Prevention Is Primary E-Book

Larry Cohen

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 857

Veröffentlichungsjahr: 2010

Beschreibung

The new edition of Prevention Is Primary provides models, methods, and approaches for building health and equity in communities. This comprehensive book includes the theory, concepts, and models needed to harness social justice and practice primary prevention of unnecessary illness and injury. Ideal for students as well as practitioners, this thoroughly revised and updated second edition combines an overview of advances in the field with effective approaches in the current economic and health care climate.

With contributions from noted experts, Prevention Is Primary shows practical applications of intervention science to social and health problems and issues facing at-risk and vulnerable groups. The book describes the overarching framework and principles guiding prevention efforts, including a focus on social justice and health equity, and community resilience. It explores the transition from prevention theory to implementation and practice and from interdisciplinary collaboration to evaluation. Highlighting the book's usefulness as a teaching and learning tool, Prevention Is Primary has real world examples, learning objectives, and review questions for each chapter.

Leseprobe

Table of Contents

Title Page

Copyright Page

List of Tables

Table of Figures

Table of Exhibits

Dedication

Acknowledgments

Foreword

REFERENCES

THE CONTRIBUTORS

Introduction

REFERENCES

PART ONE - DEFINING THE ISSUES

Chapter 1 - The Imperative for Primary Prevention

MOVING UPSTREAM WITH PRIMARY PREVENTION

THE HISTORY OF EFFECTIVE PREVENTION EFFORTS

EXAMPLES AND CHALLENGES OF PRIMARY PREVENTION

THE CASE FOR PRIMARY PREVENTION

PUTTING PRIMARY PREVENTION INTO PRACTICE

CONCLUSION

DISCUSSION QUESTIONS

NOTE

REFERENCES

Chapter 2 - Achieving Health Equity and Social Justice

WHAT IS HEALTH EQUITY?

DETERMINANTS OF HEALTH DISPARITIES

ISSUES IN ADDRESSING RACIAL DISPARITIES

STRATEGIES TO REDUCE DISPARITIES

CONCEPTUAL FRAMEWORK

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 3 - Individual, Family, and Community Resilience

RISK-BASED APPROACHES

THE GIFT OF RESILIENCE RESEARCH

RESILIENCE, YOUTH DEVELOPMENT, AND COMMUNITY DEVELOPMENT

RECOGNIZING RESILIENCE IN COMMUNITIES

MAPPING COMMUNITY ASSETS

A FOCUS ON COMMUNITY RESILIENCE

A FRAMEWORK FOR RESILIENCE AND COMMUNITY AND YOUTH DEVELOPMENT

YOUTH DEVELOPMENT, RESILIENCE, AND PRIMARY PREVENTION

CREATING A RESILIENCE PERSPECTIVE

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

PART TWO - KEY ELEMENTS OF EFFECTIVE PREVENTION EFFORTS

Chapter 4 - Community Organizing for Health and Social Justice

DEFINITIONS AND TERMINOLOGY

COMMUNITY

HISTORICAL CONTEXT

WOMEN’S HEALTH AND ORGANIZING

YOUTH ORGANIZING

CULTURE

THE WHEEL OF COMMUNITY ORGANIZING

ESSENTIAL QUALITIES

EMPOWERMENT

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 5 - Working Collaboratively to Advance Prevention

ADVANTAGES OF COALITIONS

EIGHT STEPS TO BUILDING AND MAINTAINING AN EFFECTIVE COALITION

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 6 - The Power of Local Communities to Foster Policy

COMMON STAGES IN POLICY INITIATIVE DEVELOPMENT

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 7 - Using Media Advocacy to Influence Policy

STEPS FOR DEVELOPING EFFECTIVE MEDIA ADVOCACY CAMPAIGNS

TIPS AND TECHNIQUES FOR SUCCESSFUL MEDIA ADVOCACY

OVERCOMING CHALLENGES IN MEDIA ADVOCACY

EXPECTED OUTCOMES

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 8 - The Impact of Corporate Practices on Health and Health Policy

TRANS FATS, VIOXX, AND SPORT UTILITY VEHICLES

HOW CORPORATE PRACTICES INFLUENCE HEALTH

CORPORATE PRACTICES AND THE SOCIAL PRODUCTION OF POPULATION HEALTH

BEYOND LIFESTYLE

A POLICY AGENDA FOR HEALTH-PROMOTING CORPORATE PRACTICES

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 9 - Primary Prevention and Evaluation

THE BENEFITS OF EVALUATION

THE EVALUATION PROCESS

DEVELOPING EVALUATION QUESTIONS

EVALUATION DATA

MEASURING AND EVALUATING PRIMARY PREVENTION PROGRAMS

ETHICAL AND LEGAL CONSIDERATIONS

MULTICULTURAL AND CULTURALLY COMPETENT EVALUATION

CHOOSING AN EXTERNAL EVALUATOR

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

PART THREE - PREVENTION IN CONTEXT

Chapter 10 - Preventing Injustices in Environmental Health and Exposures

ENVIRONMENTAL HEALTH

THE IMPACT OF ENVIRONMENTAL EXPOSURE

DISPARITIES IN HEALTH OUTCOMES

ENVIRONMENTAL JUSTICE

TWO PREVENTIVE APPROACHES TO ENVIRONMENTAL HEALTH

PRECAUTIONARY PRINCIPLE

COMMUNITY-BASED PARTICIPATORY RESEARCH

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 11 - Health and the Built Environment

THE SMALL SCALE

THE INTERMEDIATE SCALE

FROM NEIGHBORHOOD TO METROPOLIS

POPULATIONS AT SPECIAL RISK

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 12 - Creating Healthy Food Environments to Prevent Chronic Disease

THE STATUS AND CONSEQUENCES OF CURRENT EATING HABITS

THE FOOD ENVIRONMENT

PREVENTION SOLUTIONS

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 13 - A Public Health Approach to Preventing Violence

UNDERSTANDING VIOLENCE

THE ROLE OF THE PUBLIC HEALTH FIELD IN PREVENTING VIOLENCE

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 14 - The Limits of Behavioral Interventions for HIV Prevention

EPIDEMIOLOGY OF HIV IN THE UNITED STATES

ROOTS OF HIV PREVENTION

TYPES OF BEHAVIORAL INTERVENTIONS AND THEIR SUCCESS

STRUCTURAL-LEVEL SOLUTIONS TO PREVENTING HIV

THE STRUCTURE OF SEXUAL NETWORKS

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

Chapter 15 - Mental Health in the Realm of Primary Prevention

MENTAL HEALTH IN THE UNITED STATES

VETERANS

IMMIGRANT CHILDREN IN THE UNITED STATES

URBAN YOUTH

CONCLUSION

DISCUSSION QUESTIONS

REFERENCES

INDEX

Table of Figures

Figure 1.1 The spectrum of prevention

Figure 2.1 Age-adjusted mortality from all causes, United States, 2006, by educational attainment and gender

