14 BARRIERS And Some Suggested StrategiesFacts

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14 BARRIERSAnd Some Suggested Strategies/Facts

• for
• Environmental Programs on ATOD
• by
• James F. Mosher, David H. Jernigan and Robert W.
  Dennison

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Barriers Defined

• Obstacles, dilemmas, questions, problems
• Something that hinders...not fence or wall
• The hurdles that communities anticipate or are
  likely to face as they develop and implement
  specific environmental strategies

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Environmental Strategies Defined

• It is best defined using the public health
  model...Host-Agent- Environment

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Host

• The individual suffering from a health problem
• (drug user or person harmed by user)

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Agent

• That which is necessary or sufficient to cause
  harm to the host
• (alcohol, tobacco, illegal drugs)

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Environment

• Consists of social, economic, physical,
  political, and cultural settings in which the
  host and agent interact

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Environmental Strategies continued

• Seek to change the context in which the agent and
  host operate so there is either no interaction or
  the interaction does not cause harm
• In environmental strategies, alcohol, tobacco and
  illegal drugs are viewed as community
  issues...reflections of the communitys norms and
  practices

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Examples (past 10 years)

• National minimum purchase age for alcohol
• State and local restrictions on alcohol
  availability
• Law enforcement against sales of tobacco to
  minors
• State and Federal excise taxes on alcohol
• Campaigns to remove ATOD billboards

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Some Background

• Theres a solid research foundation now which
  establishes the effectiveness of various
  environmental strategies for ATOD
• There is, however, little experience in applying
  these strategieswhy?

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Barrier 1. Confusing terminology

• Environment suggests protecting green spaces
  and parklands
• Associated with ecological concerns
• What does ATOD policy have to do with
  environmentalists?

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Suggested Strategies

• Provide new audiences with the necessary
  background to minimize the confusion
• Define environment clearly using the public
  health model
• Combine or substitute other terms such as
  community, public health, or systems
  approach to prevention

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Barrier 2. Too abstract

• They address social forces outside the individual
• They often do not put human face on the problem
• No one person can testify that the new
  streetlights saved his/her life

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Suggested Strategies

• Take people on a guided tour of their own
  environments...show pictures, do skits, dramas,
  and ask them to relate to problems
• Present case studies of the practical benefits a
  community can experience from implementing
  environmental strategies

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Barrier 3. The Prevention Paradox is
counterintuitive and too difficult to explain

• Many question prevention efforts that target the
  entire population of a community because they
  appear to punish moderate and light drinkers
• Many argue that programs should concentrate on
  identifying heavy users and targeting preventive
  activities to them

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Suggested Strategies

• Develop simple graphics and explanations
  (emphasize that all ATOD users are at risk for
  alcohol/health problems, and give concrete egs.)
• Place the prevention paradox in a broader
  perspective
  (highlight its benefits to young
  people, its reduction of incentives for heavy
  consumption, its support of treatment programs
  etc.)

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Barrier 4. ES tend to challenge the free
enterprise system, addressing economic issues not
usually within public health area

• Some belief that public health has little or no
  involvement in econ policy decisions
• State ATOD agencies fall within a gray area
  having both econ envirn policy decision-making
  authority
• Many states give their public health agencies low
  role priority in envirn issues

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Suggested Strategies -Three
Facts-

• Public health and economic issues are
  intertwined...public health agencies cant do
  their jobs without paying attention to economic
  policies
• The free enterprise system is dependent on
  government intervention such as fraud
  competition protection, promotion of market
  stability, etc
• Private enterprise and public health are not
  incompatible

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Barrier 5. Alcohol and tobacco should be treated
like other legal products

• An alcohol and tobacco industries argument that
  ES restrict their marketing practices, that
  alcohol and tobacco not be viewed as illegal
  drugs etc
• The assumptions found under Barrier 4 underlie
  this argument

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Suggested Strategies

• Demonstrate that legal products are treated
  differently based on analysis of their potential
  for social benefit and social harm
• Emphasize importance of developing prevention
  strategies not based on a prohibition
  model...remember the Prohibition Era

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Barrier 6. State/fed tax laws and the lobbying
process are too difficult to deal with

• Organizations dont want to be fined or lose
  their nonprofit status for violation
• Organizations sometimes decide to avoid any
  action involving policy change in order to ensure
  that no illegal lobbying has occurred

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Suggested Strategies -Some facts-

