from the Centers for Disease Control and Prevention.
One day, a fisherman was fishing from a river bank when he saw someone being swept downstream, struggling to keep their head above water. The fisherman jumped in, grabbed the person, and helped them to shore. The survivor thanked the fisherman and left, and the hero dried himself off and continued fishing. Soon he heard another cry for help and saw someone else being swept downstream. He immediately jumped into the river again and saved that person as well. This scenario continued all afternoon. As soon as the fisherman returned to fishing, he would hear another cry for help and would wade in to rescue another wet and drowning person. Finally, the fisherman said to himself, “I can’t go on like this. I’d better go upstream and find out what is happening.”
This public health analogy of “moving upstream” to prevent tragedies from occurring downstream is taught in many public health courses and is relevant for our dialogue on sexual violence prevention. It is presented as a catalyst for discussion and to convey how important it is to have strong teams along the river building safe passages.
The Centers for Disease Control and Prevention (CDC) could not begin to address sexual violence prevention without the years of hard work and dedication of survivors, advocates, prevention educators, and other professionals. Their efforts ensure the provision of crisis intervention, victim advocacy, and social and mental health services that are critical to the long-term well being of those affected by sexual violence. One of the tenets of the public health approach is building partnerships and identifying the strengths and expertise that partners offer to help frame solutions to a public health problem. CDC’s niche is to be part of the team working at the top of the river: building safe passages and keeping people from being pushed into the river. The Rape Prevention and Education (RPE) grant program should be a major contributor to this effort. We also know that we are working in partnership with others along the river making sure that anyone who falls in will survive.
This document is intended to begin the dialogue about what it means to move upstream. Over the past few years — since CDC’s Injury Center became the administrator of the RPE program — we have been asked repeatedly to define what we mean by “prevention.” How does prevention look, and where should recipients of RPE funds focus their efforts and resources? Our working definition of sexual violence prevention for the RPE program is population-based and/or environmental and system-level strategies, policies, and actions that prevent sexual violence from initially occurring. Such prevention efforts work to modify and/or entirely eliminate the events, conditions, situations, or exposure to influences (risk factors) that result in the initiation of sexual violence and associated injuries, disabilities, and deaths. Additionally, sexual violence prevention efforts address perpetration, victimization, and bystander attitudes and behaviors, and seek to identify and enhance protective factors that impede the initiation of sexual violence in at-risk populations and in the community.