Figure 2.2 Age-adjusted mortality, United States, 2006, by region

Figure 2.3 Trajectory of health inequities

Figure 2.4 Framework for a comprehensive public health strategy to eliminate health disparities

Figure 3.1 The community youth development process: Resilience in action

Figure 4.1 The cultural proficiency continuum

Figure 4.2 The wheel of community organizing

Figure 5.1 Developing effective coalitions with the eight-step process

Figure 6.1 Stages in the development of a policy initiative

Figure 9.1 The CDC evaluation framework

Figure 9.2 The PRECEDE-PROCEED model

Figure 13.1 Classifcation of injury in public health

Figure 13.2 Two categories of intentional injuries in public health

List of Tables

Table 1.1 A lesson in responsible spending

Table 3.1 Protective factors and processes in families, schools, and communities

Table 3.2 How to recognize resilience in individuals, families, and communities

Table 3.3 Paradigms for prevention

Table 4.1 Four historical periods in community organizing

Table 7.1 Traditional health communication versus media advocacy

Table 9.1 Evaluation markers for progress and outcomes in the North Philadelphia Firearms Reduction Initiative

Table 9.2 Elements of the CDC’s VERB campaign logic model

Table 9.3 Evaluation Phases of the PRECEDE-PROCEED model

Table 9.4 The pros and cons of quantitative and qualitative approaches to data collection

Table 9.5 Useful evaluation measures by data collection method

Table 9.6 Summary of evaluation designs and measures for behavior change and other interventions

Table 9.7 Summary of evaluation designs and measures for policy adoption and implementation

Table 13.1 Prioritized Strategies to Prevent Violence

Table 13.2 Risk and resilience factors for violence and preventing violence

Table of Exhibits

EXHIBIT 1.1 THREE LEVELS OF PREVENTION FOR CHILDHOOD LEAD POISONING

EXHIBIT 1.2 TRANFORMING THE U.S. HEALTH CARE SYSTEM INTO A HEALTH SYSTEM

EXHIBIT 5.1 COLLABORATIVES AND COALITIONS

EXHIBIT 10.1 BENCHMARK ACHIEVEMENTS IN ENVIRONMENTAL HEALTH

EXHIBIT 10.2 LANDMARK EVENTS IN ENVIRONMENTAL JUSTICE

EXHIBIT 13.1 VIOLENCE IS A PUBLIC HEALTH ISSUE

Copyright © 2010 by Prevention Institute. All rights reserved.

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Library of Congress Cataloging-in-Publication Data

p. cm.

Includes bibliographical references and indexes.

ISBN 978-0-470-55095-3 (pbk.); ISBN 9780470873342 (ebk); ISBN 9780470873359 (ebk); ISBN 9780470873366 (ebk)

1. Medicine, Preventive—United States. 2. Community health services—United States. 3. Medical policy—United States. 4. Social medicine—United States. I. Cohen, Larry, 1947 May 21- II. Chávez, Vivian. III. Chehimi, Sana.

[DNLM: 1. Primary Prevention—organization & administration—United States. 2. Community Health Services—organization & administration—United States. 3. Health Policy—United States. 4. Social Justice—United States. WA 108 P942235 2010]

RA445.P6585 2010

362.1—dc22

2010023126

We dedicate this book to Dr. Beverly Coleman-Miller, a physicianand nurse who understood prevention with every bone in herbody. She made magic and inspired us with her vision and commitment.She emphasized that every heartbeat matters, and in our limitedheartbeats every one of us can have a profound impact in improvingthe world. In Beverly’s memory, we hope that this book will movehearts and make magic.

ACKNOWLEDGMENTS

We gratefully acknowledge the following individuals and institutions for their contributions to this edition of Prevention Is Primary.

To the entire Prevention Institute team of staff, interns, and fellows for their continuing and unwavering support and assistance. In particular, a great big thank-you to:

Alice Ricks, for her role as a graduate student editor, researcher, and writer.

Andy Riesenberg, for providing significant editorial assistance and writing on several chapters.

Ann Whidden, for extensive writing and editorial assistance, particularly on the preventing violence chapter.

Linda Shak and Nicole Schneider for editorial assistance and writing on the mental health chapter.

Melissa Murrin and Katherine Rea, for their role as student researchers on several chapters.

Omar Sahak, for providing content, editing, writing, and organizational assistance.

Shakirah Simley, for pitching in wherever needed and providing support on several chapters.

To San Francisco State University and the Department of Health Education, gratitude for a vision grounded in social justice and a mission enriched with multicultural perspectives.

To past, present, and future students, thank you for trusting Vivian Chávez with the creative freedom to teach prevention.

To Dan Perales and the San Jose State University MPH Distance Education Program, our appreciation for your using the first edition of Prevention Is Primary as an underlying framework. To Barbara Krimgold and Kalahn Taylor-Clark, our thanks for your facilitating the collaboration with past and current Kellogg Health Scholars, whose contributions to chapters and sidebars are evidenced throughout the second edition.

And last, but certainly not least, our heartfelt gratitude to all of the readers of the first edition whose enthusiasm and support made the text such a hit and this edition a reality.

Larry Cohen Vivian Chávez Sana Chehimi Editors

FOREWORD

Georges C. Benjamin

The United States spends $2.4 trillion annually on health care delivery and millions more on alternative treatments. The sum of these expenditures means we spend more per capita than any other industrialized nation; yet we rank fiftieth in the world in terms of life expectancy.

The current U.S. health care delivery system does little to promote health. It has great difficulty delivering consistent quality and struggles to eliminate disparities in health outcomes. Almost 50 million Americans do not have health insurance. These people often receive medical care late in the course of their disease, often without having had the opportunity for preventive care. Hundreds of thousands of underinsured individuals also frequently suffer the same fate.

In 2010, the nation passed historic legislation to expand quality, affordable health insurance coverage to more than 30 million Americans. The supporters of this legislation recognized that having an insurance card is not enough and added $15 billion in provisions to promote wellness and to fund prevention. Basic elements of healthy communities, such as healthy food, opportunities for physical activity, and clean air and water, are too often missing in low-income communities and communities of color. These disparities demonstrate the schism between the extraordinary potential of primary prevention and the reality of health policy and practice at the population level. As the nation becomes older, more ethnically diverse, and more deeply plagued by chronic illness, these disparities will become more apparent and will widen.

Public health improvement is part of a continuum that includes health promotion and disease prevention as well as timely and appropriate clinical care. It is delivered in a social and economic context that affects health and quality of life. Understanding this context improves our ability to efficiently address our most pressing health concerns.

Good public health practice creates a community benefit. It is science-based and prevention-oriented. A good public health system should reduce morbidity and mortality and improve quality of life. It might even right a wrong. It can save money, but, like most things, it usually requires an investment in time, money, and effort.

