Investing $1 in system and policy change (upstream prevention) can save $7 to $10 in post-disaster recovery costs (Public Safety Canada, 2019). Should we spend 7 million dollars on building homeless shelters and psychiatric facilities, or invest 1 million dollars in a system-level change with a policy direction oriented towards reducing the need for homeless shelters or psychiatric care? This is the goal of upstream prevention methods: investing wisely by solving the root of the issue (Halsall and colleagues, 2024).
Social Collapse River Analogy
Imagine a river where people are constantly being swept downstream. We can save individuals by pulling them out one by one, but more people keep falling in. This represents downstream interventions like providing emergency shelter or food banks, which address immediate needs but do not solve the underlying problem.
To truly prevent people from falling into the river, we need to go upstream and target the social determinants. Here, we might find a broken bridge causing people to fall in. Fixing the bridge represents upstream prevention, addressing systemic barriers that lead to issues such as poverty, hunger, and suicide.
Neglecting these upstream factors eventually leads to increased strain on services, higher rates of chronic illness, widespread poverty, and ultimately, social collapse due to the overwhelming burden on resources and infrastructure.
Holding Policy Makers Accountable: Poverty and Hunger Crisis
The United States and Canada, amongst several other countries, are committed to achieving the ‘Sustainable Development Goals (SDG)’ of the United Nations. Countries must do their part by honestly reporting and taking action on these national and international policy priorities. There seems to be a discrepancy between the recent report versus the population statistics.
According to the Sustainable Development Report 2024, which tracks progress on the SDGs, Canada is on track to achieve the goal of 'No Poverty' while progress on the goal of 'Zero Hunger' is stagnating (Figure 1: Sustainable Development Report, 2024).
However, these reports seem to lack integrity. ‘Zero Hunger’ is not stagnating as Canada reported, it is the worst it has ever been in history. Food bank use in Canada hit a record-breaking high in 2024 (Food Banks Canada, 2024).
Canada also reports that the goal of 'No Poverty' is on trajectory to being achieved. However, the reality is that a third of renters in Canada cannot afford their rent and homelessness and encampments are on the rise (Canadian Centre for Housing Rights, 2024).
This crisis highlights the need for upstream prevention strategies to address the systemic issues........