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REMARKS BY: DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES PLACE: The American Public Health Association Annual Conference San Diego, California DATE: October 31, 1995
April 13, 1993 was just like any other day.
That morning, the children at 49th Street School in South Central, Los Angeles woke up, grabbed their bags, waved good-bye to their parents, and made their way to school. Twenty minutes before the school bell rang, you could feel the promise of youth and hear the laughter of children in the air.
All except for one small boy.
Ten year-old Jorge stood at the school entrance crying. He reached into his backpack, slowly pulled out the gun he had taken from his parents' bedroom, placed the gun against his temple and fired.
One bullet was all it took. With one shot, Jorge ended his short life and sent shock waves of grief and confusion throughout his community -- as parents, students, and teachers tried to explain the inexplicable.
"Why?" they asked. "Why would a ten year-old boy have a gun? And why in the world would he take his own life?"
Tragically, such questions have become far too common.
Every day in this country, about fifteen children die in gun-related accidents, suicides, and homicides. And the problems that children and teenagers are facing go far beyond violence. Every day, approximately 25 young people are infected with HIV, more than 1,000 young people give birth out-of-wedlock, more than 3,000 young people start smoking, and more than 1.2 million young people have at least five alcoholic drinks.
And then there's the resurgence of marijuana among 12 to 17 year olds -- the monthly usage rate has nearly doubled since 1992.
Make no mistake, if we don't act fast, we could lose an entire generation of young people.
That was the key message of the major report, "Great Transitions: Preparing Adolescents for a New Century," released
by the Carnegie Corporation of New York two weeks ago. The report finds that at least one-half of our teenagers are at risk for dangerous behaviors that could seriously diminish their lives. We're talking about millions and millions of young people.
Maybe they'll light up that first cigarette, and start a slow-burning fire in their lungs. Maybe they'll learn the hard way that you don't handle drugs -- drugs handle you. Maybe they'll make a rash decision -- every parent's nightmare -- like driving while drunk or getting in a fight when they should have walked away.
These aren't somebody else's children, and this isn't somebody else's worry. This is a major public health issue -- an American problem that touches the lives of each and every family -- regardless of race, religion, region, and economic background.
But don't take my word that something must be done. Let's hear it first-hand, from young people themselves:
A 16 year-old girl says: "I'd like to be a model. Smoking burns off a lot of calories."
A college sophomore says: "I'm not even a heavy drinker, except every time I drink, I get drunk."
A high school freshman says, "I like violence. I like seeing violence. I just really like watching violence" -- especially video games.
And then there's a 16 year-old boy dealing drugs in New York City. He says, "My father would always say 'Stay in school. Don't drop out. Don't drink or do drugs.' But he never did anything about it himself, so what's the use?"
What's the use?
In the mouths of our teens, those may be the three saddest words in the English language.
What's they use?
They speak of emptiness in what should be a time of exploration. They speak of resignation in what should be a period of wonder. They speak of a hopelessness that makes people numb to all they are and can be.
Why do young Americans who are for many years on the right track end up veering off course and diminishing their lives?
Lots of reasons.
Part of it is poverty and the lack of opportunity -- primary indicators of a child's future health and future life chances in this country. As Marian Wright Edelman likes to say, "opportunity is the best contraceptive."
Part of it is the dangerous messages some parts of our culture send to the young, messages like:
"Smoking is glamorous."
"Marijuana is cool."
"Everybody's having sex."
"A gun gets you respect."
Part of it is that we who are public health leaders have to do a better job educating and inspiring each new generation to live healthy lives: We can never give up.
But critically important is something else:
I have a teenage advisory group -- 17 young people from all walks of life who meet with me about once a month. Whether we're talking about preventing drug use or depression, smoking or sex, they consistently say the same thing: They say that parents are by far the most influential people in their lives. They say that parents and families can do the most to save them. And -- despite the aura of independence that teenagers project so well -- they say that most young people need and want the everyday love, attention, involvement, and, yes, discipline of their parents.
There's a beautiful passage about parenting and communication in a new book called The Air Down Here, written by a 16 year-old young man in the Bronx named Gil Alicea. Gil writes: "My dad doesn't keep secrets from me 'cause he loves me too much. He doesn't keep secrets from me 'cause he doesn't want me to keep secrets from him .... Even if it's something bad, he just wants me to tell the truth ...."
We all know that Gil and my teenage advisors are right -- the family is the core institution in this country -- and yet somehow we have evolved into a society in which a gauntlet of factors keep mothers and fathers from raising their children the way they would like.
