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Prevention: The key to changing our binge drinking culture

Today GrogWatch begins a series focussing on Community Prevention and Action.  

Everyday when you leave your home, do you lock your doors? Why?  It’s because you know that if you don’t, you may get broken into. You also know that locking the doors alone won’t necessarily stop someone from breaking in, so you might go further and put locks on the windows and install in a security system. What you are doing is calculating the risk and putting prevention measures in place to reduce the risk.

Investing in prevention activities becomes much more likely once an occurrence has reached a critical mass. Seatbelts and the 0.05 BAC drink driving limit became mandatory because about 3,500 people were dying on the roads each year.

GrogWatch believes that prevention is the underfunded and oft-ignored key to reducing Australia’s binge drinking culture.

The New Economics Foundation a think-tank from the UK wrote a great piece called The Wisdom of Prevention: An economics view of the importance of prevention which argues that preventing harm is the wisest option, adopted far too rarely. Instead it says, we wait until things go wrong and end up coping with the consequences, which is costly and unsustainable.

The New Economics Foundation use a version of a well worked metaphor to illustrate the need for prevention:

“So it is a beautiful day the sun is shining, the sky is blue imagine yourself standing on the banks of a fast-flowing river. The water is full of children, women and men who are being swept along, in danger of drowning. You and others are working yourselves to a state of exhaustion, trying to haul them to dry land before they are carried out of reach. It is unrelenting hard work and more and more of you are needed because more and more bodies are caught in the current, hurtling past. You are all so preoccupied with the task that you can barely think. But at some point, someone must surely ask – what’s going on upstream? Shouldn’t we find out why all these people are falling in and try to stop it happening?”

Prevention is a vast playing field. Different levels of prevention can be described in relation to where in ‘the river’ the action occurs:

  • ‘Downstream’ or tertiary prevention:  tries to manage the consequences of harm and focuses on specific cases and stopping things from getting worse.
  • ‘Midstream’ or secondary prevention: mitigates the effects of harm that has already happened and focuses on slowing down or stopping the harm to those considered ‘at risk’ or ‘vulnerable’.
  • ‘Upstream’ or primary prevention: prevents harm before it happens and protects healthy people from harm.

(adapted from the New Economics Foundation)

There are many who will argue that change can only come about from a top-down approach such as legislation enacted by governments. Others will say that bottom-up prevention is best.

Here at GrogWatch we see the process of change as being far less linear. Change often starts in community-led grassroots movements and that community action drives governments to make changes to the law, which leads to further change in communities. Of course it can happen in reverse as well. We know grassroots community prevention programs can have a significant impact on reducing alcohol and other drug problems – especially when they are coupled with advocacy for legislative change.

But starting and maintaining a grassroots movement is not easy, Communities need support to tackle the political, economic and cultural factors that cause the harm in the first place. There is now a body of evidence demonstrating best practice in community prevention, which should be considered when planning prevention initiatives.

Over coming weeks GrogWatch will explore some of these best practise examples and share some practical tips for communities who want to take action to reduce alcohol harm in their local area.

Tell GrogWatch what you think – how can communities and governments help ‘stop people from falling into the river’? Are you working on community action prevention programs that relate to alcohol harms? Tell us about it below or email us.

Read Prevention Research: Preventing drug and alcohol problems in your community - A practical guide to planning programs and campaigns