps the best and most comprehensive on the world wide web (see white-on-black menu header section on the homepage).