prevention is primary: strategies for community wellbeing with sana chehimi and larry cohen
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TRANSCRIPT
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PREVENTION IS PRIMARY
Published by APHA and Jossey-Bass
Edited by Larry Cohen, Sana Chehimi, and Vivian Chavez
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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
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Objectives
Discover frameworks and research available in Prevention is Primary
Learn how to use other Prevention Institute tools to complement Prevention is Primary
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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
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About Prevention Institute Primary prevention
Changing norms and policies
Focus on health equity
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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
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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
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$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
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Prevention and Public Health Fund, 2010-2019
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2011 Health Equity Summit: Oakland, CA
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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
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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
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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
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Take 2 Steps to Prevention
Health Care
Services
Exposures &
Behaviors
Environment
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Causes of Death
Heart Disease
Cancer
Stroke
Diabetes
Injuries & Violence
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Photo courtesy of http://tycohealth-ece.com/files/d0003/ty_rn33d7.jpg
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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
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The 1st step ...
Health Care
Services
Exposures &
Behaviors
Environment
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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.
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Let’s take
another
step ...
Health Care
Services
Exposures &
Behaviors
Environment
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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
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The Spectrum of Prevention
is a tool for changing systems, norms, and
environments.
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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
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Example: Breastfeeding
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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
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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
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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
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Part 3: Prevention in Context
The built environment
Healthy food environments
Preventing violence
Related tool:
Communities Taking Action: Profiles of Health Equity
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Communities Taking Action: Profiles of Health Equity
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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.
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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)
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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
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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
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Publications
Order your copy of Prevention is Primary from the APHA Bookstore!
http://tinyurl.com/3wq8c9n
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Stay in touch with Prevention Institute
Sign up for e-alerts on our website: www.preventioninstitute.org
Follow us on Twitter: @preventioninst
Like us on Facebook: www.facebook.com/pages/prevention-institute
Find us on LinkedIn
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Quality prevention is the catalyst for change.
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Thank you! APHA
Jossey-Bass
Participants