"Childhood Overweight: A National Challenge"

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 National Association of Community Health Centers (NACHC) Annual Meeting

March 14, 2008
Washington, DC

"Childhood Overweight: A National Challenge"

Good morning.

Thank you, Gary (Dr. Gary Wiltz, M.D. Secretary, NACHC Board of Directors) for that gracious introduction.

It is my pleasure to be here with you.

My boss, Department of Health and Human Services (H-H-S) Secretary Michael Leavitt, and I extend our greetings and best wishes.

I am always pleased to spend time with fellow health professionals - and I am especially grateful to be here with you at this annual meeting.

I don’t have to twist your arms to have you appreciate that prevention should be our number #1 priority in healthcare - and you recognize how much work we have left in moving from a treatment-based system of care to one which emphasizes preventive medicine.

I wanted to talk to you today about my role and quickly run through my Priorities as the Acting Surgeon General …

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

… and how Community Health Centers fit in.

First, my Priorities

As Acting Surgeon General, I serve as our nation’s chief “health educator” - responsible for giving Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury.

My top priorities are:

First, Disease Prevention - You know that we spend the vast proportion of our health care dollars in this country treating preventable diseases. Yet, a modest increase in investment in preventing these diseases will save lives and precious health dollars.

My next priority is Public Health Preparedness - we must be prepared to meet and overcome challenges to our health and safety, whether caused by nature or humans.

One important area that we continue to work on - even as the media buzz has died down - is pandemic flu preparedness.

Preparedness must involve planning by every level of society, including every family.

For pandemic flu, we have preparedness checklists on our website. These include checklists for individuals, families, schools, businesses, hospitals, long term care and child care providers, and community organizations.

I encourage you to check them out on the web, and check them off your to-do list.

My next priority is Eliminating Health Disparities - and this is an area your organization has embraced; many of you work with the Health Disparities Collaborative.

While, overall, our nation's health has improved, not all populations have benefited equally and too many Americans in minority groups still suffer from illnesses and poor health outcomes at a disproportionate rate.

This is the bread and butter of the work YOU do, so I know you’re on board with this goal.

You know that:

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

You know that cancer is the second leading cause of death for most racial and ethnic minorities in the United States. For Asians and Pacific Islanders, it is the number one killer.

And you know that diabetes affects more than 20 million people above the age of 20 in the United States. An estimated 15.1 percent of American Indians and Alaska Natives have diabetes.

And these are just a few examples.

The statistics, unfortunately, go on and on.

It is imperative that things change, - and I appreciate the important role which Community Health Centers play in attacking this problem.

I know that:

… Health Centers treated over 15 million patients in 2006

… About two-thirds of these patients are minorities.

… Four in 10 are without health insurance.

You are on the cutting edge of this issue and I want to congratulate you for your efforts

The last priority I want to share with you is Improving Health Literacy, another one that I know you actively support.

We need to steadily improve the ability of an individual to access, understand, and use information and services to make appropriate health decisions.

We won’t make improvements in health care and prevention without our messages being understood through language and education barriers that exist in this country.

All of us, everyone here - any public health professional - can be an ambassador for health literacy.

The Critical Role of Community Health Centers

As we address these priorities, Community Health Centers are making a difference, all over this country.

You provide services where there otherwise wouldn’t be any.

For 40 years, you have offered preventive and primary health care to medically underserved residents in inner cities and isolated rural areas.

Your clients include many who could be unknown and invisible, thus perhaps unreachable, if not for the services you deliver.

Low income populations, the uninsured, persons with limited English proficiency, migrant and seasonal farm workers, the homeless, and residents of public housing deserve quality health care and you’re getting it to them.

You are strengthening the nation's health care safety net for those with no where to turn.

The recent Health Center Initiative to significantly increased access to primary health care services in 1,200 communities through new or expanded health center sites.

You got to that goal.

Between 2001 and 2006, the number of patients treated at health centers increased by over 4.7 million, representing a nearly 50 percent increase in just five years.

Congratulations.

In 2006 the number of patients served at those centers topped the 15 million mark for the first time.

This success in, led to another Presidential initiative, first announced in 2005, to extend the benefits of health centers to the poorest counties of the country.

And the High Poverty Counties Initiative is well on its way to success.

These grants will help an estimated 300,000 residents in these areas gain access to health center services.

Again, I commend you.

The Challenge of Overweight

My major reason for being here is to discuss a public health challenge that cuts across state boundaries, geographic areas, age groups and socio-economic status.

Childhood overweight is among the foremost health challenges or our time.

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

The CTA strongly urged all sectors of society to take action to prevent and decrease overweight and obesity.

The challenges which prompted issuance of the Call to Action still exist; some would save they are even MORE pressing now - 7 years later.

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.

I am visiting communities across the country to encourage discussions and implementation of best practices to address this alarming crisis.

