Key points

• Health promotion focuses on the social, economic and environmental determinants of health and aims to help people increase control over their own health.

• Many different groups and organisations are involved in health promotion within and without the NHS for it encompasses health policy, education, legislative action and community development.

• Disease prevention at the level of the high-risk individual is increasingly effective but population-wide approaches have greater potential to improve population health.

• Psychological models of behaviour change can support both individuals and organisations to improve health.

Disease prevention

Cervical cancer is 20 times more common in Columbia than in Israel. Twenty percent of Afghan children die before the age of 5, compared with 0.5% of children in the UK. Ischaemic heart disease death rates vary by a factor of two in different wards in Luton. In other words, diseases that are common in one place will usually prove to be rare somewhere else. Such variations suggest that common diseases – with their roots in lifestyle, social factors and the environment – are preventable but there are several misconceptions about prevention.