A 2009 survey by Lake Research Partners and Public Opinion Strategies showed bipartisan support for prevention, with 71 percent of Americans favoring an increased investment in disease prevention. Despite this support, getting people to practice prevention continues to be a problem. Whether this is due to a lack of knowledge, lack of belief in preventive measures, or inability to connect the dots from preventive measures to outcomes, this text strives to fill that void. It does so by addressing prevention in its purest form: primary prevention.

The authors of the chapters assembled here are foremost authorities in the field of population health. They represent an important collection of experts in a range of public health and prevention disciplines. Examples include Deborah Prothrow-Stith, who was a trailblazer in defining violence as a public health problem and in proposing prevention strategies for its reduction; and Howard Frumkin and Andrew Dannenberg, who have been effective advocates for changing the way we design, build, and rebuild communities. Their work offers clear guidance about the intersection between the built environment and health. The authors from Prevention Institute, led by Larry Cohen, along with his coeditors Vivian Chávez and Sana Chehimi, are an exceptional group who have made it their life’s work not only to think about prevention in the academic sense but to go one step further and put their ideas into practice by working directly with communities.

This book tackles emerging issues such as community resilience and revisits old strategies such as social justice and community organizing. The latter are viewed as primary prevention tools. The need to invest in strategies to empower communities more effectively was brought into our communal consciousness during Hurricanes Katrina and Rita, which hit the Gulf Coast of the United States in 2005, and which were followed by a number of social failures.

Using prevention as a tool to improve health and reduce costs is being increasingly touted as a component of the solution to controlling health care costs and improving national health. Primary prevention is about cost avoidance as well. The challenge is to understand its use, practice it, and evaluate its success. This book is designed to help readers understand the complex concepts of primary prevention in their purest form and incorporate them into practice. The old adage that “an ounce of prevention is worth a pound of cure” is the substance of this book; this book is also about proving the adage to be true.

REFERENCES

Holmes, M., Ricketts, T. C., & King, J. (2009, March). Updating uninsured estimates for current economic conditions: State specific estimates. Cecil G. Sheps Center for Health Services Research and North Carolina Institute of Medicine.

Lake Research Partners and Public Opinion Strategies. (July 13, 2009). New national polling data on health care system reform. http://old.preventioninstitute.org/documents/AmericasAgenda-PACMemo.pdf

World Health Organization. (2004). The world health report 2004: Changing history. Retrieved November 14, 2006, from http://www.who.int/whr/2004/en/index.html

THE CONTRIBUTORS

Dolores Acevedo-Garcia, PhD, is associate professor in the Bouvé College of Health Sciences and associate director of the Institute on Urban Health Research at Northeastern University. Prior to joining Northeastern in September 2009, she was associate professor in the Department of Society, Human Development and Health at the Harvard School of Public Health (HSPH). She is project director for DiversityData, a multiyear project studying racial and ethnic equity in U.S. metropolitan areas, supported by the W.K. Kellogg Foundation. Her research focuses on the effect of social determinants (such as residential segregation and immigrant adaptation) on racial and ethnic health disparities; the role of nonhealth policies (such as housing and immigrant policies) in reducing those disparities; and the health and well-being of children with special needs.

Deborah Balfanz, PhD, is on staff at the Stanford Health Improvement Program (HIP) division within the Stanford Prevention Research Center at the Stanford University School of Medicine. Her role includes coordinating several behavior-change programs that guide participants through gradual lifestyle change. In addition to her work with individuals, Balfanz and her colleagues have worked with the YMCA of the USA (Y-USA) on projects to bring about more global change. She coauthored Building Generation Play: Addressing the Crisis of Inactivity Among America’s Children, a paper that outlined the relationship between inactivity among children and the rising childhood obesity epidemic. With Y-USA, Balfanz and her colleagues have developed the Community Healthy Living Index (CHLI), a tool that allows communities to assess their own opportunities for healthy eating and active living and then guides them through a change process.

Bonnie Benard, MSW, is a senior program associate in WestEd’s Health and Human Development Program in Oakland, California. She writes widely, leads professional development, and makes presentations in the field of prevention and resilience and youth development theory, policy, and practice. Her book Fostering Resiliency in Kids: Protective Factors in the Family, School, and Community is credited with introducing resilience theory and application to the fields of prevention and education. Her most recent book, Resiliency: What We Have Learned, synthesizes the latest developments in resilience research and describes how it has been applied most successfully to support young people. Benard’s work in resilience led to the development of the Resilience and Youth Development Module of the California Department of Education’s Healthy Kids Survey, which polls students on their perceptions of supports and opportunities in their schools, homes, communities, and peer groups.

Georges C. Benjamin, MD, is executive director of the American Public Health Association (APHA). At APHA, Benjamin publishes the nonprofit’s monthly publication, The Nation’s Health, the association’s official newspaper and The American Journal of Public Health, the profession’s premier scientific publication. He is the author of more than one hundred scientific articles and book chapters. Formerly, he was secretary of the Maryland Department of Health and Mental Hygiene, where he oversaw the expansion and improvement in the state’s Medicaid program. Benjamin was chief of the acute illness clinic at Madigan Army Medical Center, where he managed a 72,000-patient visit ambulatory care service and later was chief of emergency medicine at the Walter Reed Army Medical Center. Benjamin chaired the department of community health and ambulatory care at the District of Columbia General Hospital, became acting commissioner for public health for the District, and later directed the emergency ambulatory bureau of the District’s fire department, one of the busiest ambulance services in the nation. Benjamin serves on the boards of Research! America, Partnership for Prevention, and the Reagan-Udall Foundation, and is a member of the Institute of Medicine of the National Academies. In 2008 he was named one of the top twenty-five minority executives in health care by Modern Healthcare Magazine in addition to being voted amongst the one hundred most powerful people in health care in 2007 through 2009 and one of the nation’s Most Powerful Physician Executives in 2009.

Vivian Chávez, DrPH, is an associate professor in the Department of Health Education at San Francisco State University. Her current research examines the role of expressive arts, somatic movement and cultural humility in the classroom as well as in public health practice. She is a registered yoga teacher whose scholarship includes innovative pedagogy to integrate the mind/body split characteristic of higher education. Chávez is a media advocacy trainer and coauthor of Drop That Knowledge: Youth Radio Stories with Elizabeth Soep.

Sana Chehimi, MPH, is a program manager at Prevention Institute, where she oversees projects related to healthy eating and active living by developing tools and strategies to promote healthier, more equitable food environments. Chehimi oversees national media advocacy efforts supporting prevention and health reform and also leads a statewide Rapid Response Media Network, providing tools and resources for effective media advocacy to promote healthy eating and active living. She leads the development of the Environmental Nutrition and Activity Community Tool (ENACT), a Web-based resource designed to improve local nutrition and physical activity environments and oversees the institute’s media advocacy efforts through the Rapid Response Media Network. She has authored numerous reports and publications for the organization.

