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Health Promotion and Disease Prevention: Logically Different Conceptions?

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Abstract

The terms “health promotion” and “disease prevention” refer to professional activities. But a “health promoter” has also come to denote a profession, with an alternative agenda compared to that of traditional public health work, work that by some is seen to be too medically oriented, too reliant upon prevention, risk-elimination and health-care. But is there really a sharp distinction between these activities and professions? The main aim of the paper is to investigate if these concepts are logically different, or if they are just two extremes of one dimension. The central concepts, health promotion and disease prevention, are defined, and it is concluded that health promotion and disease prevention are logically distinct concepts, although they are conceptually related through a causal connection. Thus, logically, it is possible to promote health without preventing disease, even if this is not so common, in practice, but it is not possible to prevent disease without promoting health. Finally, most health promoting interventions target basic health, not manifest health, and often also thereby reduce future disease.

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Notes

  1. For criteria governing such a discussion see [7, 8].

  2. Note that [51] does not discuss disease but disorder. It is clear, however, that these concepts can have the same function.

  3. Were we to find a more plausible theory of disease we could perhaps pursue this path. However, the alternative theory of disease proposed in this paper has another relation to health.

  4. The idea is found already in Galen’s [15] writings.

  5. Most likely something also happens on the level of basic health.

  6. Note that a specific instance of manifest health, which helps support some other instance of manifest health, will not count as basic health, e.g., regularly walk the stairs, and thereby enhancing one’s general fitness, does not make the ability to walk the stairs an instance of basic health.

  7. We could perhaps also add as a separate group those people who are healthy, and do not have a disease, but have some kind of increased risk, e.g., non-exercisers and smokers. They would of course also be of concern for public health.

  8. Sometimes we find that whole communities are in poor states of manifest health. Supporting these people to gain health should probably also count as health promotion, unless the measures used are narrowly medical (and will, thus, count as treatment or care). Providing nutritious and sufficient food for the population would probably count as health promotion, whereas treating a population with antibiotics would not.

  9. It is likely that here too we need other distinctions in order to prevent disease prevention collapsing into treatment. This can no doubt be done. I will, however, not pursue this issue here.

  10. However, some disease preventive programs might have positive effects on many diseases. Smoking cessation programs might target reduced lung cancer, but will in effect also reduce a number of other diseases where smoking is a contributing cause.

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Acknowledgments

I would like to thank Lennart Nordenfelt, Bengt Brülde, Peter Korp, Karin Dahlbäck, the anonymous reviewer, and the participants of “the higher seminar” at IHS, Linköping University, Sweden, for valuable comments on earlier versions of this paper.

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  1. Health and Society, Malmö University, 205 06, Malmö, Sweden

    Per-Anders Tengland

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Tengland, PA. Health Promotion and Disease Prevention: Logically Different Conceptions?. Health Care Anal 18, 323–341 (2010). https://doi.org/10.1007/s10728-009-0125-0

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