Prevention and cure: the bond between public health and primary care

The improvement of prevention in health care is an important theme in many policy documents, and also the subject of this ‘spectrum’. Up to this point in time prevention is rarely part of a programmatic approach in health care. Factors that promote a successful implementation of prevention in health care include: financial compensation for health professionals, an adequate infrastructure that fits within daily practice, and specific attention for risk groups that are difficult to reach. The focus of this article is on the cooperation between primary health care and public health within a district or neighborhood. The idea is that prevention in health care will take on a structural form and primary health care can develop into broad neighborhood care, with connections to sectors outside health care, such as local authorities, health insurers, public health workers and sport facilities.

Ton Drenthen and Marian Sturkenboom, give an insight in their project ‘Prevention in the neighborhood’. This project aims at bringing the worlds of public health and primary care together. The goal is that professionals learn about each other’s knowledge and competences, exchange instruments and interventions and share good examples. The starting point is formed by the most important problems and needs of both professionals and inhabitants of the neighborhood. Drenthen en Sturkenboom give nice examples of experiences and results. These will be used for the next step to improve prevention in primary care.

Pharos, centre of expertise on health disparities, sees opportunities for prevention and health promotion for people with a low socioeconomic status. The general practitioner is locally organized, familiar with the life situation of the inhabitants and trusted by his patients. Prevention for people with a low socioeconomic status, who often have an accumulation of medical and social problems, is a challenge. Pharos therefore advocates a total-solution aimed at collaboration between public health, primary and social care, a´nd at development of professionals’ expertise.

We end this ‘spectrum’ with an example from a Community Health Service. Overweight is a priority health problem in their region, especially among those with low incomes. To help this group, the exercise program ’Lekker in je Lijf’ (feel good in your body) is developed. This is a nice example of cooperation between public health and primary care, in this case the physiotherapist. But not only these parties are involved. Local authorities, social services and the health insurer help to make this initiative successful.