Traditional healthcare often focuses on treatment. For example, treating the symptoms of health problems after they arise, such as heart disease or diabetes. While this medical support is crucial, public health promotes upstream prevention, a proactive approach that addresses the root causes of health issues before they occur.

What is upstream prevention?

Imagine a fast-flowing river. Downstream, you see people struggling in the current. You can throw them life preservers (which treats the immediate problem). But a more effective solution is to go upstream and address the factors that are causing people to fall in the river in the first place. For example, putting up a fence or warning sign along the river, or repairing a bridge across the river.

Upstream prevention in public health works similarly. It focuses on:

• Social determinants of health: These are the conditions in which people are born, grow, live, work, and age. Factors like poverty, employment, access to healthcare, educational attainment, adequate housing, and a healthy environment significantly impact health outcomes. Upstream prevention helps practitioners understand these root causes of illness and better advocate for solutions.
• Policy changes: Advocating for policies that create healthier environments. This could include:

• Improving access to affordable, nutritious food.
• Investing in safe and accessible public transportation.
• Creating smoke-free environments.
• Implementing regulations on pollution or affordable housing.
• Community empowerment and partnerships: Empowering communities to take control of their own health by:

• Building strong social support networks.
• Increasing access to green spaces and parks.
• Promoting healthy behaviors through education and community programs.

The benefits of upstream prevention are numerous, here are just a few:

• Reduced healthcare costs: By preventing illnesses in the first place, the need for expensive medical treatments decreases.
• Improved health equity: Addresses the root causes of health disparities that disproportionately affect marginalized communities.
• Increased quality of life: Creates healthier environments and promotes overall well-being for individuals and communities.

Here are a few examples of upstream prevention in action:

• Designing walkable and bikeable communities: Encourages outdoor physical activity, active transportation, and reduces obesity rates.
• Creating innovative partnerships: Effective partnerships can be used to improve early childhood development and improve access to prenatal care.
• Utilizing health informatics to spot disease outbreaks early: Identity and react in a timely manner to disease outbreaks, such as West Nile Virus or salmonella.
• Establishing health policies: For example, smoke-free public housing protects non-smokers from secondhand smoke, reduces overall tobacco use, and increases quit attempts.

Conclusion

Upstream prevention is a crucial component of public health. By addressing the root causes of health problems, we can create healthier and more equitable communities.

For more information

• Contact Eric Aakko, Associate Professor and MPH Program Director, (402) 486-2600 or visit https://uau.edu/publichealth/about.
• The Master of Public Health (MPH) program at Union Adventist University is a 2-year, on-campus program. Options include accelerated graduation tracks with Union’s other majors, including Biomedical Science, International Rescue and Relief, or Physician Assistant Studies.  
• Union Adventist University is a professional member of the Association of Schools and Programs of Public Health (ASPPH).