Molly Chidsey, BA, is the sustainability coordinator for Metro, the regional government in Portland, Oregon. With Multnomah County’s Sustainability Program, Chidsey led efforts to prevent waste, increase recycling, reduce toxics, and make purchases more sustainable. She led development of several projects, including a waste prevention and recycling plan for county facilities, a toxics reduction strategy in partnership with the City of Portland, and a city-county sustainable procurement strategy. She also coordinated a voluntary mercury-free medicine campaign with health care facilities and the international Health Care Without Harm coalition.

Larry Cohen, MSW, is founder and executive director of Prevention Institute, a national nonprofit center dedicated to improving community health and well-being by building momentum for effective primary prevention. He was founding director of the Contra Costa County Prevention Program, where he engaged the American Cancer Society and the American Heart and Lung Associations in forming the first coalition in the United States to change tobacco policy by passing the nation’s first multi-city smoking ban. The coalition ignited other statewide and national efforts, including smoking bans on airplanes and restrictions in public places, restaurants, and workplaces. Cohen also created the Food and Nutrition Policy Consortium, whose work led to a county food policy that sparked momentum for the U.S. food labeling law. He helped shape strategy to secure passage of bicycle and motorcycle helmet laws, strengthen child and adult passenger restraint regulations, and set fluoridation requirements in California. Among his previous publications are A Time of Opportunity: Local Solutions to Reduce Inequities in Health and Safety for the Institute of Medicine Roundtable on Health Disparities and Good Health Counts: A 21st Century Approach to Health and Community for California. Cohen currently heads Urban Networks to Increase Thriving Youth through Violence Prevention (UNITY), a national initiative designed to strengthen and support the forty-five largest cities in the United States to more effectively prevent violence. Cohen developed one of the first courses in the country on preventing violence for UC Berkeley’s School of Public Health. He has authored several seminal texts, including A Public Health Approach to the Violence Epidemic in the United States, and Poised for Prevention: Advancing Promising Approaches to Primary Prevention of Intimate Partner Violence. Among his numerous awards are the Injury Control and Emergency Health Services Section Public Service Award from the APHA, the Secretary’s Award for Health Promotion from the U.S. Department of Health and Human Services, and recognition from the American Cancer Society and the Society for Public Health Education.

Dionne Smith Coker-Appiah, PhD, is an assistant professor in the Department of Psychiatry at Georgetown University School of Medicine. Coker-Appiah, a licensed psychologist, has expertise in adolescent health and using community-based participatory research (CBPR) approaches. Her research focuses on adolescent dating violence prevention, adolescent mental health, and adolescent sexual health. She has collaborated on research projects in the United States that focus on mental health utilization among African American women (In Their Own Voices), adolescent HIV/AIDS prevention (Project GRACE), and adolescent dating violence prevention (Project LOVE). She has conducted quantitative and qualitative research among African Americans in rural and urban settings. Coker-Appiah publishes in peer-reviewed journals, consults, and presents her research at local, national, and international conferences. She has won numerous awards for her scholarship, maintains memberships in professional development organizations, and volunteers with community-based organizations.

Andrew L. Dannenberg, MD, is associate director for science in the Division of Emergency and Environmental Health Services at the National Center for Environmental Health (NCEH) of the Centers for Disease Control and Prevention. He oversees NCEH activities on the health aspects of community design (the built environment), such as land use, transportation, and urban planning. He is exploring the use of a health impact assessment as a tool to inform community planners and the use of model zoning codes to promote health. Dannenberg is an adjunct professor of epidemiology and of environmental and occupational health at the Rollins School of Public Health at Emory University. He has served as director of CDC’s Division of Applied Public Health Training with oversight responsibility for the Epidemic Intelligence Service and other training programs, as preventive medicine residency director and injury prevention epidemiologist at the Johns Hopkins School of Public Health, and as a cardiovascular epidemiologist at the National Institutes of Health.

Rachel Davis, MSW, is managing director at Prevention Institute, overseeing management of projects related to prevention of violence, community health and reducing inequity, health care reform, and mental health. She creates tools and materials to support local and state initiatives and educates government agencies, foundations, and community groups throughout the country. Davis is project director for UNITY, Prevention Institute’s CDC-FUNDED national initiative to strengthen and support the forty-five largest U.S. cities in more effectively preventing violence. Davis codeveloped THRIVE (Toolkit for Health and Resilience in Vulnerable Environments), an interactive web-based tool to help identify and foster factors in the community environment that improve health outcomes and reduce inequity. Her publications include First Steps: Taking Action Early to Prevent Violence. She coauthored A Time of Opportunity: Local Solutions to Reduce Inequities in Health and Safety, Health for All: California’s Strategic Approach to Eliminating Racial and Ethnic Disparities in Health, and Good Health Counts: A 21st Century Approach to Health and Community for California. Prior to joining Prevention Institute in 1997, Davis was a social worker for the San Francisco Unified School District.

Lori Dorfman, DrPH, directs the Berkeley Media Studies Group, a project of the Public Health Institute, where she oversees BMSG’s research on the news, media advocacy training for advocates, and professional education for journalists. Her recent research examines how local television news and newspapers portray a variety of public health issues, including racial discrimination, children’s health, nutrition and agriculture, paid family leave, youth and violence, intimate-partner violence, and alcohol, tobacco, and other drugs. Dorfman cowrote major texts on media advocacy, Public Health and Media Advocacy: Power for Prevention and News for a Change: An Advocates’ Guide to Working with the Media, and teaches a course for master’s students on mass communication and public health at UC-Berkeley’s School of Public Health. She conducts media advocacy training for grassroots organizations and public health leaders, consults for government agencies and community programs across the United States and internationally, and publishes articles on public health and mass communication.

Jonathan M. Ellen, MD, is professor and vice chair of the Department of Pediatrics at the Johns Hopkins University’s School of Medicine and director of the Johns Hopkins Center for Child and Community Health Research. His research has focused on prevention of sexually transmitted diseases (STIs), including HIV, among adolescents on the effectiveness of innovative community-based strategies for controlling STIs. He has cochaired the Community Prevention Leadership Group for Adolescent HIV Prevention Trials Network, leads multisite research HIV prevention protocols, has consulted with STI investigators internationally, has been invited to lecture at international meetings, and advises the CDC and the Jamaican Ministry of Health in Jamaica on STI prevention and control.

Catherine S. Erickson, MPH, has participated in research related to fresh-food access in low-income neighborhoods and links between the sustainable agriculture and health care communities.

Stephanie Ann Farquhar, PhD, is associate professor of Community Health at Portland State University. She is a researcher on a NIH grant that seeks to reduce pesticides exposure and occupational stressors among indigenous farmworkers in Oregon. Farquhar is on the board of directors of Upstream Public Health, and served as a commissioner on the city and county Sustainable Development Commission. In partnership with Multnomah County Health Department and community organizations, Farquhar examined the role of Community Health Workers and popular education in Latino and African American communities in Portland through a three-year CDC grant. Farquhar has been the recipient of a W.K. Kellogg Foundation Community Health Scholars postdoctoral fellowship.

