Rethinking Our Investments: Primary Prevention and its Promise for Healthier Outcomes

by Laura Krausa, MNM

I’ve had the great privilege of working for the past 17 years in violence prevention. It wasn’t something I set out to do, but my career landed in a place where this work was earnestly beginning, and I just so happened to be in the right place at the right time. Honestly, I was absolutely drawn to the work because I had my own experiences with violence, both physical and emotional. And the thing my soul cried out to do was to prevent it from happening to anyone else. Because violence never fully leaves you. It becomes a part of you.  Eradicating violence? A lofty goal, indeed. And while improbable, it is actually possible. Violence is preventable. But there’s a significant reason we fail to prevent it.

We fail because we live in a society that focuses far more on responding to problems rather than preventing them. Take, for example, our US healthcare system. It’s hard to argue that it focuses more on prevention than response when you look at the disease burden in our country. In 2025, the US spent $4.9 trillion on health care, with 90% of that on treating chronic diseases[1]. And many of these diseases are associated with behavioral causes that could be addressed if we really got serious about addressing the root causes that lead to those behaviors. Prevention.

Unfortunately, our society invests in violence the very same way it does in healthcare. Most of the funding we see invested in addressing issues of violence and human trafficking is focused on response. We care greatly about helping those who have been victimized. We want to see them heal and pursue happy and healthy lives. And we should always care about that and always make investments that heal those who have been victimized! But it is essential that we simultaneously invest in preventing violence and human trafficking altogether. Why would we let people fall into the rushing, crushing river of violence when we could instead fix the broken bridge that let them fall in the first place?

This kind of prevention is called primary prevention, and I believe it goes unrecognized as a solution to violence because its power is not always evident when people think about these strategies. We tend to automatically associate response strategies with violence because we are inundated with violent messages and media. Violence has become normalized, so response strategies are simultaneously normalized as the cure. But primary prevention looks different – a lot different – so we simply don’t associate it as a cure for the condition of violence.

To make this point, here are some examples of primary violence prevention that you may or may not recognize as solutions that can dramatically reduce the risk for violence altogether:

• After-school programs that educate teens on positive relationships and empower them to advocate for healthy relationships for themselves and their peers.
• Weekend and holiday “backpack meals” that are sent home with students to supplement a family’s food needs.
• English as a Second Language education.
• Positive parenting classes and peer-mentor support for new families.
• Social activities in the community.
• Social-emotional learning in elementary schools.
• Educational pipelines that introduce people to career paths.

Primary prevention provides basic resources and meets basic human needs. It is the support system that identifies challenges and meets them pre-emptively. It is all about reducing risk and building resilience. And the most beautiful part is that a singular prevention solution prevents multiple social issues.

May is Mental Health Awareness Month in the US. If you look at the list above and imagine the absence of these strategies, can’t you just feel the stress? So many young people are not seeing positive relationship modeling at home – imagine the stress of trying to navigate a healthy first-time dating relationship if you have no idea what that looks like. So many families are experiencing food insecurity – imagine the stress this causes when the food dollars just can’t be stretched to meet the extra burdens of weekend and holiday mealtimes. Imagine not being able to navigate society because you do not know the language, or you are a first-time single parent navigating life with a newborn, or you are a struggling high school student with nobody to help you identify what life looks like after graduation. The stress in all these situations is oppressive. Unaddressed, each situation fosters isolation. Each invites the opportunity for mental health issues and provides an opening for violence, including dating violence, bullying, child abuse, interpersonal violence, criminal activity – and human trafficking.

When you consider the above scenarios and calculate the cost of preventive strategies versus the cost of a potential lifetime of physical, mental, and behavioral health issues, it seems obvious we should choose prevention. But we don’t. And we need to grapple with that as a society and as a human family. If we put more of our investments into activities that have the potential to stop violence and human trafficking altogether, how much better could this world we live in be?

Mother Teresa said, “The biggest disease today is not leprosy or tuberculosis, but rather the feeling of being unwanted.” Violence and human trafficking thrive in spaces where people feel unwanted. But we can change that by activating primary prevention strategies born out of love for others and the hope of a better world. Let us be that love and hope!

1 https://www.cdc.gov/chronic-disease/data-research/facts-stats/index.html