• Most ES dont require legislative action
• Fed tax code doesnt require activities involving
  development of legislation
• Nonprofit organizations are allowed to dedicate
  portion of their budget to lobbying 20 1st
  500,000 15 on the next 500,00s
• Advocates can join and support lobbying efforts

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4 legislative activities by ngos that do not
constitute lobbying

• Communications that do not require anyone to
  lobby
• Groups analysis of legislation that include
  direct positions on the merit of the legislation
• Discussion of broad social, economic, and similar
  policy issues whose resolution requires
  legislation
• Response to legislative requests

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Barrier 7. Proponents of ES are do-gooders who
blame the system and let bad people off

• The misperception is that an environment approach
  does not hold individuals responsible for their
  behavior and blames irresponsibility or
  negligence on the society or community at large

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Suggested Strategies -Some facts-

• ES hold individuals responsible for their own
  actions (they compliment not replace)
• In ES all people are responsible for their
  behaviors and character of their community
• Nothing wrong with doing good
• If ES are ignored, those who benefit from
  unhealthy and illegal ATOD use are let off the
  hook

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Barrier 8. ES threatens individual civil
liberties and the pursuit of happiness

• Many see ES as an intrusion upon their lives when
  decisions made by the government agencies
  restrict their individual choices

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Suggested Strategies -Some facts-

• The best environmental strategies are passive
  rather than intrusive
• ES serve as alternatives to coercive policies
• Most ES restructure, rather than limit individual
  choices
• ES that threaten civil liberties or stigmatize
  individuals have limited effectiveness and should
  be avoided

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Examples

• Wallmart
• US Navy

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Barrier 9. ES threatens limited funds needed for
individual strategies

• The fact that Americas drug problem is being
  highlighted in the face of shrinking funds, many
  think that ES proponents are in an awkward and
  unaffordable luxurious position

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Suggested Strategies -Some facts-

• Effective ES complement individual-based
  prevention approaches and can aid in the success
  of treatment programs
• ES can be cost-effective and revenue enhancing
• ES increase collaboration and power
• ES can have immediate impact

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Barrier 10. ES can conflict with traditional
research focused on individual approaches

• Some believe that ES do not preclude the need to
  identify and treat persons at risk
• That they do not produce environments that limit
  risk for individuals

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Suggested Strategies -Some facts-

• ES research draws on and is grounded in its own
  research tradition
• ES outside the mainstream of ATOD research
  doesnt diminish its importance
• Preventionists seek research support rather than
  fight over limited resources
• Preventionists gather support by translating
  research findings into lay language for community
  wide dissemination

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Barrier 11. Some ES seem controversial and
divisive even in collaboration

• The issue here is change
• ES accept that social change is necessary
• Change threatens those who are entrenched in or
  benefit from the status quo

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Suggested Strategies

• Develop new coalitions whose members share a
  commitment to developing and implementing ES
• Take advantage of the broad scope of the ES to
  expand your coalition
• Build on the ability of ES and community
  organizing to increase citizen participation in
  the decision-making process

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Barrier 12. Profits from illegal drug sales make
that market impossible to control

• When a grower or dealer is caught, another takes
  his/her place
• If drug dealers are removed from one
  neighborhood, they set up shop elsewhere
• Some law enforcement efforts have possibly
  inadvertently encouraged the development of
  large, violent drug cartels

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Suggested Strategies

• Societal focus needs to shift tot the local level
  
  This has the added
  benefit of building community empowerment and
  improving neighborhood conditions
  
  The argument that drug markets simply move to
  other neighborhoods is not necessarily true by
  close examination

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Barrier 13. Many societal vested interests
promote strategies that punish SA victims, thus
undermining the ES for controlling illegal drug
use

• Huge sums of money are indeed being poured into
  other strategies/programs that are not directed
  at changing the environment, while ES receive
  relatively little attention or support

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Suggested Strategies

• Develop a strong research base that documents the
  effectiveness of ES in reducing illegal drug
  problems
• Use community organizing political advocacy to
  build grassroots support for ES
• Build regional, statewide, national support for
  ES through coalition building, political
  advocacy, and media advocacy

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Barrier 14. The alcohol and tobacco industries
oppose ES that restrict their marketing

• They will do anything, go anywhere and stop at
  nothing
• After all, theyre not in the health business,
  but in the money business

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Suggested Strategies

• Continue building and improving on Barrier 13
  strategies

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Conclusion. Remember 4 things

• Regardless of barrier(s), the implementation of
  these ES also brings enormous rewards
• Environmental change takes time
• Communities have the resources to succeed
• Youre not alone