Nicholas Freudenberg, DrPH, is Distinguished Professor of Public Health at Hunter College, City University of New York and director of the CUNY Doctoral Program in Public Health. He is founder and director of Corporations and Health Watch. Freudenberg has published four books and more than one hundred articles and chapters on urban health, incarceration and health, public health policy, and health and social justice. For the last thirty years, he has worked with and for a variety of community organizations, advocacy groups, government agencies, and others to plan, implement and evaluate community health interventions in urban settings.

Howard Frumkin, MD, DrPH, is director of the National Center for Environmental Health and Agency for Toxic Substances and Disease Registry (NCEH/ATSDR) at the CDC. Frumkin is an internist, environmental and occupational medicine specialist, and epidemiologist. His research interests include public health aspects of urban sprawl and the built environment; air pollution; metal and PCB toxicity; climate change; health benefits of contact with nature; and environmental and occupational health policy, especially regarding minority workers and communities, and those in developing nations. Before joining the CDC in 2005, he was professor and chair of the Department of Environmental and Occupational Health at the Rollins School of Public Health of Emory University and professor of medicine at Emory. He is the author or coauthor of more than one hundred scientific journal articles and chapters. His books include Environmental Health: From Global to Local, Urban Sprawl and Public Health, Emerging Illness and Society, and Safe and Healthy School Environments.

Sandro Galea, DrPH, is professor of epidemiology at the University of Michigan School of Public Health and director of its Center for Global Health. Galea is primarily interested in the social and economic production of health, particularly mental health and behavior in urban settings. Galea has authored or coauthored more than two hundred scientific journal articles, more than twenty-five chapters and commentaries and four books. His work has been published in medical and public health journals including the New England Journal of Medicine, American Journal of Epidemiology, American Journal of Public Health, and Epidemiology. Galea’s work has been featured by several media outlets including the New York Times and NBC Dateline among others. He was named one of Time magazine’s epidemiology “innovators” in 2006. He has received research grants from the NIH, the Robert Wood Johnson Foundation, and the CDC.

Wayne H. Giles, MD, is the director of the Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion. Giles directs programmatic and research activities in community health promotion, arthritis, aging, health care utilization, and racial and ethnic disparities in health. His experience includes examinations of the prevalence of hypertension in Africa, clinical trials evaluating the effectiveness of cholesterol-lowering agents, and studies examining racial differences in the incidence of stroke. He has more than one hundred publications in peer reviewed journals and has authored several book chapters. He has been awarded the Centers for Disease Control and Prevention’s Charles C. Shepard Award in Assessment and Epidemiology and the Jeffrey P. Koplan Award.

Nancy M. Goff, MPH, coordinates outreach for the Oregon Environmental Public Health Tracking Program as well as Oregon’s new Health Impact Assessment Initiative, making environmental and health data and information available for more informed decision making at the individual, community, organizational, and policy levels. To build capacity to conduct health impact assessments around the state of Oregon, she trains community leaders and public health practitioners. Previously, Goff worked on a community-based participatory research project involving farmworker health at Portland Columbia River Crossing project with the Multnomah County Health Department.

Joseph P. Gone, PhD, is assistant professor in the Department of Psychology (clinical area) and the Program in American Culture (Native American Studies) at the University of Michigan, Ann Arbor. As a cultural psychologist, Gone studies how to provide culturally appropriate helping services to Native Americans that avoid the neo-colonial subversion of indigenous thought and practice. His published articles and chapters concern the ethnopsychological investigation of self, identity, personhood, and social relations in American Indian cultural contexts vis-à-vis the mental health professions, especially as these pertain to therapeutic processes and practices such as psychotherapy and traditional healing.

Soowon Kim, PhD, is a program manager at Stanford University School of Medicine’s Health Improvement Program, where she designs and evaluates health promotion efforts inside and outside of Stanford. She focuses on providing practical guidance to those developing health promotion programs and public policy by addressing the multiple pathways through which biological, behavioral, and contextual contributors affect individual and population health. She also participates in evaluating Y-USA’s broader community effort, the Healthier Communities Initiatives, which facilitate community health improvements through collaboration.

Barbara Krimgold serves as national program director of the W.K. Kellogg Foundation’s Kellogg Health Scholars Program and Kellogg Fellows in Health Policy Research Program at the Center for Advancing Health in Washington. She was codirector of the Diversity Data project, which launched the website DiversityData.org and produced the report “Children Left Behind: How U.S. Metropolitan Areas Are Failing America’s Children.” Her particular focus is on understanding the economic determinants of health inequities and developing policy menus designed to achieve greater health equity and life opportunity and on changing the direction of U.S. health and social policy.

Bonnie Lefkowitz is a health policy writer and consultant with twenty-four years of experience as a federal researcher, administrator and policy analyst. She is the author of the recent book Community Health Centers: A Movement and the People Who Made it Happen.

Leandris Liburd, PhD, is chief of the Community Health and Program Services Branch at the CDC where she directs a broad range of public health programs addressing community health promotion and the elimination of health disparities. Her principal research is the intersection of race, class, and gender in chronic disease risks, management, and prevention, and the social determinants of health. Liburd spent twelve years in the Division of Diabetes Translation at CDC as a community interventionist and later as chief of the Community Interventions Section. During her tenure in the Division of Diabetes Translation, her work was focused on developing community models for diabetes prevention and control programs in racial and ethnic communities. Liburd has written extensively. Her edited volume, Diabetes and Health Disparities: Community-based Approaches for Racial and Ethnic Populations, was published in September 2009.

Nancy McArdle, MPP, is a researcher and author with more than twenty years experience analyzing housing policy and demographics, migration and settlement patterns, racial segregation, and the intersection between civil rights and opportunity. McArdle was a research analyst at Harvard’s Joint Center for Housing Studies and research director of the Harvard Civil Rights Project’s Metro Boston Equity Initiative. She has served as an expert witness, providing analysis and testimony at trial in several major legal cases involving housing and school segregation. McArdle is currently codeveloper and principal data analyst of DiversityData.org. She is a recent contributor to Twenty-First Century Color Lines: Multiracial Change in Contemporary Society and The Integration Debate: Competing Futures for American Cities. She serves on the board of directors of the Fair Housing Center of Greater Boston.

GiShawn A. Mance, PhD, is a Visiting Assistant Professor at American University in Washington. Her primary research interest examines contextual and cultural influences on symptom presentation for youth exposed to chronic stressors. Mance specializes in empirically-supported treatments for youth who have witnessed or experienced multiple traumas that create vulnerability to depression, and in adapting evidence-based interventions to meet the cultural and contextual needs of communities.

