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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Our View: Prevention attention

The Spokesman-Review

A familiar allegory tells of a town where it was popular to scale a cliff, stand at the edge and gaze on the valley. But so many people tumbled over the cliff that someone suggested stationing an ambulance at the bottom to rush the maimed to the hospital.

Somebody else had a better idea: Build a fence, keep people from falling.

That moral is hard to grasp for federal, state and local policymakers who usually favor treatment of social ills over prevention.

A comprehensive study released this week underscores – again – the importance of understanding root causes. The child who grows up in poverty is more likely to get sick. So is the child of a single parent. And the child of uneducated parents.

More than 57,000 children under 18 were surveyed in the National Health Interview Survey Disability Supplement for 1994 and 1995, and researchers say it’s the first study to reveal the compounding effect of exposure to more than one of the so-called “risk factors.” Researchers said the effect was noted even when children had access to health care.

So what? Wouldn’t you expect economic and educational deprivation to lead to health problems?

You would. What’s more, there are shelves full of studies that identify risk factors that permit observers to predict problems for youngsters exposed to them.

University of Washington researchers David Hawkins and Richard Catalano have pinpointed various conditions in the community, the school, the family and the individual youngster that forecast drug abuse, teen pregnancy, delinquency and dropping out of school.

Similarly, the Search Institute in Minneapolis has a list of “developmental assets” that reflect how closely a child is bonded to family, friends and community. The more assets, the less likely a youngster is to make dumb choices about drugs, crime and sex.

“Study after study,” as UW’s Catalano puts it, demonstrates the links between early family conditions and consequences later in life.

Encouragingly, that research is being used to design programs that compensate for deficiencies and improve a child’s long-term prospects. When successful, such efforts lower the cost of jailing, healing, housing and feeding the down and out.

Catalano says some prevention programs save as much as $11 for every dollar invested, but it’s a hard sell politically. Officials and policymakers can see the results of treatment (doctor visits for 1,000 sick kids), but not the kids who didn’t get sick, didn’t get pregnant, didn’t do drugs.

No, public policy makers can’t stop dealing with the existing problems that afflict the needy. And while knowing the benefits of prevention doesn’t make any more money available for it, budget writers need to examine the research for opportunities to target expenditures on promising prevention plans. In time, it will ease the acute problems that return year after year.

The more fences at the top of the cliff, the fewer broken bodies at the bottom.