Recently our founders discussed the mystery of why prevention is such a hard concept for people to get excited about. Dr. Julie Stachowiak, a Johns Hopkins-trained epidemiologist, remarked that in the history of diseases and mankind, prevention doesn’t have the draw of the discovery of penicillin or the trials of Typhoid Mary, for example. Put simply, Julie said, “Prevention isn’t sexy.”
Mind you, Julie has spent her life trying to prevent diseases. Julie co-founded AIDS Infoshare in Russia, an organization committed to ending the suffering caused by HIV/AIDS. She’s very familiar with the long-term impact prevention can have on public health. And Julie’s painfully aware of how often individuals, governments and hospitals fail to invest in prevention.
Dr. Stachowiak, why do you think, “Prevention isn’t sexy.”?
Dr. JS: Prevention isn’t proximal. If I pulled you out of the way of a bus on the street, that’s proximal, it’s exciting and you know I just saved your life. Prevention can’t do that.
When it requires effort to prevent something that might happen to them, people are hard to convince that a consistent prevention effort is worth it. Condoms are a good example: most people don’t find their use a pleasant addition to a romantic moment, and it’s to prevent something that may or may not happen. When people do a risky thing and it doesn’t lead to a consequence, they are more likely to believe it won’t again.
We see this challenge in the broader public health realm. People might reason, “I could practice the best preventive efforts to avoid a heart attack and I could still have one, while someone who takes no preventive steps stays healthier.” We’ve all heard of sedentary smokers that lived into their 90s.
In hospitals, doctors can be susceptible to the same faulty mindset. They’ve done a procedure before with no infection. But you forget how small a sample size you is. A new infection prevention effort might require money and effort, and they can’t easily see the infections and suffering avoided.
What are the impacts of ignoring prevention in healthcare?
Dr. JS: There’s massive loss of lives, health, and dollars. But even without those motivators, prevention is just the right thing to do when someone entrusts their life to your healthcare institution. We speak about protecting vulnerable populations like infants. That adult in an ICU bed is essentially as vulnerable as a child.
If a preventive method is available and it is proven to work, it should be used. It’s an even more obvious choice if the method can pay for itself.
The successful outcome of prevention is when something bad doesn’t happen. Does that make it harder for our brains to commit to it?
Dr. JS: Definitely. It’s not an immediate payout and we’re not sure that we’ve benefited. However, the positive impact of these preventive efforts can be scientifically measured and established. We know that in the world, in our cohort, X number of people didn’t get infected. Of course, we don’t know if we would have been in that group of X patients or not.
Can you think of a prevention effort that’s been really successful?
Dr. JS: In the healthcare setting, vaccines and enhanced blood screenings for donors are two that have been noteworthy. Vaccines are a successful prevention tool that people can embrace because they remember the impact of horrific childhood diseases. Vaccines are cheap, easy and something our culture has decided that we can and will do.
Our Robots offer a modern day example. Peer reviewed published outcome studies demonstrate that these disinfecting Robots are reducing the occurrences of hospital acquired infections from 50-100%.
How might we better communicate the beauty of prevention?
Dr. JS: Any new prevention effort has the challenge of acceptance because it adds costs, time or hassle. I remember when we were little, seatbelts were a safety campaign. Now, using a seatbelt is an activity most of us never think twice about. If it’s the right thing to do, it eventually becomes the norm, like putting on your seatbelt.