Leslie Mikkelsen, MPH, as managing director at Prevention Institute advances the conceptual work of the organization and supervises the Supporting Healthy Eating and Active Living projects and team. She develops tools and materials to support local and state initiatives, and guides government bureaus, foundations and community organizations throughout the country on effective environmental approaches, coalition building, and interdisciplinary partnerships. Mikkelsen is the cofounder and project director for the Strategic Alliance for Healthy Food and Activity Environments, a statewide advocacy network for creating healthy food and physical activity opportunities. Her research and publications aided in the development of ENACT and the ENACT Local Policy Database. She is a policy consultant to the national Healthy Eating Active Living Convergence Partnership, where she directs research and helps shape national strategy related to policy priorities that support healthy food and activity environments. Leslie has written many articles, including Setting the Record Straight: Nutritionists and Health Professionals Define Healthful Food and Where’s the Fruit? Fruit Content of the Most Highly Advertised Children’s Food and Beverages. Mikkelsen worked for the Alameda County, California and New York City food banks. She received the APHA Food and Nutrition Section 2008 Catherine Cowell Award for Excellence in Public Health Nutrition.

Meredith Minkler, DrPH, is professor of health and social behavior and director of the DrPH program at the School of Public Health at UC Berkeley. She has three decades of experience in community building and organizing and community-based participatory research (CBPR) activities in underserved communities. Her current research includes documenting the impacts of CBPR on public policy, empowerment intervention studies with youth and the elderly, and national studies of health disparities in older Americans. Minkler has written more than one hundred articles and book chapters and has written, cowritten, or edited seven books, including Community Organizing and Community Building for Health, Community-Based Participatory Research for Health (with Nina Wallerstein), Grandmothers as Caregivers (with Kathleen Roe), and Critical Perspectives on Aging (with Carroll L. Estes).

Peter Murchie, MPH, has worked for the World Health Organization, the International Joint Commission, and the U.S. Environmental Protection Agency using collaborative approaches to solve environmental health issues. At the U.S. EPA, Murchie helped start and led the West Coast Collaborative, a partnership among leaders from federal, state, and local government, the private sector, and environmental groups working to reduce heavy duty engine emissions along the West Coast. Murchie was a member of the U.S. EPA Regional Climate and Clean Energy Team and the Mobile Source Workgroup of the Green House Gas Reporting Rulemaking. Presently, Murchie leads an effort at the Policy Consensus Initiative and the National Policy Consensus Center at PSU that supports state and local leaders in using public-private collaboration to implement climate and clean energy strategies and projects.

Marion Nestle, PhD, is Paulette Goddard Professor in the Department of Nutrition, Food Studies, and Public Health (the department she chaired from 1988-2003) and professor of sociology at New York University. Nestle was senior nutrition policy advisor in the Department of Health and Human Services and managing editor of the 1988 Surgeon General’s Report on Nutrition and Health. She has been a member of the FDA Food Advisory Committee and Science Board, the USDA/DHHS Dietary Guidelines Advisory Committee, and American Cancer Society committees that issue dietary guidelines for cancer prevention. Her research focuses on how science and society influence dietary advice and practice. She is the author of Pet Food Politics: The Chihuahua in the Coal Mine, What to Eat, Food Politics: How the Food Industry Influences Nutrition and Health, and Safe Food: Bacteria, Biotechnology, and Bioterrorism. Her forthcoming book, coauthored with Malden Nesheim, is Feed Your Pet Right.

Theresa L. Osypuk, SD, is a social epidemiologist researching racial, socioeconomic, and nativity disparities in health, their geographic patterns, and causes. She is particularly interested in why place affects health and health disparities, including the role of racial residential segregation, neighborhood context, and social policies. Osypuk’s research has appeared in leading epidemiology, social epidemiology, public health, and urban studies journals. Osypuk is an assistant professor in the Bouvé College of Health Sciences at Northeastern University.

Donald Parker, BA, works for Project Momentum, Inc. a community-based organization founded in 2005 to address the many social, environmental, and health issues that face the mostly rural community of Edgecombe County, North Carolina. Donald has served as a community advisory board member for Project LOVE and Project EAST (another HIV/AIDS research project that helps reduce the stigma of HIV/AIDS) and is a steering committee member and data collection supervisor for Project GRACE. Donald’s work spans HIV/AIDS education, adolescent dating violence, and research on health disparities in rural counties in North Carolina.

Neha Patel, MS, is a work group process manager for Zero Waste Alliance’s Outdoor Industry Association Eco Index project. Neha worked for eight years as the program director for the Oregon Center for Environmental Health’s Health Care Without Harm campaign with measured reductions in mercury, PVC use, and waste, and increased integration of green building techniques, environmentally preferable purchasing and sustainable food procurement within the hospital sector.

Daniel Perales, DrPH, is full professor of public health in the Department of Health Science at San Jose State University. He teaches health promotion planning and evaluation in the university’s MPH program and social marketing and epidemiology in the undergraduate program. His twenty years of research include observational studies of bicycle safety helmet use and a needle exchange HIV/AIDS harm reduction program. He has evaluated programs in tobacco control, adolescent pregnancy prevention, nutrition education and food security, child immunization, and coalition development and maintenance. In 1995 and 1996, he served on the APHA’s Strategic Planning Committee. Perales is former treasurer and upcoming president of the Society for Public Health Education in 2010-2011. He sat on the editorial board of Health Education and Behavior, the editorial advisory board of the journal Health Promotion Practice, and the editorial board of the Californian Journal of Health Promotion. He has served on the Prevention Institute’s board of directors since 2003.

Deborah Prothrow-Stith, MD, works at Spencer Stuart, an executive search firm, and serves as adjunct faculty in the Health Policy and Management Department at Harvard School of Public Health. She has been associate dean for diversity and Henry Pickering Walcott Professor of Practice of Public Health at Harvard School of Public Health. As commissioner of public health for the Commonwealth of Massachusetts, she established the first Office of Violence. She continues to develop programs and nurture partnerships with community-based programs locally, nationally, and internationally that include the Community Violence Prevention Project, the Girls and Violence Project, and Partnerships for Preventing Violence, a six-part satellite broadcast training providing education, justice, and health professionals with a thorough understanding of comprehensive, effective, school-centered violence prevention approaches. Prothrow-Stith developed and wrote The Violence Prevention Curriculum for Adolescents. She has written or cowritten more than eighty articles and books on medical and public health issues. Prothrow-Stith has received numerous professional awards.

Juliet Sims, MPH, is a program coordinator at Prevention Institute. Sims’ research and advocacy efforts focus on developing tools, resources, and strategies to advance environmental and policy change in the realm of healthy eating and active living. She supports the Institute’s media advocacy efforts, including its Rapid Response Media Network, and she facilitates development of ENACT. Sims developed “Setting the Record Straight: Nutrition and Health Professionals Define Healthful Food,” a definition of healthful food that looks beyond nutrients to acknowledge that truly healthful food comes from a system where food is produced, processed, transported, and marketed in environmentally sound, sustainable, and just ways. Prior to joining Prevention Institute, she worked in clinical nutrition.

