Cohen´s article in Huffington Post (http://www.huffingtonpost.com/larry/preventive-care_b_879626.html) heralds great news indeed but there are lessons between the lines.
It is important to note that successes achieved so far are focused on specific outcomes such as smoking, seat belts, crime, obesity and so on. Other than the argument that prevention is better than cure and the use of public health strategies. They do not flow from generalised actions such as targeting population determinants without significant dollars.
Cohen warns of the fragility of prevention dollars. In a negative fiscal environment, we need to be careful that real money is invested – $ for prevention for every $ for reaction. Policy makers can use population determinants as an excuse to kill several birds with one stone while not investing in any of them and so no outcomes. So the National Strategy needs to strengthen the ability of outcome focused strategies such as stopping violence to get the funds that are needed.
In the crime area, including UNITY, the evidence is clear that the real returns from prevention come from real reinvestments – maybe 10% of reaction – to get 50% reductions. Ten per cent of $225 billion is $22 billion – that is what is needed to cut homicides, rapes, robberies and more by fifty per cent. The evidence is there.
However, these returns can only be achieved if there is a permanent leadership centre to make and sustain the shift. This centre must be hierarchically important enough and with the human capacity to achieve the outcomes. Justice reinvestment as token actions is not enough.
The Boston gang prevention strategies did not survive and even was morphed into low effectiveness SACSI and Neighborhood safety that are not prevention. Bogotá did survive and indeed flourishes.. Alberta, Canada provides a unique north American example of how to do this as do cities like Waterloo Region and Edmonton. Winnipeg has an amazing auto theft prevention strategy with $20 million invested saving $80 million and more.
No where is the investment in prevention to stop crime more urgent than in California. The good news is proposition 36, the bad news is the cost overruns on prisons that could and now should be invested in stopping violence using the evidence and so stopping the unrelenting admissions to prison.
