Prevention Works for Children. Adults Need It Too.

She is 47 years old.

She works full-time. She is raising two teenagers while helping her father recover from a stroke. She hasn’t exercised for months. She sleeps too little, skips her own medical appointments, and has started relying on a couple of glasses of wine most evenings, not because she has an alcohol use disorder, but because she is simply exhausted.

Who notices?

For children, we know the answer: Pediatricians routinely ask about development and behavior and families, teachers, coaches, and youth workers all help children grow into healthy adults. No single institution carries the responsibility alone, but together they create something powerful: a prevention system.

For adults, that system largely fades into the background. Without ever intending to, we built a prevention system with doors that close when people age out.

Adults keep developing

At EDC, I work with a team of prevention scientists and experts whose work is guided by the understanding that development doesn’t stop at age 18. Young adults become part of the workforce, then parents, aunts, and godparents. They navigate financial stress, career transitions, disease, grief, divorce, and retirement. These experiences shape health and behavioral health just as surely as childhood experiences do.

The National Academies find that promoting healthy mental, emotional, and behavioral development in childhood creates a foundation for lifelong health. Prevention science has begun extending that logic forward. In a widely cited 2023 commentary, researchers argued that middle and later adulthood represent important but underdeveloped frontiers for prevention research and practice.

The encouraging part is how much opportunity already exists.

What extending prevention looks like

Decades of research have already identified the conditions that help people thrive across the lifespan: supportive relationships and social connection, economic stability, healthy work environments, safe and healthy environments, and the routine identification of emerging behavioral health concerns. These are not personal responsibilities, but the conditions that communities, employers, healthcare systems, and public institutions can help create.

We know what works, science isn’t the missing piece. Instead, we need specific actions to make these conditions consistently available.

First, make prevention a routine part of adult life. Screening, Brief Intervention, and Referral to Treatment, originally developed for substance use and since expanded to identify depression and other behavioral health conditions, can be embedded wherever adults regularly interact with trusted institutions. Studies show that supportive check-ins about substance use in clinical settings, even in appointments unrelated to substance use, can help adults cut back, prevent early deaths linked to alcohol, and keep problems from developing into disorders.

Second, invest in the conditions that make healthy development possible. Libraries, parks, senior centers, local gyms, adult sports leagues, faith communities, and neighborhood organizations all create connections, reduce isolation, and foster a sense of purpose and belonging. Strengthening these conditions is not separate from prevention. It is prevention.

Finally, build community infrastructure rather than isolated programs. SAMHSA’s Prevention Collaboration in Action toolkit points to communities including rural Arkansas, Rhode Island, and United Indian Health Services, and finds consistently that prevention is strongest when health care, public health, housing, employers, and aging services work through shared partnerships rather than in isolation.

These steps share a common principle: prevention should not depend on luck. Whether someone remains healthy should not be determined by having an unusually supportive employer, an exceptional physician, or a devoted family member.

America has spent decades building a treatment system that follows us throughout life. The next chapter of public health should be building a healthy development infrastructure that allows prevention to do the same.

Explore related resources and services:

• Prevention Solutions @ EDC trains and equips the prevention workforce that communities depend on, providing training, consultation, and tools to help states, tribes, and local coalitions plan, implement, and sustain prevention systems.
• Our Strategic Prevention Technical Assistance Center team has produced a wide array of free, evidence-based resources to support prevention for people of all ages.