"Preventive Medicine and Improved Public Health"

Remarks as prepared; not a transcript.

RADM Steven K. Galson, M.D., MPH
Acting Surgeon General
U.S. Department of Health and Human Services

Remarks at the American College of Preventive Medicine Annual Meeting

Thursday, February 21, 2008
Austin, Texas

"Preventive Medicine and Improved Public Health"

Good Afternoon.

Thank you, Mike [Michael Parkinson, M.D.,M.P.H., President of the American College of Preventive Medicine] for that gracious introduction.

And thank you to Mike Barry and the Drs. Tilson for getting this opportunity set up.

It is an honor to be here.

You play a key role in training physicians in this country.

And since you’re “my” medical specialty organization, I’m particularly pleased to be able to be here and share this time with you.

Yesterday I met with your Board of Regents; you’ve got great and motivated leadership in place and I look forward to working with them and the membership.

I also want to acknowledge all the efforts of the Association for Prevention Teaching and Research, even though their awards lunch is competing with me today!

I wanted to talk to you today about:

First, My role and priorities as the Acting Surgeon General;

Then, about a serious public health problem in our society that I am focusing on - prevention of childhood overweight and obesity.

As most of you know, the Surgeon General serves as our nation’s chief “health educator” - responsible for giving Americans the best scientific information available on how to improve their health.

Some would say that speaking at events such as this one, with so many public health professionals who share such a similar outlook as the Public Health Service in the audience, is like preaching to the choir.

I’ve been a member of this choir, unofficially or officially since I started my work in public health in 1986

Not to stretch the choir metaphor too much, but every choral group needs both good leadership and good music to sing - and having both AMA President Ron Davis and me here at your annual meeting shows that ACPM sees itself where it should - … at a critical juncture between the practice of medicine and the practice of prevention and public health , the juncture between serving the larger public good while also taking care of patients…

So let me take out my conductor’s baton now….

I don’t have to tell you that prevention should be our number #1 priority in healthcare—and you also know that we have a lot of work left to do …

To move prevention more towards the mainstream in medicine

To move prevention higher in our national medical investment list

To move prevention more into every interaction between a public health professional and a patient

To recognize that prevention extends out of the medical setting into the design of our cities, our buildings and schools,

Since President Bush has declared February “American Heart Month,” and Congress just endorsed this - an example of cooperation between these two branches of government,

… and I was lucky to attend an event a few weeks ago with numerous women wearing red dresses for National Wear Red Day.

The theme of your 2008 conference - “Cardiac Health” - is both appropriate and timely.

Heart disease is the leading cause of death in the United States.

Cardiovascular diseases, many of which are PREVENTABLE, cost the nation more than $300 billion each year.

The vast proportion of our health care system is focused on treatment of preventable conditions - so as ASG, like all of you here, my focus is on PREVENTION.

A second priority for me is

Eliminating Health Disparities - too many Americans still suffer from illnesses at a disproportionate rate. Socio-economic, racial and ethnic disparities in health are simply unacceptable.

While, overall, our nation's health has improved, not all populations have benefited equally.

African Americans are 1.5 times as likely as non-Hispanic whites to have high blood pressure

African Americans are 29 percent more likely to die from heart disease than non-Hispanic whites.

And the statistics, unfortunately, go on and on.

I am also focused on Public Health Preparedness - We advocate an all-hazards approach to preparing America to meet and overcome challenges to our health and safety, whether wrought by humans, an emerging illnesses or a natural disaster.

And no, Public Health Preparedness does not mean duct tape, it means being ready, at home and at your workplace - having a disaster plan and being ready to implement it..

Over the past few years, emergency preparedness has become a major part of our mission to protect, promote, and advance the health and safety of the nation.

The Office of the Surgeon General oversees the 6,000-member Commissioned Corps of the United States Public Health Service.

These officers are available to respond rapidly to urgent public health challenges and emergencies, and are becoming more highly trained each and every day to respond to all-hazards emergencies.

There are those in the audience today with sons and daughters, family and friends who may be interested in joining with us in our public health mission. We’ve got a career session here at this meeting tomorrow at 3PM. Admiral Sam Shekar from the Corps will be there to talk to anyone who is interested.

You can also visit our website www.usphs.gov and learn how to become one of America’s Health Responders.

Medical Reserve Corps

The Office of the Surgeon General also oversees the Medical Reserve Corps - a national system of community-based teams of medical and public health volunteers.

We have organized health professionals who want to donate their time and expertise to prepare for and respond to emergencies,

They also support good health in communities through sponsorship of diabetes and HTN screening/vaccination events and other promotion activities. M-R-C units are strengthening the public health infrastructure and improving emergency preparedness.

And make no mistake about it: Prevention professionals are an important part of this volunteer network.

Just here in Texas, there are 9669 volunteers representing 32 MRC units; these units have taken on many roles and missions.

