An opportunity to cure.

Today's environment for health and human services presents significant challenges and opportunities. Every day we see tremendous advances within health care, yet the number of those unable to access basic medical care continues to grow. We live in a country with rich and diverse agricultural resources, yet many go hungry and too many of us are obese. Many of us are living longer but too many die prematurely from causes we can prevent. Too many of our children and too many adults are abused and neglected and the gap between the rich and the poor grows ever wider.

Continuous growth in the demand for our services combined with revenue streams that do not keep pace with that demand will negatively affect the services we provide. Doing nothing is not an option and simply doing more of what we currently do will not be enough.

The fact that this is a challenging time also makes this an opportune time to play a leadership role. It gives us the opportunity to invent new and better ways to do our work. Solutions will need to come from those of us dedicated to preserving our core values and to creating innovative ways to do our work and new tactics and strategies to achieve our goals.

Certainly a renewed focus on prevention needs to be at the core of what we do in health and human services. Preventing problems before they emerge and addressing the root cause of problems need to be the foundation upon which we base our work.

This preventive role is particularly important in an era when our population is aging, our lifestyles are more sedentary, drug and alcohol abuse rates remain high, and more children and adults are obese and face the resulting long-term health problems that poor nutrition and obesity create.

Historically as a society we are more comfortable investing in solutions for problems once they occur. However, we can do better. We need to change our priorities and focus on prevention, intervention and early treatment.

Take, for example, child abuse. Most child welfare directors will tell you that more than half of all children enter our state child welfare systems because of parental substance abuse and mental health problems. Our response is often to increase the numbers of foster parents and invest greater resources in our foster care systems. Yet, when we give parents with drug and alcohol addiction the treatment they need, we prevent their children from living a life in foster homes and we help ensure their success later in life.

By developing more front-end community mental health services and ensuring that those in need have easy access to them, we can intervene and treat mental illnesses in the early stages before individuals require expensive and possibly long-term hospitalization, or before they end up in our criminal justice systems. And by doing so, we can help people with mental illness live fulfilling and successful lives.

Let us consider the problems with the growing prevalence of obesity across our nation. Because of obesity, today's generation of children may be the first in history to have a shorter expected life span than their parents. If that doesn't alarm you, it should. Our children are developing serious health problems, such as diabetes and high blood pressure, at a far earlier age than any previous generation. And we are the generation who is letting that happen.

We have an aging populace that is going to face a higher rate of obesity-related chronic illnesses. We have the younger generation facing those same illnesses at an earlier age.

The economic and the human costs of obesity are and will be substantial. The increasing need for services is going to strain our health care delivery system, possibly to the breaking point. And it is likely to overload Medicaid and Medicare beyond the point of sustainability and drain resources from other vitally needed human services.

As such, we need to look beyond approaches that treat obesity once it materializes and develop new strategies to make sure that our children eat nutritiously and are physically active.

We will also need fresh organizational structures and a new focus for some of our existing programs. Consider for example our nation's Medicaid and Food Stamp programs in the context of the epidemic of obesity and our need to prevent it. If our food stamp program is to succeed as a health and nutrition program, and our Medicaid program as a health and prevention program, then, this calls for a new strategy and a new strategic partnership between these two important programs at the federal, state and local levels. In fact, we might even envision an entirely new way for these two programs to do their work.

We can do all of these things and more, if we as a society change our priorities, focus on prevention and invest the type of resources in prevention that we currently do in treating problems after they emerge. To do so will require political will and vision. We need to step up as parents, concerned adults and community leaders, and direct the necessary resources toward prevention. It will be the best investment we can make.

Bruce Goldberg is the director of the Oregon Department of Human Services and chair of APHSA's National Council of State Human Service Administrators