Levels of Risk, Levels of Intervention

What Are Risk and Protective Factors?

Prevention practitioners have long targeted risk and protective factors as the “influences” of behavioral health problems. The 2009 report Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities defines risk and protective factors as follows:

• Risk factor: a characteristic at the biological, psychological, family, community, or cultural level that precedes and is associated with a higher likelihood of problem outcomes
• Protective factor: a characteristic associated with a lower likelihood of problem outcomes or that reduces the negative impact of a risk factor on problem outcomes

Some risk factors are causal: cigarette smoking, for instance, has been closely linked to lung cancer. Others act as proxies (e.g., living in an area with a high prevalence of cigarette smoking) or markers of an underlying problem (e.g., having a smoker’s cough). 

Some risk and protective factors, such as gender and ethnicity, are fixed: they don’t change over time. For instance, at a population level being a boy is a risk factor for substance abuse because boys develop substance abuse problems more quickly than girls. Other risk and protective factors are considered variable: these can change over time. Variable risk factors include income level, peer group, and employment status.

Many factors influence an individual’s likelihood to develop a substance abuse or related behavioral health problem. Effective prevention focuses on reducing those risk factors, and strengthening those protective factors, that are most closely related to the problem being addressed.

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