"Childhood Overweight: It’s the Business of Business"

Remarks as prepared; not a transcript.

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

Keynote Address to National Business Group on Health

May 13, 2008
Washington, DC

"Childhood Overweight: It’s the Business of Business"

Good morning. Thank you, Helen (Helen Darling, President of NBGH) for that gracious introduction.

I’m pleased to be here at the 5^th annual Leadership Summit hosted by the NBGH’s “Institute on the Costs and Health Effects of Obesity.”

These events provide excellent opportunity for dialogue and information sharing, which are crucial in combating overweight and obesity in America.

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 appreciate the opportunity to address you today — our corporate leaders.

Moreover, the N-B-G-H membership understands that good public health makes for healthy business - and you’ve wisely “made it your business” to promote both.

And while the mission of most American businesses may seem fundamentally different from ours at H-H-S, public health and private enterprise actually have much in common.

Whether one is an executive who makes decisions which affect the balance sheet of a Fortune 500 company, or

A public health professional, like me, whose interest may be to provide underserved populations routine access to health care services We both seek to preserve and improve individual and family health and safety.

We both seek to reduce risks and lower costs.

We all want to improve quality of life, individual health status, and the environments that affect health.

Our respective organizations are also in the necessary business of creating change in the way we think about and approach the delivery of health care.

At H-H-S, Secretary Leavitt and the leadership of the Department 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, the Secretary is leading an effort to bring about a future in which consumers:

…are able to find out which hospital in their area has the highest success rate for the procedure they need

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

…approach health care they way they would any other major purchase - by consulting an impartial source of information on quality and cost.

So, we are talking about a profound change; you are doing the same.

Your Summit theme - Health At Work: Changing Culture, Behavior, Environment - reflects the broad-based change that the N-B-G-H and H-H-S envision.

As an organization, NBGH has seen the wisdom and advantage of moving from a treatment-oriented society - where too little time, money and effort are invested in preventing disease - to a prevention-centered society.

For multiple reasons, effective disease prevention is good for YOUR companies.

It improves the health of employees, decreases absenteeism, increases productivity and promotes cost efficient business success.

It is just as important to MY organization’s business bottom line: creating healthier, physically active nation families and communities.

So I believe that everyone in this building - perhaps for different reasons and some more formally than others - is in the business of chronic disease prevention, creating a more fit population, and producing long-term systems change.

These overarching goals are illustrated in the priorities we have in the Office of the Surgeon General.

I want to talk to you about these priorities.

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

And I also want to identify ways that H-H-S, the N-B-G-H and others must collaborate to create lasting improvements in public health.

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]

As I just mentioned, my first priority is Disease Prevention. And while we spend the vast proportion of our health care dollars in this country treating preventable diseases - a modest increase in investment to prevent 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 must 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, hospitals, and community organizations. In addition, there is a focused checklist for businesses recognizing their important role in protecting employees’ health and safety and helping to minimize negative impacts to the economy and society in the event of a national pandemic.

[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 50 percent more likely than non-Hispanic whites to have high blood pressure.

• And Hispanics have higher rates of obesity than non-Hispanic Caucasians.

• 2 in 5 African Americans and Hispanics born in 2000 will develop diabetes in their lifetime

This is unacceptable.

It is essential that things change, that health disparities diminish, and that we - the public and private sectors in partnership -work creatively and collaboratively to achieve this outcome.

[Slide 6: Health Literacy]

And woven through all of these priorities is the important issue of Health Literacy.

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 - from CEOs to employees, from health professionals 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.

That is the startling trend in adult obesity rates in our country just in the past decade.

[Slide 7: Obesity Maps Slide]

This slide depicts the 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.

Obesity, improper nutrition, and lack of physical activity are occurring in persons under age 15 years.

The increased observation of Type 2 diabetes in children is especially alarming - because, as younger people develop the disease, the complications, morbidity, and mortality associated with diabetes are all likely to occur earlier at younger ages than is currently the case.

And, of course, as overweight children and adolescents grow older, they are more likely to have additional risk factors associated with cardiovascular disease such as high blood pressure and high cholesterol.

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

I applaud the N-B-G-H and your Obesity Institute for having such keen awareness of these obesity data and their implications, and for your work in responding to them.

Your organization was among the first to articulate the challenge that child overweight and obesity represents to the business community.

Obesity and its related health conditions hurt the health and well being of the current workforce. And the increased prevalence of overweight among children and adolescents suggests an even greater problem awaits large employers in the workforce of the future.

We don’t have to look very far to find a vivid illustration of the overweight and obesity challenge.

The District of Columbia ranks last in overweight and obesity prevalence among young people 10 to 17 years of age. In other words, prevalence rates in all 50 states were reported to be lower than those in DC (2003 National Survey of Children’s Health)

Another study, the 2005 Youth Risk Behavior Survey, found that among DC high school students, some 32 percent were overweight or at risk of becoming overweight. 82 percent did not meet recommended levels of physical activity.

However, the District of Columbia is hardly alone.

[Slide 9: HYHF Tour Map Slide]

Data like these are why I am visiting communities across the country to encourage discussions and implementation of best practices to address this alarming crisis. This is part of an initiative called “Healthy Youth for a Healthy Future.”

The initiative involves multiple agencies in H-H-S (shown here) - and is focused on bringing attention to communities with effective prevention programs.

These are programs successful in motivating organizations and families to work together to promote the goals of this initiative which are to:

[Slide 10: Healthy Quadrants Slides]

• Help Kids Stay Active
• Encourage Healthy Eating Habits
• Promote Healthy Choices

To those ends, communities are gathering and exchanging information, 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 visit includes discussion with public health professionals, community leaders, and others active in the fight against obesity.