I will recognize and bring attention to communities with effective prevention programs that motivate community organizations and families to work together to:

• Help kids be more active
• Encourage healthy eating habits in young people, and
• promote availability and selection of healthy choices.

I know it seems easy to say and much more difficult to do.

Our society has become more and more inactive and is seeing a rise in obesity rates.

Chronic diseases linked to obesity have become a catastrophe.

Chronic diseases cause 7 out of 10 deaths every year - and the costs are staggering.

Food is abundant, portion sizes have increased, and society has become increasingly sedentary.

Our efforts to reduce overweight among our Nation’s children are critical.

Childhood overweight prevalence has nearly 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.

Imagine…, the population of New York City is 8.6 million people.

And physical activity rates among our youth are also declining: 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

Our host city offers an illustration of what we are facing:

The District of Columbia has the 40th highest rate of adult obesity at 22.2 percent and the highest rate of overweight youths (ages 10-17) at 22.8 percent in the nation, according to a 2007 report by Trust for America’s Health (TFAH).

Healthy Kids for a Healthy Future

Because the factors contributing to overweight and obesity are complex, reversing the epidemic will take concerted action, by 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.

Our “Healthy Youth for a Healthy Future” initiative - seeks to change children’s eating and activity habits.

The initiative concentrates on many of the people who influence our children including parents, caregivers, schools, public health leaders, the food industry and local community leaders.

We want to spread the word about creative ideas - and the communities that support them.

The primary focus of “Healthy Youth for a Healthy Future” will be programs and campaigns through which local communities address the problem of overweight and obesity.

Again, this is where you can be of great help.

Health Centers are a recognized, trusted community resource.

On a day-to-day basis, health centers are helping to address overweight/obesity; promote healthy eating and physical activity; provide necessary health screenings; and provide public education pertaining to major health issues affecting your communities.

Not only do health centers you already provide important preventive health services…

…you also address the problem of childhood overweight in creative, but concrete, ways.

Take the Let’s Get Movin’ Program in East Boston Neighborhood Health Center, for example.

Young people served by the Health Center there are increasing their physical activity levels

…They’re also getting in shape - losing weight, and learning how to eat Better

Let’s Get Movin’ is centered on exercise, nutritional education, and medical monitoring. It includes after-school and summer programs, as well as educational seminars for adults who want to learn more about supporting their children’s healthier lifestyle.

It’s multilingual, integrated with other activities at East Boston Health Center in and includes transportation.

My hat’s off to the Let’s Get Movin’ program and I hope to see more like it around the country

Efforts like this one are why I consider Community Health Centers invaluable assets as we create a healthier Nation.

On the national level, The President’s Council on Physical Fitness 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 “National President’s 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 through April 3.

We’re going to be announcing this new President’s Challenge at the National Press Club next week - with, hold on to your seats - football great Eli Manning.

As exciting as this may be, I know that the federal government should not be alone, and cannot be effective alone in this fight.

As I’m traveling around the country, I’m collecting examples of locally-initiated programs that work.

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

One great example is the American Beverage Association who has worked with educational administrators in public schools to establish guidelines that limit those beverages available in public schools vending machines during the school day.

Local communities are doing likewise.

For example, the Austin, Texas School District has prohibited the sale or distribution of "Foods of Minimal Nutritional Value," during the school day, at all grade levels.

These items include carbonated beverages, and very sweet products like hard candy and candy-coated popcorn.

These types of foods cannot be sold or distributed to students during the school day.

Another good example is the National Football League, Ad Council and H-H-S collaboration 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, but anyone can get on board and join our effort.

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

But the most important point here is that the process starts in communities like your own.

…It starts with the promotion of healthy lifestyle activities conducted in local settings.

…One way to jump start this locally is to become a WE CAN community or organization, like 555 others in the US “This is a NIH/NHLBI program to motivate people on the local level.

Participation can take the form, for example, of

creating a walking path…,

or constructing an all-weather track for runners…

…Or sustained, community-wide promotion of healthy eating habits….

We in H-H-S are also helping on the physical activity 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.

I have met with the committee working on these guidelines, and they’re really interested in making the key link between activity and overall health.

Their work will be enormously helpful.

Closing

We will not achieve results against childhood overweight and obesity overnight.

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 community-based stakeholders that can make a difference.

I look forward to working with Community Health centers everywhere on our fight against overweight and obesity and my other priorities.

The end result of this work will NEED to be a population of physically active Americans centered on prevention, routinely conscious of diet and nutrition whose healthy choices add years and quality to their daily lives.

This outcome is one which can best be achieved through day-to-day efforts, collaborations all across this country - between all levels of government, parents, teachers and kids themselves.

You can find more info on www.surgeongeneral.gov

We can all be responsible for achieving the changes necessary to prevent childhood overweight and obesity.

We can all be agents of the needed cultural change.

Let us step up together to make a difference.

Thank you.

###

Last revised: September 04, 2008