Primary Prevention

Primary Prevention

There is a popular parable, especially in healthcare, that explores the benefits of “upstream thinking” —the need to look at prevention, rather than just solutions—if we want to end social ills. Each telling of the story varies but essentially:

“Two people are standing at the edge of a river. All of a sudden a drowning child floats by and one person jumps in to save her. Then another child comes floating by and the other individual jumps in to pluck him from the water. But soon, more and more children are in the river and drowning. People cannot keep up with the demand. Eventually, someone decides to go upstream to figure out why kids keep falling/being thrown in the river in the first place.”

The same is true with homelessness. We understand a great deal these days about the pathways in and out of homelessness. We know a lot about how to provide services to people while they are homeless and we understand effective solutions, such as Housing First, that can end homelessness. We often fail, however, by not paying enough attention to how homelessness can be prevented in the first place.

The goal of primary prevention is to ‘work upstream’ to reduce risks, and typically involves universal interventions directed at whole communities, as well as targeted interventions for ‘at risk’ communities. With regards to homelessness, this could include information campaigns and educational programs, as well as strategic interventions designed to help address problems that may eventually contribute to homelessness, well before they arise. Poverty reduction strategies, anti-violence campaigns, early childhood supports and anti-discrimination work all can contribute to a reduction in homelessness down the road.

Eviction Prevention, including programs such as rent banks or tenant advocacy supports, is an example of primary prevention aimed at a specific population. Often the assistance of someone to help them navigate a rental tribunal or mediate with a landlord, or a loan/grant of a few hundred dollars can keep someone housed. Similarly, energy support programs for low-income households can help people facing energy poverty. In some climates the amount of money necessary to keep a home heated or cooled can mean the difference between staying housed or becoming homeless.

At-risk populations such as LGBTQ2S youth also need support: statistics show that 25-40% of homeless youth fall into this population group. By supporting families to understand sexual and gender orientation or by training/supporting foster homes to be LGBTQ2S positive, the number of youth who are homeless can be dramatically reduced.