"Collaborating to Reduce Childhood Overweight"

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 to the American Beverage Association
Fly-In Participants and Board of Directors

April 30, 2008
Washington, DC

"Collaborating to Reduce Childhood Overweight"

Good morning. Thank you, Larry (President and CEO, Cadbury Schweppes Beverages, Philadelphia, PA) for that gracious introduction.

I’m pleased to be here.

Welcome to all American Beverage Association board members in the audience as well as everyone here today as part of the ABA “fly-in.”

My bosses, Department of Health and Human Services Secretary Michael Leavitt, and Assistant Secretary for Health Dr. Joxel Garcia, also extend their greetings and best wishes.

I find it particularly gratifying to address organizations like the ABA, an organization whose mission is fundamentally different than that of H-H-S, but one who is mobilizing its members to act voluntarily to improve public health.

I am confident that our organizational relationship is one which will continue to develop.

Your decision to issue School Beverage Guidelines in 2006 was positive step.

Since then, ABA staff advised me that the amount of “beverage calories shipped” to schools has been substantially reduced.

The manner in which association members - ABA- affiliated producers, bottlers, retailers and others -re adopting healthier beverage guidelines in turn means student consumers are making better choices,

This is an excellent illustration of “sending the right message” where needed.

By doing so, the ABA has become an agent of change.

You’ve made the decision to bring organizational resources to bear to combat childhood overweight and obesity.

In that way, you have joined H-H-S in the necessary and ongoing effort to shift the culture in American medicine and public health.

I applaud you for this.

Healthier beverage guidelines are but one small step of the many which will be required in order to change the way we think about public health and the delivery of care.

I am talking about systemic change.

We must move from a treatment-oriented society - where too little time, money and effort are invested in preventing disease - to a prevention-centered society.

Chronic disease prevention should be our number 1 priority in health care.

This objective is reflected in the priorities we have in the Office of the Surgeon General.

Before I move forward, I want to first talk to you about these priorities.

I want discuss the strides we’re making at the community level and elsewhere in the prevention of overweight and obesity in children and teens.

And… ways the beverage industry can continue to help.

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.

[Slide 2: Disease Prevention]

My first priority is Disease Prevention. As I said earlier, 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.

[Slide 3: Public Health Preparedness]

My next priority is Public Health Preparedness — we must be prepared to meet and overcome challenges to our health and safety, whether natural or man-made.

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 to respond to all-hazards emergencies.

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

[Slide 4: Pandemic Flu checklist]

One important area that we continue to work on, even as the media has died down, is pandemic flu preparedness. We do everything we can, every day, to be ready.

To help communities and families prepare, we have preparedness checklists on our website.

These include checklists for individuals, families, schools, businesses, hospitals, and community organizations.

[Slide 5: Health Disparities]

My next priority is the Elimination of Health Disparities. 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 at a disproportionate rate.

A couple of illustrations:

• African Americans are 1.5 times as likely as non-Hispanic whites to have high blood pressure.
• Cancer is the second leading cause of death for most racial and ethnic minorities in the United States.
• For Asians and Pacific Islanders, cancer is the number one killer.
• And Hispanics have higher rates of obesity than non-Hispanic Caucasians.

It is imperative that things change, and we need to work collaboratively to make change happen.

[Slide 6: Health Literacy]

And woven through all of these priorities is an issue we call Health Literacy.

It is the currency for success in everything that we are doing in the Office of the Surgeon General.

We cannot make improvements in health care and prevention if our messages aren’t being understood because of language and educational barriers.

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

Unfortunately, our low health literacy is a major problem:

Every day, health care providers witness the health literacy gap…the chasm of knowledge between what professionals know and what patients understand.

We have to make sure that good health information is getting into the hands of the people who need it.

Each one of us - anybody from health professionals to retail bottlers to moms and dads - can be an ambassador for health literacy.

Overweight and Obesity

One pressing public health challenge cuts across state boundaries, geographic areas, age groups and socio- economic status. There has been a startling trend in adult obesity rates in our country just in the past decade.

[Slide 7: Obesity Maps Slide]

This slide depicts the startling trend in adult obesity rates in our country in the past decade. This is national survey data of the percent of the population of each state with a BMI greater or equal to 30, or about 30 lbs overweight for a 5’4” person.

[Slide 8: Call to Action Slide]

Back in 2001, the Office of the Surgeon General released a “Call To Action to Prevent Overweight and Obesity.”

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

The factors which brought about the C-T-A remain; some would say they are even MORE pressing today.

That is why, as the Surgeon General of the US, I am committed to making the prevention of childhood overweight and obesity my top priority.

Childhood overweight and obesity is among the foremost health challenges of our time because children are the future of our nation.

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.

