Changing Systems to Address Health Issues Such As Child Overweight

REMARKS BY:	Steven Galson, Acting Surgeon General
PLACE:	Kansas City, Missouri
DATE:	Friday, September 5, 2008

Remarks As Prepared, Not a Transcript

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

Address to Kansas City University of Medicine and Biosciences

September 5, 2008
Kansas City, Missouri

Good afternoon.

Thank you, Karen (Karen L. Pletz, J.D., KCUMB President and Chief Executive Officer) for that gracious introduction.

It is my pleasure to be with you today.

Michael Seward, the University’s Director of Grant Development, and Vice President of the KCUMB Health Policy Institute, was instrumental in the efforts to bring me to this event.

I thank you for having me.

I know that Michael has been tireless in his efforts to establish a broad coalition of organizations and people to address the health, educational, and safety needs of the Northeast Kansas City community.

I know too that Michael’s leadership is emblematic of the university itself.

This institution is surely a “good citizen” and regional leader. Because of the university’s vision and willingness to become involved in a broad range of community issues, yours is a better city – one with a bright future.

And I also thank also RADM John Babb, H-H-S Region VII Health Administrator for all that your office does.

John’s diligent efforts are the reason that tour of Region VII has been so beneficial to me.

When thinking about my remarks for today, I reflected upon the fact that, while the basic missions of H-H-S and KCUMB differ - my organization delivers health services broadly and nationally, yours provides academic, medical, and scientific instruction and training - we actually share a focus.

Both organizations seek to foster communities in which individuals and families live longer, healthier and more productive lives

We are both advocates for a better quality of life for people whose names we will never know.

And we have one pressing challenge in common with each other and with multiple cities, states and communities.

That cause is reducing and preventing childhood obesity.

Before I address the subject of child overweight at greater length, I want to first familiarize you with the broader vision we at H-H-S have for the future of American health care.

H-H-S Secretary Leavitt and the H-H-S leadership have been talking about the critical need for change in American health care and how important it is that we have a system which is value driven.

As the Secretary says, “...consumers know more about the quality of their television than about the quality of their health care.”

At H-H-S, we are committed to bring about a future in which consumers:

...can compare doctors, not just on what they charge, but also in the quality of the care they give, and

...approach health care the way they would any other major purchase.

We foresee a future in which:

... Personalized health care - service delivery carefully tailored to meet an individual’s needs - is the norm.

... Every American is insured – every citizen, without exception, has access to basic health insurance at an affordable price.

This leads me to discuss the priorities that we have in the Office of the Surgeon General

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. Right now, we spend the vast proportion of our health care dollars in this country treating preventable diseases.

Seven out of 10 Americans die each year of preventable chronic illnesses such as heart disease, diabetes and cancer.

The medical care costs of people with chronic diseases account for as much as $1.4 trillion of the nation’s medical care costs.

A modest increase in the time, emphasis and resources we invest to prevent chronic diseases will save lives and potentially reduce healthcare costs.

I know you recognize how important is that we change the way we think about health care in this country – that “we change systems to improve health.”

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

And make prevention a real and routine part of every interaction between health professionals and their patients.

[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.

Emergency preparedness has increasingly become a major part of the H-H-S mission to protect, promote, and advance the health and safety of the nation.

In fact, my office 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.

Medical Reserve Corps

My office 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 activities such as screening/vaccination events and other health promotion activities.

M-R-C units are strengthening the public health infrastructure and improving emergency preparedness.

There are 13 MRC units in Missouri alone. The Kansas City MRC serves Missouri and Kansas counties.

There are those in the audience today who may be interested in joining with us in our public health mission. Anyone who is interested can visit www.usphs.gov and learn how to become one of America’s health responders.

[Slide 4: Health Disparities]

Another priority of mine 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.

[Slide 5: Health Disparities Graph]

Some illustrations:

African Americans are 50 percent more likely than non-Hispanic whites to have high blood pressure.
African Americans babies are twice as likely to die within the first year of life;
And Hispanics have higher rates of obesity than non-Hispanic Caucasians.
1 in 2 Hispanic women born in 2000 will develop diabetes in their lifetime

Data like these are unacceptable. It is essential that things change.

[Slide 6: Health Literacy]

Meanwhile, 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.

In 2003, an estimated 77 million American adults, about 36 percent of the population, were reported to be at or below basic health literacy levels (Source: National Center for Education Statistics, Institute for Education Sciences).

Basic health literacy is fundamental to the success of each interaction between health care professionals and patients - every prescription, every treatment, and every recovery.

When a patient does not understand that certain factors increase his or her risk for a disease...that is a problem.

When a student does not understand the reality of alcohol poisoning...that is a problem.

We cannot make improvements in health care and prevention if our messages aren’t being understood.

What a difference it makes when a young person is able to identify Nutrition Facts on a food container and use them to better manage their diet...

I use the food label as an example because food label literacy is related to our ability to eat right.

Unfortunately in the United States, we don’t necessary eat RIGHT, we eat A LOT, contributing to our current epidemic of childhood overweight and obesity.

Overweight and Obesity

The epidemic cuts across state boundaries, geographic areas, age groups and socio- economic status.

I’d like to pause and show you an entertaining but serious video clip illustrating what has happened in American society.

[Slide 7: LAZY BONES CLIP]

The clip focuses on bone health, but you all know the health risks of obesity go way beyond the bones.

There has been a startling trend in adult obesity rates in our country just in the past decade.

[Slide 8: 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 9: 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, 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. The data are telling.