Upstream or Downstream

Staying healthy and practicing preventative care not only leads
to less aches, pains and disease, but it reduces the need for
expensive drugs, doctor visits and lost time from work or school.
In simple words, staying well, rather than getting sick, saves
money and increases happiness.
Could this same preventative approach work on a larger scale for
a whole community? Well, all of us in Sonoma County are getting the
chance to find out. We think it is a worthwhile proposition.
How do you practice preventative care for an entire
society? What aches, pains and troubles are we trying to avoid or
eliminate? If it requires tax money, how will it save on future
costs?
Our county Board of Supervisors has authorized a search by its
Human Services Department to answer these very questions. They
think they have found some fund-worthy answers and they are holding
a series of local forums to introduce “Upstream Investments.”
The basic premise is that early childhood education, infant
nutrition, anti-poverty and family support programs can reduce
later years of welfare dependency, child abuse, academic failure,
substance abuse and criminal justice system costs.
The Upstream Investments initiative is based on the age-old
wisdom that “an ounce of prevention is worth a pound of cure.” Or,
in the words spoken by West County Supervisor Efren Carrillo last
week, “this is a hand up, not a handout.”
There is no doubt that the costs of our criminal justice system,
mental health and welfare programs continue to increase just when
our local government revenues are shrinking. And, then there are
other social costs that come with higher unemployment, substance
abuse, gang membership, high school drop outs and domestic
violence.
If these are all the social “aches and pains” we want to prevent
then we must admit the basic disease we need to fight is
poverty.
Poverty breeds homelessness, hunger, anti-social behaviors, drug
abuse, low self-esteem, crime and welfare dependency. Poverty is
caused by lack of opportunity, loss of hope and denied access.
There has never been a miracle anti-poverty pill or treatment.
Like keeping your own body healthy and free of disease, a
successful set of Upstream Investments will require community-wide
commitments from local governments, partner agencies and from the
rest of us.
It would seem an easy bargain for everyone to support healthy
development of kids, broader access to education and job training
for all, and a promise of safe and secure shelters and
neighborhoods.
But if it were so easy, we wouldn’t have an expensive and
overflowing jail, thousands of homeless families and an overload of
untreated mental illness and drug abuse cases.
Knowing that it costs 6-7 times more to incarcerate a jail
inmate for a year, than we spend to send a student to school for a
year, you’d think we’d have started some upstream investing long
ago.
Instead, we are making drastic cuts to local school funding for
the third year in a row. Part of the $12 billion in cuts being
proposed in next year’s state budget will eliminate or greatly
reduce such programs as Medi-Cal coverage, child nutrition programs
and mental health services, including substance abuse
prevention.
What’s wrong with this picture? It’s always been difficult to
win support and money for social prevention programs that seek to
“cure” invisible problems before they happen. Politicians,
especially, need a crisis before they take action. It’s an easy
target to put a methamphetamine addict in jail; it takes a lot more
community commitment to support early intervention programs many
years before the addict gets hooked.
Nearly half (42 percent) of all Sonoma County households live
below the federal poverty line. That is definitely a crisis that
demands we take action. Without upstream investments, we will all
pay the higher costs downstream.
— Rollie Atkinson