PREVENTION IS PRIMARY

Published by APHA and Jossey-Bass

Edited by Larry Cohen, Sana Chehimi, and Vivian Chavez

Agenda Introduction

About Prevention is Primary

Part 1: Defining the Issues

Part 2: Key Elements of Effective Prevention Efforts

Part 3: Prevention in Context

Closing

Question and Answer

Objectives

Discover frameworks and research available in Prevention is Primary

Learn how to use other Prevention Institute tools to complement Prevention is Primary

Presenters

Larry Cohen, MSW

Executive Director

Prevention Institute

Larry Cohen, MSW

Executive Director

Prevention Institute

Sana Chehimi, MPH

Program Director

Prevention Institute

Sana Chehimi, MPH

Program Director

Prevention Institute

About Prevention Institute Primary prevention

Changing norms and policies

Focus on health equity

Behaviors & Environment

70%

Medical Care, 10%

Genetics 20%

$2.2 Trillion

SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000

Factors InfluencingHealth

National Health Expenditures

Current U.S. health care spending

Behaviors & Environment

70%

Medical Care, 10%

Genetics 20%

$2.2 Trillion

SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000

Factors InfluencingHealth

National Health Expenditures

Prevention 4%

Medical Services96%

Current U.S. health care spending

$1 Investment

SOURCE: Prevention for A Healthy America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities, Trust for America’s Health, July 2008

$5.60Return on Investment

$16 Billion Annual Savings

In 5 Years

Savings at 5 Years

Return on investment with prevention

Prevention and Public Health Fund, 2010-2019

2011 Health Equity Summit: Oakland, CA

Training Future Leaders Motivation for second edition

New Sector Alliance

Academic outreach

Photo Credits: http://uninews.unimelb.edu.au/media/2008_05/girl-studying-outside_rs_ri.jpghttp://webmedia.unmc.edu/sorrellphotos/DrMichaelSorrellstudents.jpg

Prevention Is Primary: Strategies for Community Well-Being, 2nd ed.

15 chapters, 46 expert contributors

Theory, concepts, and models

Updated in light of new national recognition for prevention

Part 1: Defining The Issues The case for primary prevention

Social determinants of health/disparities

Resilience-based approaches

Related tools:

Taking Two Steps Back to

Prevention

The Spectrum of Prevention

Take 2 Steps to Prevention

Health Care

Services

Exposures &

Behaviors

Environment

Causes of Death

Heart Disease

Cancer

Stroke

Diabetes

Injuries & Violence

Photo courtesy of http://tycohealth-ece.com/files/d0003/ty_rn33d7.jpg

Not the primary determinant of health

Treats one person at a time

Often comes late; can’t always restore health

Medical Care Alone Cannot Reduce Injuries and Inequities

The 1st step ...

Health Care

Services

Exposures &

Behaviors

Environment

Heart Disease

Cancer

Stroke

Type 2 Diabetes

Injuries

& Violence

Diet &

Activity

Patterns

Tobacco

Alcohol

& Drugs

Making Links to Exposures & Behaviors

SOURCE: McGinnis JM , Foege WH. Actual causes of death in the United States. Journal of the American Medical Association. 1993; 270: 2207-2213.

Let’s take

another

step ...

Health Care

Services

Exposures &

Behaviors

Environment

Influencing Policy and LegislationDeveloping strategies to change laws and policies

Changing organizational practicesAdopting legislation and changing norms

Fostering coalitions and networksConvening groups and individuals for greater impact

Educating providersInforming providers who influence others

Promoting Community EducationReaching groups with information and resources

Strengthening individual knowledge and skillsEnhancing individual capacity

The Spectrum of Prevention

The Spectrum of Prevention

is a tool for changing systems, norms, and

environments.

Norms

sanction behavior

attitudes, beliefs, ways of being

based in culture & tradition

taken for granted

more than a habit

behavior shapers

communicate regularity

in behavior

Example: Breastfeeding

Influencing Policy and Legislation

Developing strategies to change laws and policies Changing organizational

practicesAdopting legislation and changing norms

Fostering coalitions and networks

Convening groups and individuals for greater impactEducating providers

Informing providers who influence others

Promoting Community EducationReaching groups with information and resources

Strengthening individual knowledge and skillsEnhancing individual capacity

The Spectrum of Prevention:Breastfeeding

Part 2: Key Elements of Effective Prevention Efforts Community organizing

Media advocacy

Evaluation of primary prevention programs

Working collaboratively

Related tool:

8 Steps to Building and Maintaining an Effective Coalition

Faith Community

Health Care Providers

Public Transit

Public Health

LocalBusiness

8 Steps to Building and Maintaining an Effective Coalition

8. Make improvements through evaluation

7. Maintain coalition vitality

6. Develop a successful structure

5. Anticipate necessary resources

4. Convene the coalition

3. Devise preliminary objectives and activities

2. Recruit the right people

1. Analyze program objectives and determine whether to form a coalition

Part 3: Prevention in Context

The built environment

Healthy food environments

Preventing violence

Related tool:

Communities Taking Action: Profiles of Health Equity

Communities Taking Action: Profiles of Health Equity

www.preventioninstitute.org/UNITY

UNITY builds support for effective, scalable, sustainable efforts to prevent violence before it occurs so that urban youth can thrive in safe environments with ample opportunities and supportive relationships.

UNITY is funded by the Centers for Disease Control and Prevention as part of the CDC’s national youth violence prevention initiative, Striving to Reduce Youth Violence Everywhere (STRYVE), and in part by The California Wellness Foundation and The Kresge Foundation.

www.preventioninstitute.org/UNITY

UNITY City Network

Oakland

San DiegoTucson

Seattle

MinneapolisDetroit

Denver

St. Louis

Chicago

Louisville

Boston

Newark

Los Angeles

New Orleans

Nashville

PhiladelphiaClevelandRichmond

Houston

(San Jose)

Our tools and frameworks in action

Prevention is Primary is used at schools including: University of Pennsylvania San Francisco State University Boston College San Jose State University

Other tools that have been adapted for classroom use

THRIVE at Case Western Reserve University School of Medicine

The Spectrum of Prevention at schools including:

University of Pennsylvania School of Social Policy and Practice

UC Berkeley School of Public Health

Developing Effective Coalitions: An Eight-Step Guide at the University of Pennsylvania School of Social Policy and Practice

Publications

Order your copy of Prevention is Primary from the APHA Bookstore!

http://tinyurl.com/3wq8c9n

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Quality prevention is the catalyst for change.

Thank you! APHA

Jossey-Bass

Participants