# Prevention and Health Promotion

Psychology I · Society and Health · https://tryals.app/learn/psychology-i/prevention-and-health-promotion

## Three Tiers of Health Prevention

Public health splits **prevention** into three levels based on **when** they intervene in a disease's natural course. **Primary prevention** acts before disease onset to stop it entirely, using vaccination and safety rules.

| Level | Timing | Example |
| --- | --- | --- |
| **Primary** | Before disease | Vaccination |
| **Secondary** | Early, before symptoms | Cancer screening |
| **Tertiary** | After establishment | Rehab |

**Secondary prevention** catches disease early before symptoms worsen, like cancer screenings. **Tertiary prevention** manages established disease and limits complications, like cardiac rehab after a heart attack.

## The Ottawa Charter & Population Health

The WHO's 1986 **Ottawa Charter for Health Promotion** reframed health as a societal project across multiple levels: healthy public policy, supportive environments, community action, personal skills, and reoriented health services.

Health is produced by social conditions, not just medical encounters. **Common pitfall:** treating prevention as undifferentiated. Confusing early screening with stopping disease creates flawed, non-interchangeable public health policies.

## Practice questions

6 of this lesson's 12 practice questions, with answers. The full set is in the app.

### 1. These five moments all come from one man's cardiac history, and prevention acts at four of them. Put them in the order they happened.

**Answer:**

1. The town rebuilds its main road with cycle lanes and safe crossings
2. A routine check at his GP surgery flags raised blood pressure
3. He is started on medication to bring the pressure down
4. He has a heart attack on a Tuesday morning
5. A supervised exercise programme begins six weeks later

**Why:** Cycle lanes, then the flagged reading, then the medication, then the attack, then rehabilitation.

Laid out on a life, the three levels stop being categories to memorise and become a matter of timing. The cycle lanes are primary prevention - they act before there is any disease, on a whole population, and the man never knows they helped him. The blood-pressure check and the medication are secondary: the disease process has started silently, and the point is to catch it before it announces itself. Rehabilitation is tertiary, and it begins only once the damage is done.

The attack itself is the pivot. Everything to its left is an attempt to stop it happening; everything to its right is an attempt to limit what it costs. That is the whole distinction, and it is a question of WHEN you intervene rather than of what the intervention looks like.

Page: https://tryals.app/practice/psychology-i/prevention-and-health-promotion/these-five-moments-all-come-from-one-mans-cardiac-history-and

### 2. Order the three levels of prevention by when they intervene in a disease's natural course.

**Answer:**

1. Primary prevention: acts before the disease occurs at all.
2. Secondary prevention: acts early, after onset but before symptoms worsen.
3. Tertiary prevention: acts after the disease is already established.

**Why:** The levels run primary (before onset), secondary (early detection), tertiary (after establishment) along the disease's natural course. Their names encode their position in that timeline, which is what makes them non-interchangeable.

Page: https://tryals.app/practice/psychology-i/prevention-and-health-promotion/order-the-three-levels-of-prevention-by-when-they-intervene-in-a

### 3. The classic public-health image is a **fence at the top of a cliff** against an **ambulance at the bottom**. Which levels of prevention are those, and what does the picture get right?

A. The image is misleading, prevention levels describe severity, not timing
B. Fence is primary and ambulance tertiary; they are not rivals
C. Fence is primary and ambulance secondary, screening catches people mid-fall
D. Both are primary, since each is designed to stop harm

**Answer:** B. Fence is primary and ambulance tertiary; they are not rivals

**Why:** Fencing acts before anyone falls and the ambulance after, primary and tertiary, separated by when they intervene rather than by how serious they are. The image earns its longevity by refusing the false choice: fencing is far cheaper per life, and a service without ambulances is not a service.

Page: https://tryals.app/practice/psychology-i/prevention-and-health-promotion/the-classic-public-health-image-is-a-fence-at-the-top-of-a-cliff

### 4. Select every statement that is TRUE about prevention and health promotion.

A. Secondary prevention relies on early detection, such as screening.
B. An intervention can protect people who never learn it existed.
C. The three levels of prevention are interchangeable in practice.
D. Tertiary prevention aims to stop disease from ever occurring.
E. Health promotion, on the Ottawa view, is as much a planning question as a clinical one.

**Answer:** A. Secondary prevention relies on early detection, such as screening.; B. An intervention can protect people who never learn it existed.; E. Health promotion, on the Ottawa view, is as much a planning question as a clinical one.

**Why:** Primary acting before onset, secondary's early detection, and the Ottawa Charter's societal framing are all true. Stopping disease from ever occurring is primary (not tertiary), and the levels are not interchangeable - so those two are false.

Page: https://tryals.app/practice/psychology-i/prevention-and-health-promotion/select-every-statement-that-is-true-about-prevention-and-health

### 5. The Ottawa Charter reframed health promotion as a broad societal project rather than a matter of educating individuals. A city responds to rising obesity by funding a poster campaign urging people to walk more. Why would the Charter treat this as an incomplete response, and what would it add?

A. Because it works on personal skills alone, one action area of five.
B. Because obesity belongs to tertiary prevention.
C. Because personal skills are not one of the action areas.
D. Because individual behaviour makes no difference to health.

**Answer:** A. Because it works on personal skills alone, one action area of five.

**Why:** The campaign acts on personal skills, one action area of five, and asks people to walk in a place built entirely around cars. The Charter's point is that the other four are where a city actually has power: planning, safe crossings, community say, services. Telling people to walk puts the burden on the actor with the least leverage.

Page: https://tryals.app/practice/psychology-i/prevention-and-health-promotion/the-ottawa-charter-reframed-health-promotion-as-a-broad-societal

### 6. Confusing secondary prevention (early screening) with primary prevention (stopping disease before it starts) would lead to different, non-interchangeable public health policies.

**Answer:** True

**Why:** True. Screening programs and before-onset prevention act at different points in a disease's course and demand different strategies and resources, so confusing them produces materially different - and non-interchangeable - policies.

Page: https://tryals.app/practice/psychology-i/prevention-and-health-promotion/confusing-secondary-prevention-early-screening-with-primary