Parents are working longer hours with less job security. They have less time to spend with their children. They're finding it harder to pay today's grocery bills while saving for tomorrow's college bills.
There are more families in which both parents are working. There are more single-parent families. There are more parents who walk away from the children they created. There are fewer families that feel connected to strong, supportive communities. And there is more competition for their children's attention.
So there you have it: It has become harder and harder for parents to raise their children -- at the precise moment when children need their parents -- and other caring adults -- more than ever.
No wonder so many parents are terrified.
One mother in suburban Virginia put it best when she said, "I went from wanting my son to win the Nobel Prize to wanting him to survive."
As a society, we have to lock arms to help that mother and all parents, and that means -- first and foremost -- we have to stop those self-proclaimed revolutionaries on Capitol Hill from implementing a budget that would burn holes in our public health system and harm every single family in America.
Consider their radical plans to slash Medicare and hammer Medicaid -- changes that would eliminate coverage for as many as 4.4 million children nationwide in 2002.
How does that help families?
Consider their radical plans to slam the door on 1 million women and 74,000 newborns per year who depend on Healthy Start infant mortality prevention services.
How does that help families?
Consider their radical plans to roll back the Earned Income Tax Credit -- which means that the working families of 23 million children will have their taxes raised by an average of $415 in 2002.
Tax increases for people who play by the rules .... How does that help families?
Consider the radical House plan to say that no teenager under 18 will ever again receive welfare if they have a child.
How does that help families?
Consider their radical plans to gut education, drug prevention, and summer jobs for teenagers -- all commonsense efforts to prevent the galaxy of risky behaviors that leave parents lying awake at night.
How does that help families?
These radicals care more about protecting uzis than school lunches.
They care more about tearing down speed limit signs than putting up decent housing.
They care more about lavish tax breaks for the few than health security for all.
They think summer jobs are pork and tobacco is a vegetable.
They think environmental justice means an equal opportunity to pollute.
They're giving up on children, teenagers, and parents exactly when they need us the most.
That reminds me of the old saying that the only difference between genius and stupidity is that genius has its limits.
The President has laid down his marker.
He has promised to send their budget right back where it came from with a big fat veto -- unless they come back with a plan to balance the budget the right way -- by protecting families, protecting our health system, and protecting the principle of the "common good" that has held our country together for 219 years.
We do need change .... We do need more flexibility to integrate our health and social service programs.
I'd like you to think with me about a new public health strategy -- a new youth development strategy -- a comprehensive, collaborative approach that I call, "Safe Passages."
Safe Passages means working in partnership with all the different adults and institutions in young people's lives -- to help them steer their precious young people through the sometimes rocky waters of adolescence.
This is not the old top-down, heavy-handed, overly programmatic approach to solving problems.
Instead, we need to define our role more clearly -- to serve as the glue that holds together our various partners and fills gaps that would become gaping holes without state-federal- community partnerships.
So what does Safe Passages mean specifically?
It means increasing our capacity to support major research on all aspects of adolescent health and development -- everything from the needs of vulnerable populations to how much unsupervised time kids have and what they do with it.
It means moving away from the old "model program" approach to federal grants -- where we tell communities what they need. Instead, we're using federal, state and private resources to catalyze community coalitions to develop comprehensive plans for youth development -- plans that understand that teenage drug use, violence, sexual activity, and other problems are related to one another, and to overarching social problems like poverty and racism.
It means sponsoring major new national health campaigns in areas like AIDS prevention and the nutrition food labels -- to empower children and teenagers and their parents with critical information needed to choose healthy lives.
It means getting into teenage communication networks.
You know, I come from a Washington world in which people honestly believe that the only way to communicate with the American public is through brochures and posters.
But you all know that the brochure approach to public health communications is a relic from a bygone era. Most teenagers don't spend five minutes per year reading brochures.
What they do is absorb popular culture by the ton.
They rent videos. They play interactive video games. They log on to the Internet. They watch TV -- no, they interact with TV -- channel surfing through cable stations at the speed of sound; shouting back at the television; tuning into talk shows in which the audience is as important as the guests; and continuously incorporating popular culture into their own speech and their own thinking.
I do believe that groups like the Ad Council and the Partnership for a Drug Free America do get it: Their public service announcements always seem to keep up with where kids are -- but that's just one piece of what's needed. We need to bring public health communications into the 21st century -- and into our teenagers' heads and hearts.
And the first step is to candidly admit that we health experts can't do this alone and certainly shouldn't try.