Michael S. Spencer, PhD, is associate dean for Educational Programs and associate professor at the University of Michigan School of Social Work. His research examines the causes and consequences of disparities in the health, mental health, and service use of people of color. Spencer is the principal investigator of the NIH-funded REACH Detroit Family Intervention, a community-based participatory research project whose goal is to reduce health disparities, particularly diabetes, among African American and Latino Eastside and Southwest Detroit residents through the promotion of a healthy lifestyle and self-management of health. Spencer teaches courses in contemporary cultures in the United States, multicultural and multilingual organizing, facilitation training for dialogues in diversity and social justice, social work practice in communities and social systems, and community development.

Makani Themba-Nixon is executive director of the Praxis Project, a nonprofit organization dedicated to helping communities use media and policy advocacy to advance health equity and justice. She was previously director of the Grass Roots Innovative Policy Program (GRIPP), a national project to build capacity among local organizing groups to engage policy advocacy to address institutional racism in welfare and public education. She served as staff for the California state legislature, was media director for the Southern Christian Leadership Conference in Los Angeles, and worked five years for the Marin Institute for the Prevention of Alcohol and Other Drug Problems, including three years as director of its Center for Media and Policy Analysis. Themba-Nixon has published numerous articles and case studies on race, media, policy advocacy, and public health. Her latest book, cowritten with Hunter Cutting, is Talking the Walk: Communications Guide for Racial Justice. She is the author of Making Policy, Making Change, which examines media and policy advocacy for public health through case studies and practical information. She is coauthor of Media Advocacy and Public Health: Power for Prevention, a contributor to the volumes We the Media and State of the Race: Creating Our 21st Century, among other edited book projects.

M. Taqi Tirmazi is a W.K. Kellogg Postdoctoral Fellow at Morgan State University School of Community Health and Policy. He is conducting a community-based participatory research project that examines the contextual factors associated with the preconception and interconception health of African American youth in Baltimore. Tirmazi has studied the impact of demographic, social, educational, and environmental factors on the acculturation and psychosocial adaptation of immigrant Muslim youth in the United States, the impact of social and physical determinants on the mental health of urban black youth, maternal depression among African American mothers, hip hop and youth development, elderly Muslims and mental health, socialization of adolescent Muslim girls, and acculturation of immigrant Muslim youth. At Utrecht University, he conducted a comparative study on the ethnic and religious identity of Muslim youth in the Netherlands and United States.

Nina Wallerstein, DrPH, is Professor, Masters in Public Health Program, Department of Family and Community Medicine; and director of the Center for Participatory Research, Office of Community Health, Health Sciences Center, University of New Mexico. She has worked in empowerment and popular education and CBPR since the mid-1970s. Recent books include Community-Based Participatory Research in Health: From Process to Outcomes, 2nd edition (edited with Meredith Minkler) and Problem-Posing at Work: A Popular Educator’s Guide (with Elsa Auerbach).

Anita M. Wells, PhD, is an assistant professor and the graduate program coordinator in the Department of Psychology at Morgan State University in Baltimore. Wells’ work is grounded in the theory that social, psychological, and biological factors all interact, often in complex ways, to produce health outcomes. Her areas of research are cancer health disparities, health promotion, and mental health and well-being. She investigates health decision-making among African Americans, the impact of trauma and violence on mental health, and the relationship between health policy and health outcomes. Wells has conducted community based research with African American populations since 1995.

Dan Wohlfeiler, MPH, is chief of the Office of Policy and Communications of the Sexually Transmitted Disease Control branch of the California Department of Health Services. From 1990 to 1998, he served as education director of San Francisco’s STOP AIDS Project, a leading HIV-prevention organization run by and for gay and bisexual men in San Francisco. He is a nationally recognized expert on structural interventions for HIV prevention and offers training through the California STD/HIV Prevention Training Center. His current interests focus on structural and network-level interventions for STD/HIV prevention.

Ashby Wolfe, MD, joined Prevention Institute in 2005 as a contributing editor for the first edition of Prevention Is Primary. She is a family physician in the Department of Family and Community Medicine at the UC Davis Medical Center in Sacramento, California. She has worked in family practice as a researcher and clinician and holds a particular interest in the development of policies and programs to improve the quality of care for underserved and low-income populations. She has experience with health policy at the local, state, and federal levels. Wolfe served as acting medical officer for the Centers for Medicare and Medicaid Services Region IX office in San Francisco during 2006-2007, and has worked with a number of health care organizations, provider groups and patient organizations in an effort to reduce disparities in care for vulnerable populations. She has worked on several outreach campaigns for the Department of Health and Human Services and has experience developing and evaluating quality improvement initiatives.

Ellen Wu, MPH, is the executive director of the California Pan-Ethnic Health Network (CPEHN), a statewide network of multicultural health organizations working to ensure that all Californians have access to quality health care and can live healthy lives. CPEHN played a critical role in mobilizing the health community to defeat Proposition 54, which would have prohibited the collection of race and ethnicity data by government agencies, and in the chartering of SB 853, a bill that ensured language services to all limited-English proficient health plan members. During Wu’s tenure, CPEHN has doubled in size, expanding its advocacy capacity and increasing its impact. Wu helped establish Having Our Say, a coalition of community organizations working to ensure communities of color have a voice in health care reform, and the Healthy Places Coalition, which advances public health involvement in land use planning. Prior to joining CPEHN, Wu consulted with the community health center network, was a program officer at the Tides Foundation, and served as director of health education and cultural linguistic services for the Alameda Alliance for Health. Wu is an adjunct faculty member at San Francisco State University and serves on numerous boards and advisory committees that include the Department of Public Health, the California Budget Project, and Healthy Families. Wu has coauthored studies on cultural competency and health care reform and is a frequent presenter on health disparities.

Mysha Wynn, MAEd, is founder and executive director of Project Momentum, Inc., a community-based organization that collaborates with UNC researchers in efforts to address health disparities in Edgecombe County, North Carolina. Wynn’s work spans mental health, teaching, HIV/AIDS education, and research on health disparities in rural counties in North Carolina. Wynn was community mentor for Coker-Appiah at the University of North Carolina through the Kellogg Health Scholars Program, sits on the community advisory board of Project LOVE, and is a subcontractor for Project GRACE.

INTRODUCTION

Larry Cohen, Vivian Chávez, Sana Chehimi

It is simply undeniable that prevention works. From mandatory seat belt use to regulation of chemicals in children’s toys, from fluoridated water to childhood immunizations, our daily lives are filled with reminders that prevention saves lives and reduces unnecessary suffering. Although only three years have passed since publication of the first edition of this text, the role of prevention, in policy and in practice, has undergone a significant transformation, with unprecedented visibility and unheralded support.

