Menu of Systems
Change Strategies

What do we mean by upstream prevention?

Negative health outcomes such as violence, suicide, or substance misuse can be stopped before they ever start. Upstream prevention involves identifying and addressing the root causes and conditions that may be contributing to negative health outcomes such as these. To prevent these negative outcomes before they ever occur, we look upstream to examine what underlying conditions may be addressed so the problem never arises in the first place.

These underlying conditions are often referred to as the social determinants of health or shared risk and protective factors, which are the upstream factors that are part of the environment in which people live, learn, work, and play. Learn more about upstream prevention, the social determinants of health, and the shared risk and protective factor approach to prevention.

What do we mean by systems change?

The largest determinant of an individual’s health status is the community and environment in which they are raised and interact with others. This includes a person’s physical surroundings as well as the social and economic forces and structures that influence their decision-making and behaviors. Because the intervention is subsequently focused on changing the community or environment broadly, we refer to these intervention efforts as systems changes, which include the creation or improvement of public policies, regulations, and community systems or structures. Learn more about systems change to improve the health of communities and how we can identify and address core components of the systems that either hold a problem in place or promote healthy behaviors in order to create positive and sustainable change.

Because of the expansive work that is inherent to changing systems, these efforts can have an effect on the entire population within a community. However, it is likely that health disparities already exist within communities, making it important to focus on deep equity, uprooting systems of oppression, and addressing disparities as part of this work.

Why does this menu exist?

The purpose of this menu is to highlight evidence-based and evidence-informed strategies that create systems changes within communities and environments to ultimately reduce risk factors and protect youth from adverse health and social outcomes. The focus is only on local systems change (within a neighborhood, town/city, or county), not at changes that might occur at the state or federal level. Learn more about the background and purpose of the Menu of Systems Change Strategies.

Given that local community contexts are all unique, these strategies may subsequently look different across various communities. It is critical that these strategies are thus implemented as part of community organizing efforts that engage the local community and use data to drive decision-making. Learn more about the critical precursors to implementing these strategies.

Who can I contact if I still have questions after looking over this site?

The Menu of Systems Change Strategies was created in partnership by the Violence and Injury Prevention - Mental Health Promotion Branch at the Colorado Department of Public Health and Environment (CDPHE) and the Injury and Violence Prevention Center at the Colorado School of Public Health (CSPH) to help guide community-based primary prevention efforts that prioritize population health strategies with the goal of reducing risk factors and improving protective factors for youth in Colorado. Please submit this form to have any additional questions answered!