17.E. Workshop: Returning disease prevention and health promotion back to the table: from the 1980ies to the 2050ies
Authors:   Organised by: Euro Health Group (Denmark), School of Public Health and Health Management (Serbia),   Chair persons: Michele Gross - Denmark, Ulrich Laaser - Germany
Published: October 2020

Disease prevention is part of medical thinking since the time of Hippocrates in the 5th century B.C. However, as a scientific concept, it developed only since the middle of the 19th century through the work of Louis Pasteur and Robert Koch developing and working along with the new germ theory of infectious diseases. Chronic diseases, cardiovascular ones in particular, came into focus only after WW II culminating in the work of Geoffrey Rose and his publication on Sick individuals and sick populations, published 1985. At that time, the new concept of health promotion entered the stage culminating in the Ottawa Charter for Health Promotion, 1986.

The classical concepts embrace two basic interrelated modern risk behaviors, sedentary lifestyle and, typically, associated, intake of high caloric food and alcoholic beverages. All of them contribute to obesity diabetes mellitus, elevated blood pressure and cholesterol, often accompanied by smoking as a key risk factor for lung cancer and vascular damage. The individual consequences in terms of reduced quality of life and death due to non-communicable as well as uncontrolled infectious diseases - exemplified by HIV and recently the COVID epidemic - can be considerable and the socioeconomic costs constitute a heavy burden for the population.

Whereas research in the field of prevention tries to identify risk factors which may with a certain probability lead to disease, in the field of health promotion efforts are made to find out how to change risky lifestyles, at the individual as well as the community level. Thus, disease prevention and health promotion are two sides of the same coin and should be an essential subject matter for all bachelor or master programs in public health. In this workshop, we shall focus on four questions: 1) What information do we have on modules for disease prevention and targeted health promotion in European Schools of Public Health? 2) What do we know and what should it be? 3) What can we learn from experience in Europe's disadvantaged neighbourhood? 4) How can disease prevention and health promotion contribute to the well-being of humanity in the second half of our century?

The last question reaches out beyond the classical concept as a new dimension entered our discourse in the last years which may become the future priority: A healthy environment as a precondition of everything else, in essence in a global dimension: Air, Water, Soil, and Plants, Animals, Humans. Is this - One Health - in the making: A strategy? Leadership? Teaching and training? Solutions do not lay anymore at the individual or community level but require a collective global effort to save our Noah's Ark.

Key messages

The classical concept of disease prevention and health promotion has lost ground as regards teaching and training at European Schools of Public Health. To strengthen it life-style change is critical. Lifestyle change remains a crucial challenge for prevention and calls for targeted health promotion. The future demands to reach out to the dimension of a healthy environment, the ONE HEALTH concept.