adj. Towards the source of a stream or river; against the normal direction of water flow.
Imagine walking along a riverbank with a friend. Suddenly, you notice someone drowning in the river, flailing his arms and screaming for help as he is swept downstream.
You jump into the river to pull him to safety, but as soon as you reach the shore, you see someone else in the river, screaming for help. This happens again and again.
Exhausted, you shout for your friend to help you. Instead of jumping into the river, your friend begins running up the river bank. When you ask her what she is doing, she replies, “I’m going upstream to find out why these people are falling in, and to keep them safe on the riverbank!”
"If we don't change the direction we are headed,
we will end up where we are going."
In Public Health we are constantly fighting the current misunderstandings of the time. There seems to be many vast health disparities that have resulted from such misunderstandings. This story relays the mission of Public Health and upstream politics. To understand and get to the root cause of any health disparity--whether it be socioeconomic, environmental, or personal--our mission is to move as far upstream as possible.
Upstream causes deal with interventions that are beyond the individual's control. These interventions focus on implementing new laws, policy and programs to help assist individual's health behaviors and choices. We have all seen how effective focusing on upstream factors can be, just take a look at the Tobacco industry and how effective they are at advertising to adolescents. The day of the Marlboro man and Joe Camel are long gone. There are other ways the Tobacco industries target audiences that require further implementations, but we'll address that another day.
If we are to effectively reduce these health disparities that plague our societies day in and day out, then theory-based health prevention programs require our attention.