Moreover, overweight adolescents have a 70 percent chance of becoming overweight or obese adults.

[Slide 9: HYHF Tour Map Slide]

That’s why I am visiting communities across the country to encourage discussions and implementation of best practices to address this alarming crisis as part of an initiative called “Healthy Youth for a Healthy Future”

During this “Healthy Youth” tour, I will recognize and bring attention to communities with effective prevention programs that motivate organizations and families to work together to promote the goals of this initiative which are to:

[Slide 10: Healthy Quadrants Slides]

• encourage kids to stay active,
• eat nutritiously
• make healthy choices

To those ends, communities are coming together to address childhood overweight and obesity prevention. They are developing programs and sharing ideas.

As you can see from this slide, to date, I have visited the highlighted states and I look forward to visiting several more over the course of the next few months.

At each stop, I’ve learned about effective local childhood overweight and obesity programs; I’ve shared information about these programs at each subsequent stop on the tour.

Each stop includes discussion with public health professionals, community leaders, and other partners who are active in the fight against obesity.

We want to motivate and mobilize parents, kids and others who influence our children - mentors, caregivers, schools, public health leaders, and local community leaders

It seems easy to say and more difficult to do.

However, we each have a role — every person and every organization can help.

The American Beverage Association knows and understands this.

To the A-B-A board and membership:

You are doing the right thing.

You took the initiative with your voluntary school beverage guidelines.

Your members are complying with those guidelines in increasing numbers.

You are “capping calories” in the drinks you market.

You are engaged in nutrition education.

You are acting systematically and with purpose to curtail the availability of sugary beverages in school vending machines that are accessible to young people.

Of course, while various challenges remain -

We need to make sure that students actually diminish their overall calorie intake and don’t just replace one source of excess calories (sugared soft drinks) with another one.

• as an association, the ABA is doing the right thing. Please keep it up.

I intend to encourage other sectors - like the food, dairy entertainment industries, for instance - to consider the value of issuing their own content standards.

They too can be pro-active on behalf of kids’ health. Other industries can also call on their membership to do what they can to improve public health and promote the health and fitness of young people.

Make no mistake: improving children’s health, and changing their habits, is more critical than ever.

We know that 12.5 million children and adolescents - 17 percent of people ages 2 to 19 years - are overweight.

As overweight children and adolescents grow older, they are more likely to have risk factors associated with cardiovascular disease such as high blood pressure, high cholesterol, and Type 2 diabetes.

Just as importantly, 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 which is half the time recommended for youth.

This must change.

Parents need to encourage young people to spend less time in front of computer and television screens and more time getting up and moving around.

Others businesses recognize the implications of childhood overweight and have joined the ABA in taking action.

A 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.

[Slide 11: NFL Video Clip]

[Slide 12: NFL Slide]

Another is the Robert Wood Johnson Foundation: in April, 2007, RWJF pledged $500 million over the next five years to combat childhood obesity in the US - the largest commitment by any foundation to this issue.

Few organizations have the visibility, resources or stature of the RWJF or the National Football League, but anyone can get on board and join our effort.

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

Our approach must be multi-faceted: clinical, educational, and ultimately transformational.

However, the process starts in communities — the cities and towns you call home.

[Slide 13: We Can! Slide]

It is enhanced when an interested partner formally becomes a “WE CAN” community or participant organization, like more than 600 others in the United States. WE CAN is an NIH/NHLBI program to motivate people on the local level to ‘become and remain physically active.

It continues by setting the bar as the ABA has done…by offering healthy food and beverage choices in school vending machines as Austin, TX, certain West Virginia counties and others are doing

It is enhanced by North Carolina’s “Be Active Hops” program and others like it…which show kids how much fun physical activity can be..

By taking a look at what each of us can do in our lives and communities - whether a parent, neighbor, or business person - to make ourselves and our families healthier we can begin to tackle this epidemic.

H-H-S, for our part, is working on a number of fronts to do the same.

[Slide 14: President’s Challenge Slide]

The President’s Council on Physical Fitness and Sports is encouraging kids, adults, and organizations to log on to join the President’s Challenge at www.presidentschallenge.gov

Later this year H-H-S will issue 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 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.

[Slide 15: Closing Family Slide]

It is important to keep in mind that we will not achieve results against childhood overweight and obesity overnight.

But we won’t make any progress at all unless all of you redouble your commitment to do what you can as an industry, and as good citizens, make prevention and child health priorities now and for the foreseeable future.

In closing: we are in this together and we need one another. Government needs the help of businesses, industries, and associations, organizations like to ABA, in order to sustain the progress we make in combating overweight and obesity.

And 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.

Together, let us resolve to make it happen.

Thank you.

- END -

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Last revised: September 04, 2008