A new and vigorous commitment to reforming the U.S. healthcare system provided unprecedented opportunities to promote prevention and community wellness strategies that could simultaneously improve health and conserve resources. Public health and equity advocates, many of whom were readers or contributors to this text, were instrumental in ensuring that the health, equity and well-being of our communities were seen as key elements in discussions about the health of our economy. Thanks in no small part to these efforts, the American Recovery and Reinvestment Act (ARRA) of February 2009 included a landmark investment in prevention and wellness, totaling more than $1 billion. Nearly $400 million of this funding was earmarked for the “Communities Putting Prevention to Work” initiative, which aims to create healthier communities across the nation through exactly the kinds of innovative and proven prevention approaches described throughout this text.

Equity and community prevention were also built into the health reform legislation. Although overall the debate on health reform was contentious, the provisions on prevention were barely debated, perhaps because there was bipartisan recognition that we must refocus our health system to keep people healthy in the first place and cannot continue to simply treat problems after the fact. The funding commitment to prevention in ARRA and health reform is nothing less than a down payment on the nation’s future; it represents the critical understanding that prevention requires a government commitment to community wellness, safety, and equity in all policies. This greater focus on prevention will save both lives and money; recent studies forecast a savings of $5 for each $1 invested in prevention (Trust for America’s Health, Prevention Institute, The Urban Institute, New York Academy of Medicine, 2008).

By making a strong case for primary prevention, our hope is that this edition of Prevention Is Primary: Strategies for Community Well-Being changes the ways in which a new generation of community and public health leaders approach health. Shaping and maintaining quality prevention initiatives is not easy. It requires an understanding of the underlying determinants of health and inequities and knowledge of how to apply primary prevention strategies. During the past few years, the notion of social determinants of health and the need to address the underlying causes of health and health inequities has received more attention. At the same time, we are increasingly aware that the health sector cannot work alone. Instead, it is imperative that we work hand-in-hand with other practitioners and sectors, including transportation, agriculture, and economic development, to name a few.

Prevention Is Primary deliberately builds on cross-disciplinary wisdom and experiences of a variety of sectors and defines a coherent set of principles and approaches that guide the practice of prevention across a wide range of contemporary health and social issues. The social and health concerns of our time were not created in isolation, and they cannot be ameliorated in isolation, either. We all share responsibility for addressing monumental concerns, which include global warming, violence, and inequitable distribution of resources. These concerns cannot be simply siloed into issue areas or disciplines. The task for emerging public health practitioners is to recognize the connection between issues and to develop practices that are synchronous, collaborative, and concerted. This kind of prevention approach holds the promise of addressing multiple concerns simultaneously. Even more important, this holistic view sees communities, practitioners, families, and legislators as partners who are interconnected, interdependent, and equally invested in building healthy, thriving communities.

The text is organized in three sections: “Defining the Issues,” “Key Elements of Effective Prevention Efforts,” and “Prevention in Context.” The sections are arranged in sequence, and we suggest readers move through them sequentially. Each section includes its own introduction, which provides the context and analysis for each of the included chapters. A number of chapters are complemented by sidebars that further contextualize primary prevention from a variety of disciplines and perspectives. These sidebars represent the perspectives of the editors or sidebar contributors, not necessarily the chapter authors.

Part One, “Defining the Issues,” begins with a thorough definition of what primary prevention is and, equally important, what it is not. It continues by describing the overarching framework and principles guiding quality prevention efforts, including a focus on social justice, health equity, and community resilience.

Part Two, “Key Elements of Effective Prevention Efforts,” describes the transition from prevention theory to implementation and practice, that is, from interdisciplinary collaboration to the evaluation of primary prevention efforts.

Part Three, “Prevention in Context,” explores the application of prevention efforts to a wide range of contemporary health and social issues and demonstrates both current successes and the potential inherent in prevention practice.

Although we recognize we are members of a global community with transnational connections and implications, we focus predominantly in this book on the United States. We also recognize primary prevention efforts will not resolve every health and social problem, and yet these efforts are nonetheless a much-needed complement to care and treatment.

As much as this book is about health, it is equally about social justice and equity. We draw our inspiration in putting this text together from the many other social movements in which ordinary people united to fight for what they believed in (for example, the Suffragette movement, the ongoing Civil Rights movement, and the Peace Movement). As the civil rights leader Fannie Lou Hamer of the Student Nonviolent Coordinating Committee stated, “I’m sick and tired of being sick and tired” (DeMuth, 1964, p. 549). She then transformed her despair at U.S. injustice into voter registration leadership. For the new generation of leaders, the readers this book is intended for, health and justice must be inseparable. As César Chávez explained, “We can choose to use our lives for others to bring about a better and more just world for our children” (National Farm Worker Ministry, 2005, p. 1). “Our movement,” Chávez stated, referring to the United Farm Workers, “is spreading like flames across a dry plain” (1966, p. 14). Our hope is that this book becomes a small spark in the movement for good health for all.

REFERENCES

Albee, G. W. (1983). Psychopathology, prevention, and the just society. Journal of Primary Prevention, 4, 5-40.

Chávez, C. E. (1966, March 17). The plan of Delano. El Malcriado, pp. 11-14.

DeMuth, J. (1964, June 1). Tired of being sick and tired. The Nation, pp. 548-551.

McGinnis, J. M., & Foege, W. H. (1993). Actual causes of death in the United States. Journal of the American Medical Association, 270, 2207-2212.

Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. Journal of the American Medical Association, 291, 1238-1245.

National Farm Worker Ministry. (2005, November 22). Litany of Christian hope. Retrieved October 7, 2006, from http://www.nfwm.org/worshipresources/litanies.shtml

Trust for America’s Health, Prevention Institute, The Urban Institute, New York Academy of Medicine. (2008). Prevention for a healthier America. Investments in disease prevention yield significant savings, stronger communities. Retrieved October 7, 2006, from http://preventioninstitute.org/component/jlibrary/article/id-75/127.html

PART ONE

DEFINING THE ISSUES

Typically, medical approaches treat people after they get sick and look at one individual at a time. But a better option for societal health and well-being would be to create quality prevention techniques to keep people from getting sick in the first place. What is quality prevention? It is far more than a message in a brochure or information received during a medical visit. The three chapters in Part One explain the fundamental concepts needed to complement medical treatment with quality prevention efforts and to improve and maintain societal health.

Chapter One, “The Imperative for Primary Prevention,” by Larry Cohen and Sana Chehimi, establishes the need to address factors that cause unnecessary illness, injury, and death. The authors show that primary prevention provides an important solution to an overburdened health care system where, as health care services weaken, everyone is increasingly at risk and marginalized populations are most vulnerable. A prevention-oriented approach to health and well-being is needed to help eliminate the injustice of the greatest impact of illness and injury falling on disfranchised populations. The authors note that primary prevention is far from a new idea and highlight its long and proven record of success. The chapter emphasizes the importance of a comprehensive approach and presents the Spectrum of Prevention, a framework for putting primary prevention into practice.

Health inequities