Larry Cohen

A Community Resilience Approach to Reducing Ethnic and Racial Disparities in Health

Prevention Institute, a nonprofit, national center dedicated to health and well-being, developed a toolkit for health and resilience in vulnerable environments (THRIVE), a community assessment tool, to help communities bolster factors that will improve health outcomes and reduce disparities experienced by racial and ethnic minorities. THRIVE is grounded in research and was developed with input from a national expert panel. It has demonstrated utility in urban, rural, and suburban settings. Within months of piloting, several communities had initiated farmers markets and youth programs. THRIVE provides a framework for community members, coalitions, public health practitioners, and local decisionmakers to identify factors associated with poor health outcomes in communities of color; engage the range of partners needed to improve community health outcomes, such as planners, elected officials, businesses, housing, and transportation; and take action to remedy disparities.

A public health approach to the violence epidemic in the United States

A public health approach to the violence epidemic in the United-States describes the dimensions and root causes of the problem with violence in the United States. After defining the problem and who is affected, the paper criticizes the dominant policy and describes an alternative, community based, public health approach to violence prevention that the authors are currently helping to implement in Northern California.

Transforming Our World: Implementing the 2030 Agenda Through Sustainable Development Goal Indicators.

Abstract The United Nations’ 2030 Agenda for Sustainable Development recognizes violence as a threat to sustainability. To serve as a context, we provide an overview of the Sustainable Development Goals as they relate to violence prevention by including a summary of key documents informing violence prevention efforts by the World Health Organization (WHO) and Violence Prevention Alliance (VPA) partners. After consultation with the United Nations (UN) Inter-Agency Expert Group on Sustainable Development Goal Indicators (IAEG-SDG), we select specific targets and indicators, featuring them in a summary table. Using the diverse expertise of the authors, we assign attributes that characterize the focus and nature of these indicators. We hope that this will serve as a preliminary framework for understanding these accountability metrics. We include a brief analysis of the target indicators and how they relate to promising practices in violence prevention.

Community Engagement in Design and Planning

Community engagement is a critical element of efforts to improve the built environment because it ensures that concerns of community residents are considered in projects and plans, strengthens local partnerships, and builds social capital. Improvements to the built environment can facilitate social connections and increase opportunities for social interaction, leading to greater community ownership, deepening opportunities for engagement, and instilling a sense of pride for physical improvements. A range of mechanisms can be employed to engage community residents or representatives of the community; the technique must fit the purpose. Disenfranchised communities must have a genuine voice in the planning and implementation of projects. Community engagement provides a mechanism for cultivating this voice and maximizing the likelihood that the outcome will reflect its input.

Partnerships for Preventing Violence A Locally-Led Satellite Training Model

Local face-to-face provider training has the benefit of enabling participants to network with people in their communities who are working on similar issues, to engage in interactive discussions, and to learn from local experts and local program examples. However, face-to-face training has considerable costs (labor and expense) and provides limited exposure to national experts. In recent years, technology has allowed training methods to expand to include distance learning methods (satellite and web-based). The newer methods can decrease per-person training costs, provide exposure to national experts, and result in wide dissemination of information. Yet these distance learning methods often limit the ability of participants to interact and network with each other and substantially reduce opportunities to apply the learning objectives to local circumstances. To maximize the benefits of both models, the Harvard School of Public Health, the Prevention Institute, and the Education Development Center developed, implemented, and evaluated Partnerships for Preventing Violence (PPV), an innovative six-part satellite training series on the public health approach to preventing youth violence. Using a unique hybrid methodology that combines satellite training with local, face-to-face facilitation by trained experts, PPV trained over 13,000 people, generated youth violence prevention activities across the country, and created a national cadre of youth violence prevention leaders.

Violence, health, and the 2030 agenda: Merging evidence and implementation.

The Guest Editors introduce the Special Issue for the Journal of Public Health Policy on violence, health, and the 2030 Agenda. Emphasizing the importance of collaboration between scholars and practitioners, they outline the process of jointly imagining and designing the next generation of violence prevention strategies. They include representative works of members of the World Health Organization (WHO) Violence Prevention Alliance (VPA), including the World Bank, the United States Centers for Disease Control and Prevention, Prevention Institute, the Danish Institute Against Torture, the University of Cambridge Institute of Criminology, the London School of Hygiene and Tropical Medicine Gender Violence and Health Centre, and the Yale University Law and Psychiatry Division, among others.

