What Have We Got to Lose?


Never before has the value of prevention science become so apparent to the American public. It took a pandemic to expose the contrast between tackling a problem that has already become entrenched, and preventing the underlying conditions that give rise to the problem in the first place.

But the value of prevention extends well beyond disease management. It’s about how to create conditions conducive to healthy child development, nurturing families, strong communities and a supportive social fabric. And like with most things, we have a choice...

We can continue to rush Narcan to people overdosing on opioids. Or we can address the risk factors for substance abuse our young people experience so they never go down that road.

We can continue to urgently resuscitate patients in heart failure. Or we can adopt healthy lifestyles.

We can continue to accept chemotherapy. Or we can detect and act on the early warning signs.

We can continue to treat people in emergency rooms. Or we can make health care affordable and accessible, regardless of zip code.

We can continue to address the effects of adverse childhood experiences on mental and physical health throughout the lifespan. Or we can reduce exposures to adversity before they occur.

We can continue to bury the bodies of children killed in school shootings and vow to make a difference. Or we can enact legislation that actually makes a difference.

We can continue to protest the police killings of Black and Brown people. Or we can reform policing and reverse shrink disproportionate minority contact.

We can continue to expend trillions of dollars on welfare for families living in poverty. Or we can provide opportunities for people in areas of concentrated disadvantage to flourish.

We can continue to wring our hands about unemployment rates. Or we can provide a high quality education to all our children.

We can continue to invest in mass incarceration. Or we can provide an opportunity structure that works for all.

We can continue to deny that structural racism and injustice hurts us all. Or we can use a racial lens to collectively eradicate inequalities from our communities and systems.

We can continue to wait for therapeutics and a vaccine while hundreds of thousands lose their lives to COVID-19. Or we can wear a mask.

We can continue to believe our own rights are more important than other people’s rights. Or we can remember the meaning of the phrase “love thy neighbor” and reembrace a sense of community.

America has at its disposal significant body of scientific knowledge about the social determinants of health. We can solve the hard problems if we choose to do so.

An ounce of prevention is worth a pound of cure… as Benjamin Franklin once said. And it has never been more true or more imperative.

Dr. Diana Fishbein

Co-Director, the National Prevention Science Coalition to Improve Lives

Senior Research Faculty, The Pennsylvania State University

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