For example, during a recent Texas radiologic emergency exercise , one MRC unit, working with Houston CC and UT SPH worked together to try out radiologic mass screening techniques that would be employed if a local health care became overloaded. This kind of teamwork pays off in real emergency situations.

I urge you to consider joining your colleagues in this critical part of America’s impressive volunteer force.

Another priority of my office is Health Literacy.

Low Health literacy is seriously jeopardizing our progress in all of the three priority areas I just mentioned.

Health literacy is the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions.

We know that people with low health literacy are:

• Less likely to know how to navigate the health care system,
• less likely to understand basic health information,
• less likely to get preventive health care services,
• more likely to use expensive emergency care services, and
• more likely to be hospitalized more often for longer periods of time.

Prevention professionals play an important role in improving out nation’s health literacy.

As preventive medicine specialists, you understand the importance of being able to translate complicated health information into easy to understand information that is communicated clearly, accurately and effectively

The concept of health literacy includes helping the American public understand the messages they are hearing in the media about health and medical products

For example, we know that fad diets and dietary supplements don’t work to help people maintain sustained weight loss, yet these products continue to be purchased with billions of dollars that could be better spent on prevention measures that work.

Health literacy includes you helping the public understand what does and doesn’t’ work in prevention among the cacophony of misinformation out there.

Overweight and Obesity

One area where our DEFICITS in health literacy are just part of a national public health catastrophe is the epidemic of overweight and obesity facing this country.

As you may know, back in 2001, the Office of the Surgeon General released a “Call To Action to Prevent Overweight and Obesity.”

The challenges which prompted this Call to Action still exist; some would save they are even MORE pressing now—7 years later.

Weight trends among America’s children are very disheartening.

Childhood overweight prevalence has more than tripled for children ages 6 to 11 years since 1980. Today, approximately nine million children over the age of 6 are considered overweight in this country.

To put this number into perspective, the entire population for New York City is 8.6 million people.

In addition to the social burden on our kids, overweight children are at far greater risk for numerous health consequences, including cardiovascular disease, type 2 diabetes and other chronic diseases.

Some of you are aware of the disturbing physical activity rates among our youth: just a quarter of high school students are moderately physically active for 30 minutes a day, 5 days a week-half the time needed for youth, according to the federal Dietary Guidelines.

Because the factors contributing to overweight and obesity are complex, reversing the epidemic will take concerted action, by public health professionals and prevention specialists like you, parents, educators, and youth - indeed by all sectors of society.

That's why I am especially eager to move forward now in leading the Surgeon General's coordinating council to prevent childhood obesity.

For its part, the H-H-S childhood obesity initiative will focus on programs that let communities address the problem of overweight and obesity on their own terms in their own ways.

For example:

• The Head Start people will oversee a competition for a $12 million, four-year grant fund the construction or improvement of Head Start playgrounds.
• Centers for Disease Control and Prevention’s and NIH are developing community-based tools and programs to address obesity
• The Indian Health Service and our Office of Minority Health are is working on culturally appropriate diabetes and obesity prevention activities among racial/ethnic minorities
• Food and Drug Administration’s is emphasizing the food label as a source of good nutrition information - right on our supermarket shelves.
• The President’s Council on Physical Fitness and Sports is initiating a new National Fitness Challenge. The Council was going strong when I was in grade school and it’s going strong today. This new Fitness Challenge is a 6 week physical activity challenge to get America moving - 30 minutes a day, five days a week. It’s designed to help people live healthier by finding activities they really like to do.
• YOU can sign up on the web from March 1 - April 3.

You and I know that the government cannot be effective alone.

The food, sports, beverage and entertainment industries must step up to the plate and do their part.

One example is the American Beverage Association.

Another great example is the National Football League, Ad Council and H-H-S effort to produce a Public Service Announcement designed to motivate young people to get the recommended 60 minutes of daily exercise into practice.

Few organizations have the visibility, resources or cultural stature of the National Football League, so I’m glad they’re on board.

Commitments like this - and I expect to see more of them - CAN make a difference.

We’re helping on the physical activity in DHHS front by issuing later this year inaugural Physical Activity Guidelines for Americans.

The guidelines will provide a consistent message for the American public about physical activity, one which will be flexible enough for use by children as well as other specific population groups.

The guidelines will send the messages that wellness is a hard-won habit, physical activity is important, and the adoption of a healthy lifestyle begins with simple, but important steps.

Closing and Charge

We will not achieve results against the obesity epidemic overnight. As prevention experts we know that.

But we won’t make any progress at all unless all of you commit with me to make this a prevention priority for all of the healing professions.

I look forward to working with you on our fight against overweight and obesity and my other priorities.

Although not all in uniform, you - each of you - are my prevention army.

I want to close this luncheon address by thanking you for your continuing work, and for your commitment to improving the health of all Americans.

Through your efforts and our own, together we can create a healthier America.

Thank you very much.

I would like next to hear from you. I’m pleased to take your questions. Thank you again.

- END -

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Last revised: September 04, 2008