Communities are not all created equal: Strategies to prevent violence affecting youth in the United States

Abstract We describe violence in the United States (US) and solutions the Urban Networks to Increase Thriving Youth (UNITY) Initiative has developed, led by Prevention Institute, a US non-governmental organization (NGO) and authors of this article, with initial funding from the US Centers for Disease Control and Prevention (CDC). Safety distribution across populations is unequal, while public health research has identified aspects of community environments that affect the likelihood of violence, or risk and resilience factors. An overwhelming number of risk factors have accumulated in some US communities, disproportionately impacting young people of color. US policies, systems, and institutions powerfully shape how and where these factors manifest. Violence is preventable, not inevitable. We argue that comprehensive strategies for improving community environments can reduce violence and promote health equity. We present lessons, tools, and frameworks that UNITY cities use to adapt for international application, including multi-sector collaboration, strategies for influencing policy and legislation, and strengthening local violence prevention efforts.

In the first place: community prevention's promise to advance health and equity

This paper highlights the role of community prevention in improving overall health and in supporting health equity. By addressing the underlying causes of illness and injury, community prevention efforts can prevent illness and injury before they occur. The paper presents three frameworks that support quality community prevention efforts. The first, Taking Two Steps to Prevention, analyzes the underlying causes of illness, injury and health inequities and helps identify key opportunities for intervention and prevention. The second framework, the Spectrum of Prevention, guides users in thinking through the elements of a comprehensive community prevention strategy: strengthening individual knowledge and skills; promoting community education; educating providers and leaders (in all sectors); fostering coalitions and networks; changing organizational practice (within government, health institutions and workplaces, among others); and influencing policy and legislation. Both Taking Two Steps and the Spectrum are explained through the demonstration of two successful and ongoing community prevention efforts: first, preventing smoking; and second, promoting breastfeeding. The third framework, Collaboration Multiplier, focuses on developing sustainable interdisciplinary partnerships capable of addressing a variety of health and social problems. Collaboration Multiplier provides a matrix that clarifies the contributions that different sectors bring to a particular health or social problem and helps develop a shared language and understanding for working together.

Violence Affecting Youth: Pervasive and Preventable

Violence is a preventable, public health crisis in the United States. Young people are powerfully affected by violence, and it is critical that we advance prevention as a vital part of the solution to defend childhood. Violence affects where we live, where we work, where we go to school, and whether our children go to school or if we can work. Experiencing or fearing violence in the street, in their homes, and in their relationships directly impacts children’s physical and emotional health and has long-term emotional and mental health consequences that can, in turn, further affect physical health, relationships, learning, and the ability to work. These impacts are disproportionately felt by disenfranchised and under-resourced communities where children nearly always suffer the most and bear the greatest burden of reduced health and safety, but have the fewest resources to respond to these mounting challenges. Fortunately, there is a strong and growing evidence-base that confirms that violence is preventable if it is approached with commitment and sustained attention. It requires coordinated and comprehensive efforts and resources, and the active cooperation of sectors and fields that might not typically work together. This chapter provides the three keys to preventing violence and emphasizes comprehensive strategies for changing norms so we no longer allow a culture of violence to flourish without protest.

Building a Thriving Nation 21st-Century Vision and Practice to Advance Health and Equity

It is a great time for prevention. As the United States explores what health in our country should look like, it is an extraordinary time to highlight the role of prevention in improving health, saving lives, and saving money. The Affordable Care Act’s investment in prevention has spurred innovation by communities and states to keep people healthy and safe in the first place. This includes growing awareness that community conditions are critical in determining health and that there is now a strong track record of prevention success. Community prevention strategies create lasting changes by addressing specific policies and practices in the environments and institutions that shape our lives and our health—from schools and workplaces to neighborhoods and government. Action at the community level also fosters health equity—the opportunity for every person to achieve optimal health regardless of identity, neighborhood, ability, or social status—and is often the impetus for national-level decisions that vitally shape the well-being of individuals and populations.