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One of my issues with the primary-secondary-tertiary concept of prevention is its breadth. You can essentially count anything as prevention, which gets policy makers off the hook. It lets them say they’re focusing on prevention when they’re not.
Perhaps we should keep the term ‘prevention’ only for primary prevention. Instead of primary, secondary and tertiary prevention we could have, say, prevention, early identification and intervention, and mitigation. A politician therefore couldn’t take credit for focusing on prevention through, say, a screening program, because that’s early identification. Palliative care isn’t prevention, it’s mitigation of the effects of a terminal illness. Just semantics perhaps, but it would at least make it clear what should – and shouldn’t – be included in a proper prevention strategy.