This paper highlights the role of community prevention in improving overall health and in supporting health equity. By addressing the underlying causes of illness and injury, community prevention efforts can prevent illness and injury before they occur. The paper presents three frameworks that support quality community prevention efforts. The first, Taking Two Steps to Prevention, analyzes the underlying causes of illness, injury and health inequities and helps identify key opportunities for intervention and prevention. The second framework, the Spectrum of Prevention, guides users in thinking through the elements of a comprehensive community prevention strategy: strengthening individual knowledge and skills; promoting community education; educating providers and leaders (in all sectors); fostering coalitions and networks; changing organizational practice (within government, health institutions and workplaces, among others); and influencing policy and legislation. Both Taking Two Steps and the Spectrum are explained through the demonstration of two successful and ongoing community prevention efforts: first, preventing smoking; and second, promoting breastfeeding. The third framework, Collaboration Multiplier, focuses on developing sustainable interdisciplinary partnerships capable of addressing a variety of health and social problems. Collaboration Multiplier provides a matrix that clarifies the contributions that different sectors bring to a particular health or social problem and helps develop a shared language and understanding for working together.

Any strategy to end the opioid epidemic must include recognizing and addressing the role of widespread individual and community trauma and the need for solutions that build protective factors and agency within communities while supporting long-term treatment and recovery for those experiencing substance use disorders. In this chapter, the authors describe how a community trauma–informed approach can be applied to address and mitigate the exposures, behaviors, and high levels of hopelessness that are fueling the opioid crisis. Further, the chapter explores how primary prevention strategies can complement opioid treatment and long-term recovery interventions and address other conditions that co-occur in communities experiencing trauma.