Health Promotion or Disease Prevention: A Real Difference for Public Health Practice?
- 2k Downloads
It appears that there are two distinct practices within public health, namely health promotion and disease prevention, leading to different goals. But does the distinction hold? Can we promote health without preventing disease, and vice versa? The aim of the paper is to answer these questions. First, the central concepts are defined and the logical relations between them are spelt out. A preliminary conclusion is that there is a logical difference between health and disease, which makes health promotion and disease prevention two distinct endeavours. However, since disease is defined in relation to health, as those kinds of internal processes and states that typically lead to ill health, the difference is smaller than it might appear. Second, in order to answer the practical question whether it is possible to promote health without preventing disease, and vice versa, several kinds of public health interventions are discussed. The conclusion is that while health promotion and disease prevention can be distinguished conceptually, they can hardly be distinguished in practice. Most general measures do both at the same time.
KeywordsBasic health Disease prevention Health promotion Interventions Manifest health Public health
I would like to thank Lennart Nordenfelt, Bengt Brülde, Glenn Laverack, 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.
- 1.About.com:Sports Medicine. (2008) http://sportsmedicine.about.com/od/injuryprevention/a/Ex_Immunity.htm 2008-11-07.
- 2.Abrahamson, L., Andersson, A., Becker, W., & Nilsson, G. (Eds.). (2006). Näringslära: För högkolan [Nutrition: For the University]. Stockholm: Liber.Google Scholar
- 3.Beaglehole, R., & Bonita, R. (2004). Public health at the crossroads: Achievements and prospects. Cambridge: Cambridge UP.Google Scholar
- 4.Brülde, B., & Tengland, P.-A. (2003). Hälsa och Sjukdom: En begreppslig utredning [Health and illness: A conceptual investigation]. Lund: Studentlitteratur.Google Scholar
- 5.Bryan, J., Calvaresi, E., & Hughes, D. (2001). Foods for thinking and memory. Food Australia, 53, 477–479.Google Scholar
- 6.Buchanan, D. (2000). An ethic for health promotion: Rethinking the sources of human well-being. Oxford: Oxford UP.Google Scholar
- 7.Cleveland Clinic. (2008). http://my.clevelandclinic.org/disorders/Chronic_Fatigue_Syndrome/hic_Diet_Exercise_Stress_and_the_Immune_System.aspx 2008-11-07.
- 8.Culver, C. M., & Gert, B. (1982). Philosophy in medicine. Oxford: Oxford University Press.Google Scholar
- 9.Davies, M., & Macdowall, W. (2006). Health promotion theory. Maidenhead: Open University Press.Google Scholar
- 10.Earle, S., Lloyd, C. E., Sidell, M., & Spurr, S. (2007). Theory and research in promoting public health. London: Sage.Google Scholar
- 13.Holland, S. (2007). Public health ethics. Malden, MA: Polity.Google Scholar
- 14.Hummel, T., & Nordin, S. (2008). Quality of life in olfactory dysfunction. http://www.senseofsmell.org/feature/whitepaper/whitepaper_print.html 2008-11-08.
- 15.Korp, P. (2004). Hälsopromotion [Health promotion]. Lund: Studentlitteratur.Google Scholar
- 16.Lalonde, M. (1974). A new perspective on the health of Canadians. Ottawa: Information Canada.Google Scholar
- 17.Laverack, G. (2004). Health promotion practice. Power and empowerment. London: Sage.Google Scholar
- 18.Lindstrand, A., Bergström, S., Rosling, H., Rubenson, B., Stenson, B., & Tylleskär, T. (2006). Global health: An introductory textbook. Lund: Studentlitteratur.Google Scholar
- 20.MayoClinic. (2008). http://www.mayoclinic.com/health/exercise/HQ01676 2008-11-07.
- 21.McKeown, T. (1979). The role of medicine. Oxford: Routledge.Google Scholar
- 22.NCI (National Cancer Institute). (2008). http://www.cancer.gov/cancertopics/pdq/screening/overview 2008-11-09.
- 23.NNII (National Network for Immunization Information). (2008). http://www.immunizationinfo.org/immunization_issues_detail.cfv?id=140 2008-11-09.
- 24.Nordenfelt, L. (1991). Towards a theory of health promotion: A logical analysis. Linköping: Linköping University Press.Google Scholar
- 25.Nordenfelt, L. (1995). On the nature of health: An action-theoretic approach. Dordrecht: Kluwer. Second revised edition.Google Scholar
- 27.Nutbeam, D (1998). Health Promotion Glossary. WHO/HPR/HEP/98/1. (See also: http://www.who.int/hpr/NPH/docs/hp_glossary_en.pdf) (on behalf of the WHO).
- 28.Pellmer, K., & Wramner, B. (2002). Grundläggande folkhälsovetenskap [Basic public health]. Stockholm: Liber.Google Scholar
- 29.Raeburn, J., & Rootman, I. (1998). People-centered health promotion. Chichester: Wiley.Google Scholar
- 31.Seedhouse, D. (1997). Health promotion: Philosophy, prejudice and practice. Chichester: Wiley.Google Scholar
- 32.Svanström, L. (2003). Sjukdomslära [Pathology]. Lund: Studentlitteratur.Google Scholar
- 36.Tengland, P-A. (2009). Health promotion and disease prevention: Logically different conceptions? Health Care Analysis. doi: 10.1007/s10728-009-0125-0.
- 37.Tones, K., & Green, J. (2004). Health promotion: Planning and strategies. London: Sage.Google Scholar
- 38.WHO. (1986). Ottawa charter for health promotion. Geneva: WHO.Google Scholar
- 39.WHO. (1990). Some options for improving nutrition in the 1990s. http://www.unsystem.org/scn/archives/scnnews07supplement/begin.htm#Contents 2008-11-09.