My visits include consultation with private sector and corporate leaders — like the 52 businesses to whom the N-B-G-H will present “Healthy Lifestyles Awards” during this Summit.

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

It seems easy to say and more difficult to do.

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

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.

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.

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.

Not every business will become an N-G-B-H “Healthy Lifestyles Award” winner.

But anyone can get on board and join our effort.

For instance, the food, sports, beverage and entertainment industries must each 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 beverages available in public school vending machines during the school day.

Commitments like those I have just described CAN make a difference.

I expect to see more commitments — from all sectors of society.

For the stakes are high in the fight against childhood overweight and obesity.

As a matter of individual and community well being;

For the sake of the futures of America’s young people;

As a matter of public health, national productivity and economic sustainability, the outcome of the fight against child overweight is critical.

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

Progress against child overweight starts in the cities where you do business.

The support and involvement of respected employers — from Fortune 500 companies to fledgling businesses — is especially critical if we are to make meaningful progress.

And small businesses must follow the N-B-G-H lead.

The 2004 National Worksite Survey results revealed that only 6.9 percent of worksites reported meeting the definition of a comprehensive worksite health promotion program.

We see a distinct pattern: companies with fewer employees offer fewer health promotion programs, offer fewer screening services, and have fewer health-supportive work environments.

Given that small businesses represent 99.7 percent of all US employers and employ 50 percent of the private sector workforce, important opportunities are missed to improve the public’s health because we are not promoting health among employees of small business as well as we should.

Again: consider the added value of prevention.

As more corporations recognize the added value of prevention…as more design and adopt comprehensive wellness strategies - employee health screening programs, vaccination opportunities and the like employee absenteeism is likely to decrease; productivity is likely to increase, and business costs likely to begin a decline.

Achieving these kinds of results, and making progress in overweight and obesity, is a part of a process which must grow, much like a successful business.

Indeed, combating obesity and promoting health is a process that gets its lifeblood from successful organizational leaders who care such as you.

[Slide 13: We Can! Slide]

It is dynamic process enhanced when a community or interested business organization becomes a “WE CAN” community or participant organization, like more than 700 others in the United States. WE CAN is an NIH program to motivate people on the local level to ‘become and remain” physically active.

The process grows with the success and expansion of initiatives like “Trim Kids,” a twelve-week plan for overweight youngsters from ages 6 to 18.

Each week, parents and kids in metropolitan New Orleans and the surrounding area practice scientifically proven ways to increase daily activity and set “achievable” eating and exercise goals.

Parents learn nutrition strategies -- including shopping lists and dining-out tips -- for busy caregivers. The “Trim Kids” program also identifies how parents can “coach” their child in well-established behavioral strategies for making healthier lifestyle choices away from home.

The change process continues by acting responsibly and setting the bar high — for instance, by offering healthy food and beverage choices in school vending machines as Austin, TX, certain West Virginia counties, the Beverage Association and others are doing.

It is enhanced by projects like the ‘Big Fat Industries and Kidz Bite Back,’ a public awareness campaign with in Pinellas County, Florida.

Participants in the campaign learn about food marketing practices and good health science; they are also taught techniques to increase their physical activity and healthy nutrition choices.

The process gains momentum through North Carolina’s “Be Active Hops” program and others like it, which show kids that physical activity is user friendly and how much fun it can be.

It builds through other promising, community driven projects to combat childhood overweight that I have observed in visits to Baltimore, MD, Wilmington, DE, Philadelphia, PA and other locales.

By taking a look at what each of us can do in our lives and communities - whether as a business CEO or good citizen - to make ourselves and our families healthier: we can begin to forcefully push back against the overweight epidemic.

H-H-S, for our part, is working on a number of fronts.

[Slide 14: President’s Challenge Slide]

The President’s Council on Physical Fitness and Sports is encouraging kids, adults, and organizations including businesses of all sizes 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 theme 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 resonating message of the guidelines will be that wellness is a hard-won habit, physical activity is important, and a healthy lifestyle begins with simple steps.

I have met with the committee working on these guidelines.

Committee members are 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 us redouble our commitment to do what we can to make prevention and child health priorities NOW.

They must remain OUR priorities for as long as it takes.

That means as long as it takes to get a handle on overweight and obesity…to reduce its prevalence.

That means as long as necessary to end the spike of associated conditions like Type 2 diabetes.

That means as long as required to diminish the prevalence of other chronic conditions that imperil kids’ future.

Closing

Before I close, I want to remind you that we are in this together and we must work in partnership to combat overweight and obesity and to make sustained progress against the epidemic.

All of us have a stake - individuals, families, businesses and communities - in improved public health. Each of us has the responsibility to be its advocate.

All of us can be ambassadors for

• health literacy;
• disease prevention;
• lowering the costs associated with health care;
• a physically active workforce; and
• employees, colleagues and friends able to enjoy sustained good health and fitness of mind, body and spirit;

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

In time, as we continue to work cooperatively, it WILL happen.

Again, I applaud all that the National Business Group on Health has done - individually and collectively - to HELP MAKE IT HAPPEN.

You joined the battle before most others.

Your vision is far-reaching.

Your work is purposeful.

Your actions - such as the creation of the obesity institute - are thoughtful and dynamic. You’ve made your organizational voice heard. You’ve influenced the debate. You’ve shaped policy.

BECAUSE OF YOU, companies, corporations and communities have chosen to bring resources to bear to fight the obesity epidemic.

For all of this, I am pleased to present the National Business Group on Health with a Champion Award.

Congratulations and thank you. I look forward to continuing to work with you in the future.

- END -

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Last revised: December 30, 2008