On April 25, 1996, 129 people participated in a conversation about the civics and politics of prevention. Participants in the Making Prevention Work Conference heard a variety of perspectives about the role of public policy in influencing public health from presenters throughout the day. Participants were also actively involved in many discussions about their reactions to the presenters' comments and beliefs.

Jean Funk, Director of the Minnesota Prevention Resource Center (MPRC), opened the Conference with an invitation to "participate fully in today's dialog.... learn from each other... teach each other... and leave this conference more knowledgeable and confident in our ability to influence prevention policy..." Jean then explained the purpose of the conference as an opportunity to explore with one another what are our individual and collective rights, responsibilities and limitations are in influencing both formal and informal social policy regarding alcohol, tobacco and other drugs.

The morning session was organized as a panel presentation by six individuals who offered six unique perspectives on the role of policy in influencing public health. They included: Makani Themba, The Praxis Project; Carol Ogren, Hennepin County; Bruce Bomier, Minnesota Institute of Public Health (MIPH); John Berglund, Minnesota Licensed Beverage Association, Inc.; Kathy Mock, BlueCross BlueShield of MN; and Alex Wagenaar, University of Minnesota-Epidemiology. Two 45 minute sessions followed by a question and answer session were facilitated by Jerry Jaker, President of the MIPH.

Makani Themba, The Praxis Project

Each panelist carefully used his or her 15 minutes to explain what he/she believed to be key questions to consider and themes to remember. Kathy Mock suggested that a key to collective efforts to influence policy toward improving health is to "do what you do best and help with the rest." Bruce Bomier echoed the need for collaboration by identifying the important challenge of "learning to responsibly work with managed care organizations to prevent people from getting hurt." Makani Themba suggested that we think of policy as an agreement about how a community is going to deal with an issue and John Berglund suggested that conference participants recognize that public health is only one element of public policy and must be considered along with other social and economic factors. While all of the panelists acknowledged the remarkable costs of alcohol and tobacco related problems in the United States, not all shared the same vision for responding to these costs.

Carol Ogren spoke of her own radicalization resulting from 30 years of experience in the social service arena. She encouraged participants to "step back and consider societal norms, including capitalism and the veneration of individualism.... As long as the maximization of profits is valued, we'll continue to see problems." John Berglund suggested targeting efforts on "abuse not consumption" and identified car crashes as the most serious alcohol related problem we face today. Alex Wagenaar pointed out the wide range of alcohol related problems in the United States and suggested that the most effective prevention approach will be to change the environment rather than focus on individuals. He explained that risk is not a dichotomy, but rather a continuum. While acknowledging the role of environmental prevention strategies, Bruce Bomier emphasized the role of persuasion in prevention. He stated that an important question for the future of prevention efforts is to "find the best mix between coercion and persuasion."

Each of the panelists spoke passionately of the need for continuing efforts to prevent alcohol, tobacco and other drug related problems. Kathy Mock encouraged individual and collective action to support espoused policy, and stated that policy without action is just wishful thinking. Carol Ogren called for "a major public discussion of the values and norms that we take for granted today." Alex Wagenaar reminded the audience that, "We in a democracy, create the conditions that allow these problems to emerge. We can create the conditions that prevent them." Bruce Bomier encouraged participants to recognize the changing world of laws, regulations and the health care system, and realize that regulation itself does not always work to improve the public health. Makani Themba challenged participants to become public health advocates and provide input to help resolve the question of whether profit or public health will shape public policy. John Berglund stated that we all have a duty and a right to try to influence public policy if we have an opinion about an issue.

After a full, but well paced morning, it appeared that participants of the Making Prevention Work Conference were ready to continue their conversations about their own opinions about prevention policy. The panelist's comments were provocative and stimulating. The follow-up questions and answers were informative. And, the participants' informal discussions were animated and productive. The impact of this morning's conversation will no doubt continue in offices, local city halls and the state capital in the weeks and months ahead.