Goals of Prevention

The general goal of prevention is to reduce a person's likelihood of becoming ill or disabled or of dying prematurely. Some factors that increase risk are beyond a person's control, such as age, sex, and family history. But other factors, such as a person's lifestyle and physical and social environment, can be altered. And, risk can be reduced through good medical care.

Preventive medical care is not a case of "one size fits all"; specific goals are developed by and for each person.

Specific goals usually depend on a person's overall health. For example, a healthy older person who can function independently may focus on preventing disease. A person with several mild chronic diseases who remains independent may focus more on preventing or slowing decline in function and avoiding frailty. A frail person with several advanced chronic diseases who has become mostly dependent on others may focus on preventing accidents and complications that could lead to complete dependence or death.

Specific goals also depend on a person's risk factors for developing health problems, sometimes referred to as a risk profile. Information in a risk profile includes many considerations, including whether the person is sedentary, smokes cigarettes, drinks alcohol, gets a lot of sun exposure, has balance problems, has friends and relatives who check in on him, drives without a seat belt, and eats well-balanced meals. Working from this profile, health care practitioners can develop goals and help a person make any necessary changes.

Setting specific goals also depends on how much proof there is that making a change will be helpful. Quitting smoking, for example, is undoubtedly beneficial at any age. Screening for prostate cancer, on the other hand, is of questionable benefit and even controversial in older men, because its role in preventing complications and death is less certain. If effectiveness of a preventive health measure is in doubt, a frank discussion with the doctor is important.

Finally, some lifestyle changes prompted by prevention goals are easier to make and more acceptable than others. Many smokers, for example, are resistant to quitting smoking. The same people, however, may not find it burdensome to begin wearing a seat belt while driving. Some people are unwilling to make even the smallest change, such as walking briskly a few minutes a day, even if they know it will help prevent disease. Others are willing to comply with major changes, such as following highly restrictive diets, when they learn that such changes can help prevent life-threatening or disabling diseases.