That's why, as a part of Safe Passages, we're teaming up with leaders throughout the media and entertainment industries -- from daytime talk show hosts to TV scriptwriters to the editors of all the popular magazines.
As public health leaders, we need to challenge and cajole and ultimately help the media industries to use their enormous access into American homes to promote real dialogue between parents and teenagers, and to get rid of the mixed messages that cause so much confusion to families around the kitchen table.
This is the future of public health communications in this country: getting on board the information superhighway to transport our young people to safe passage.
Perhaps the administration effort that most clearly reflects our Safe Passages strategy is the children's tobacco initiative, which is ultimately about giving power back to parents.
As we were developing our proposal, some people said we can't afford to incur the wrath of a Goliath-like power like the tobacco industry.
We said, we can't afford not to.
There are more than 400,000 tobacco-related deaths per year in this country -- and the vast majority of those people began smoking regularly in their teens -- or younger.
The tobacco culture has essentially functioned as a "third parent" for American children -- enticing them with attractive images; playing upon their desire to be glamorous; alluring them with T-shirts and trinkets; and giving them easy ways to obtain cigarettes from vending machines, the mail, and even free give-aways.
There's not a parent in this country who wants their children to endure the suffocating death grip of emphysema or lung cancer.
That's why we have proposed both to limit the access and the appeal of tobacco products to children under age 18 with what are -- I believe -- some of the boldest public health proposals this country has ever seen.
Some might say, "Can't parents take care of their children?"
The answer is, of course they can.
That's precisely the point of our proposal -- to make sure that parents -- not the tobacco culture -- are in control when it comes to educating children about an addiction that could take years off their lives. That's why we must all stand with parents and say, "Yes, we will help you protect your child. Yes, we will put your interests before the special interests" -- and not just with tobacco.
We are a safer country because of the Brady Handgun Law and the assault weapons ban. We are a healthier country because we didn't let the extreme right abolish family planning services under Title X. And we will be a wiser country when parents are able to take advantage of the new V-chip technology -- which this administration strongly supports -- to control the level of violence that their children are exposed to on TV.
Time and time again, this administration has taken on the tough issues and the powerful special interests because that's what good for parents and their children.
That's the right role for the federal government, the national government, the people's government -- in partnership with states, counties, cities, communities, schools, universities, and parents.
The fact is, government alone can't solve the galaxy of health problems our children face.
The real passports to safe passage must come from people who share the everyday worlds of our children and teenagers --primarily parents -- but also other caring adults: grandparents, older siblings, teachers, coaches, counselors, clergy, caregivers, employers, media figures, community leaders, and, of course, young people themselves.
And we all must testify.
We all must preach a pro-youth message from our own personal bully pulpits:
A message that inspires our communities to create the presence of opportunity for young people -- strong schools, meaningful jobs, safe streets, and real opportunities to serve.
... And a message that shows young people how much we value them and want to hear their views.
No audience is too small. No pulpit is too close to the ground. And no voice can ever be too soft to save a life.
As healers and educators and public health leaders, you have a special role to play.
You see the human face of public health tragedies like AIDS, violence and substance abuse. You know the complexity of teenage life. You know the importance of prevention. You know the value of comprehensive, community-based solutions. And you know that the imperative of reaching kids early -- gaining their trust -- giving them our ears -- getting our arms around them -- and never letting go.
We need your leadership as part of a national crusade on behalf of our youth -- one that goes community by community, block by block, home by home -- making sure that children and teens become hooked on hope and too strong for wrong.
And why should we make this crusade?
It is the simple fact that -- anywhere you look in this country -- west of the Mississippi or east, south of the Mason-Dixon line or north -- what you find is an enormous reservoir of great young people ... national treasures, not an alien nation, and they're doing great things.
I'm talking about 15 Girl Scouts in Greensboro, North Carolina who raised $40,000 last year and used it to build a house for Habitat for Humanity.
I'm talking about a Louisiana group called Teens for Life that is canvassing the state to provide AIDS prevention and counseling to their peers.
I'm talking about some New York City teenagers -- volunteers in the President's AmeriCorps program -- who produce their own documentaries on topics like pollution, discrimination, and domestic violence.
And I'm talking about millions of young Americans who show quiet courage and commitment every day of their lives:
Doing their homework in the library after a gruelling soccer practice; going right from an 8-hour school day to violin practice or a part-time job; helping out their parents by looking after younger sisters and brothers; and, above all, living their lives with passion and intensity and enormous energy.
They are our national future -- our national present -- and the reason we must put our heart and souls in motion to assure safe passages for all. Thank you.