Prevention Basics
The Health Impact Pyramid, Dr.Thomas Frieden, CDC
The idea of prevention has been around a long time (an apple a day keeps the doctor away). As a field it is still new and evolving. Early prevention strategies focused on providing information to the consumer (Surgeon General’s cigarette warning), or using slogans (Just Say No). We now realize that behaviors that lead to poor health outcomes are rooted in family, community, and society’s cultures, laws, and norms.
The very meaning of the word prevention is changing as well. In healthcare, it is often thought of as early screening and detection. It is common to hear terms such as prevention, wellness, health promotion, and healthy communities used somewhat interchangeably. The WMCHC uses all of these terms, but the key to understanding how we define our work is that we are trying to change the conditions in which we all live, work, and play to reach our goal of healthy people living in healthy places.
Our understanding that many behavioral outcomes (substance abuse, teen pregnancy) share common risk and protective factors has grown substantially. Our realization that those risk and protective factors operate at the level of individual, peer, family, school, and community has been made stronger through experience and research. And, our ability to plan and evaluate our progress has become more precise.
We commonly think of prevention as being on a continuum of services: prevention, intervention, harm reduction, and treatment. Prevention can be applied universally (everyone gets it), selectively (those with extra risk are selected for additional prevention) or when indicated (those in the early stages of engaging in the problem behavior or at very high risk). Prevention is at its best when it is applied to an entire population, and when it is impacting the root causes of poor health (see the pyramid).
Ecological approach to prevention
Risk and protective factors
When collecting data on health within a community or in a target population within the community, state-of-the-art prevention science has us not only look at risky behaviors of the population we are concerned about but also at the risk and protective factors that are implicated in certain health outcomes. A risk factor is a characteristic that is known to increase the likelihood of a negative outcome. Likewise, a protective factor is a positive characteristic that will reduce the likelihood of negative outcomes. See the links below to review the research of Hawkins and Catalano at the Social Development Research Group that describes the risk and protective factors shown to make a difference for adolescents.