The natural history of disease is an epidemiological model, showing how an individual’s health condition will progress over time without any interventions. Intervening at the weakest link in the chain of progression of specific diseases sometimes means addressing the symptoms of a problem long after the disease has progressed past a treatable point. Usually, high technology, high-cost solutions are required when intervening late in the stage or progress of a disease. On the other hand, focusing on prevention and the application of lower cost and less invasive solutions to preventable problems can promote public health and reduce burdens on the healthcare system.
Most diseases do have a natural progression or natural history, which can be altered via strategic healthcare interventions (CDC, 2017). The natural history of disease model starts with the stage of susceptibility, the point at which the individual is at risk but has not yet acquired the disease. During the susceptibility stage, a person can receive a vaccination, for example, or practice healthy lifestyle choices like good diet, exercise, and not smoking. Exposure is the first point of weakness. If a person has been vaccinated and is exposed to the disease, their chances of progressing with the disease are almost negligible compared to a person who is exposed. Genetics and other individual factors might determine whether the individual’s natural history progresses further to the next stage of pathological changes and what the CDC (2017) calls the stage of...
From the subclinical disease stage, the individual exhibits symptoms. This could be where the child first exhibits signs of gaining weight or being overweight, for example. The manifestation of clear symptoms is usually when a physician offers a diagnosis. An official diagnosis has tremendous implications, not just for the trajectory of the disease but also for access to funding via insurance.
A medical care culture that focuses on prevention helps to eliminate the costs associated with the current model of intervening at the weakest link. Maintaining health through prevention is a far more cost-effective and sensible approach to healthcare. However, hospitals and other health care institutions, whether voluntary or for-profit, make choices based on financial solvency and the bottom line. In order to remain in business, healthcare institutions need to respond to market pressures, which does not necessarily mean promoting prevention. The profit-driven, market-driven model of healthcare in the United States affects public attitudes towards health and wellness. Insurance companies may offer the means by which a person can receive a high-cost, high-technology intervention at the weakest link in the natural history of the disease, but fail to provide the means by which a person can receive the preventative services needed to maintain health. “The treatment-oriented rather than prevention-oriented health care philosophy is encouraged by an insurance system that, before managed care, rarely paid for any…
