"Prevention of Childhood Overweight and Obesity"

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 National Childhood Obesity Congress
National Initiative for Children’s Healthcare Quality Conference (NICHQ)

March 19, 2008
Miami, Florida

"Prevention of Childhood Overweight and Obesity"

Good morning.

Thank you, Charlie (Dr. Charlie Homer, Chief Executive Officer, National Initiative for Children’s Health Quality (NICHQ) for that gracious introduction.

I want to also thank Dr. Ana Viamonte Ross, Florida’s Surgeon General, for joining us.

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

It’s a special treat to be here with you today. My activities in your state will include not only my speech here; I’ll also be visiting the Miami-Dade County and State of Florida Health Departments as well to talk about PREVENTION.

At the outset of my remarks, I want you to know how much I appreciate the opportunity to share my thoughts with you at this important conference.

Protecting and maintaining kids’ good health is what NICHQ is about …

So, talking to you is like preaching to the choir…and I like that …

I appreciate your singleness of purpose: for those of you who are practitioners, that purpose is to ensure the best possible health status in the children and adolescents you see …

… for those of you who are here on behalf of constituency or community organizations, it means improving the quality of care and quality of life enjoyed by those you represent.

In those pursuits, my sense is that NICHQ successfully combines vision -

“…to eliminate the gap between what IS and what CAN BE for all children …”

- with the recognition that collaborations are essential to timely progress in bettering children’s health.

And your compilation of resources for clinicians is a model for other public health organizations.

I salute NICHQ’s pro-activity, your ongoing advocacy, your visibility and your support of this conference and others.

I want recognize in particular the 1500 members of NICHQ’s Childhood Obesity Action Network (COAN). You demonstrate a keen awareness of the serious economic consequences of childhood overweight and obesity.

You are on the front lines of the fight against America’s obesity epidemic. Thank you.

You are on the front lines of the cultural change we must make to prevent pediatric overweight and obesity.

I know how well most of you appreciate that prevention should be our number #1 priority in healthcare.

Yet, you also recognize how much work we have left in moving from a treatment-based system of care to one which emphasizes preventive medicine.

I want to talk to you today about my role and quickly run through my priorities as the Acting Surgeon General before I get into the heart of this talk.

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 - 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.

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

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

Frankly, we must prepare as if the pandemic strikes tomorrow. This way, we do everything we can, everyday, to be ready. And, our job is never done; we can always do more.

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, and check them off your to-do list.

Eliminating Health Disparities - While, over the last few decades, 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.

That’s why eliminating health disparities is also on the top of my priority list.

You know that:

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, it is the number one killer.

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

Hispanic women were 2.2 times as likely as non-Hispanic white women to be diagnosed with cervical cancer.

And the statistics, unfortunately, go on and on.

It is imperative that things change, and we need to work collaboratively to improve health care access.

The last priority I want to share with you is Improving Health Literacy.

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.

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

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

The Challenge of Overweight

The primary reason I am here today, and the reason you are attending this particular conference session, is to discuss a pressing public health challenge that cuts across state boundaries, geographic areas, age groups and socio economic status.

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

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 the Call to Action are the same ones that led NICHQ in 2006 to designate “assessing, preventing and treating childhood obesity” a priority.

The factors which brought about the CTA, and which led NICHQ to act, still exist; some would save they are even MORE pressing today.

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.

During this “Healthy Youth for a Healthy Future” tour, I am working to identify and bring attention to communities with effective prevention programs to help motivate organizations and families to combat this problem by:

• Helping kids be more active
• Encouraging healthy eating habits in young people,
• And promoting availability and selection of healthy choices.

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

For, as you are well aware, our society has become more and more inactive and is seeing a rise in obesity rates.

Chronic diseases linked to obesity have become are a catastrophe - and its going to become worse.

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 - and pediatric and family physicians are among our ‘first responders.’

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

Florida, the host state for this conference offers an illustration of what we are facing:

Approximately 11 percent of high school students were reported overweight in 2005; (Youth Risk Behavior Survey, 2005), and

About 30 percent of high school students met currently recommended levels of physical activity in 2005; (Youth Risk Behavior Survey, 2005).

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 and organizations 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.

I am also interested in sharing information about useful products and how to access them.

And one of the best illustrations of a product tailored to improve children’s health and fitness is close to home.

I am referring to the “Implementation Guide” accessible through the NICHQ website.

As a web based resource, it is easy-to-access.

And again its focus on “sharing knowledge, successful practices and innovation…to address the obesity challenge,” closely tracks our own interest.

I find this clinician’s guide notable for its emphasis on “well care visits,” prevention counseling and the recommended “staged approach” to addressing overweight and obesity in patients.

Just as your Childhood Obesity Action Network, through the Implementation Guide and other means, is successfully reaching out to the wider community of practitioners with important information…

… So too must we must broadly recruit parents, families, community organizations, teachers, mentors and kids themselves if we are to make progress against the national overweight epidemic.

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

The approach must always be one which appeals to those who will benefit most.

One example is a new national fitness challenge initiated by the President’s Council on Physical Fitness. 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.

ANYONE HERE can sign up on the web through April 3.

We are going to be announcing this new President’s Challenge tomorrow at the National Press Club in Washington with football star Eli Manning.

As exciting as this may be, I know the federal government cannot be alone in the fight against overweight and obesity - and need not be, as the NICHQ and other partners have demonstrated.

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 and do their part.

The American Beverage Association has worked with educational administrators in public schools to establish guidelines which limit those beverages available in public schools vending machines during the school day.

Local communities are doing likewise.

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 particularly sweet products like hard candy and candy-coated popcorn.

These 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.

However, the process starts in communities across America.

… It starts with the promotion of healthy lifestyle activities in local settings…in communities like the one in which you live...

… One way to jump start this locally is to become a WE CAN community or participant organization, like 555 others in the United States. This is an NIH/NHLBI program to motivate people on the local level to ‘get up and move.’

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 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 and Charge

In closing, we will not achieve results against childhood overweight and obesity overnight.

But, we will make progress, thanks to commitments like that which NICHQ membership has made.

… We will make progress as you and others of like mind remain steadfast in your commitment to make PREVENTION the highest priority of the patients you see, the individuals to whom you provide information and guidance or the organizations you represent.

I look forward to working NICHQ 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 - among practitioners, scientists, government at every level, parents, teachers and kids themselves.

As I close - a final web address for your reference …

… One that I hope will be easy to remember. You can find more information on the Surgeon General’s website: www.surgeongeneral.gov

Thank you.

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Last revised: December 30, 2008