For more than two years, many of us have been working first to pass, and now to implement, health care reform. But making health care reform work in the long run will require holding down costs. And that will require engaging everyone in an effort to promote healthy lifestyles.

One example of what I’m referring to is childhood obesity, which I’ve been talking and writing about quite a bit lately.

One in four Massachusetts high school kids is overweight or at risk of becoming overweight. Those students are more at risk for heart attacks, strokes, diabetes and other serious diseases later in life. And their medical status will drive up the health care costs for them and everyone else in the health insurance risk pools. Nationally, obesity adds $90 million to medical bills every year.

Dealing with this problem will require a broad and constant effort on all of our parts. We need to support funding for physical education and after-school athletics. Schools should have nutritional standards for lunches and also for drinks and snacks sold in school vending machines, as state Senator Richard Moore has proposed.

We as health plans also have an important role by creating benefit designs that reward better choices and better outcomes. Fallon Community Health Plan, for example, has extended the traditional fitness reimbursement to include student athletic programs. We will measure the impact of these benefits over time.

Finally and perhaps most importantly, all of us as parents must model healthy behavior for our kids when it comes to exercise and nutrition. We can’t rely solely on the schools or a piece of legislation to teach our kids these important lifelong habits.

None of this will be easy. Changing behavior never is, especially when the return on effort and investment may not be realized immediately. But given our investment in health care reform — and the importance of the health of our own children — it’s worth the effort. Let’s start the debate.

Eric H. Schultz is CEO of Fallon Community Health Plan.