Emphasis on Prevention Slide 10 of 29

Go to slide: 1: "Public Health Challenges for Parkinson's Disease in the US" 2: Context and Goals 3: US Health Care System 4: PD Organizations in the US 5: Political Strength 6: NIH PD Research Agenda 7: Public Health Action Plan for PD 8: Public Health Concept 9: Scientific Tools of Public Health 10: Emphasis on Prevention 11: Literature Review on 12: Current Public Health 13: Sources of Information 14: Costs of Parkinson’s Disease 15: Cost and Resource Use 16: PD Use of Services 17: Elevated Comorbidities with PD 18: Costs of Parkinson’s Disease 19: Physician Care 20: Access to Comprehensive Care 21: PDF Access Survey 22: Access to Specialty Physician Services 23: Specialty Physician Care 24: Use of Comprehensive Services 25: Access to Comprehensive Care 26: Summary of Findings 27: Challenges for Public health 28: Focus on Quality 29: A True Mover and Shaker

---

Prevention – Emphasis of Public Health -- -- €Primary prevention€ averts the occurrence of the disease before it starts. Since we do not know causes of PD, not much can be done here currently. With the help of PD lobbying efforts, in the past year the NIEHS has initiated a research program on "environmental causes of PD." Research confirms that PD is predominantly environmental and recent findings point to pesticides and herbicides € €-- €Secondary prevention€ reduces consequences of disease by detection and treatment at an early stage. To be beneficial here we need biomarkers that are accurate and inexpensive to find PD cases and we need treatments to slow or reverse disease progression. While research is advancing on both fronts the technology is not currently ready for widespread application. Currently, detection and diagnosis of PD are primarily clinical; definitive biomarkers are not yet established. Research is making progress however on biomarkers using PET/Spec scans, spinal fluid and even blood tests. Tests that can be useful for screening populations to find presymptomatic cases or to identify cases in population surveys for surveillance. motor tests, smell tests, eye movements. € €-- €Tertiary prevention€ attempts to minimize complications and severe disabling consequences of disease after it has progressed. Most medical care is at this level. The initial emphasis of our PH efforts iin the USA is on access to quality care (maximizing functional status and quality of life) -- including as we will see later issues of specialty care, education of primary care providers, prevention of falls.

---