Remarks as prepared; not a transcript
Vice Admiral Richard H. Carmona, M.D., M.P.H, FACS
United States Surgeon General
U.S. Department of Health and Human Services
Interagency Committee on Smoking and Health meeting
Tuesday, March 9, 2004 9 a.m.
Howard University
"Opening of meeting: Tobacco-Related Disparities Among Racial and Ethnic
Groups"
Good morning. Welcome to today's meeting of the Interagency Committee
on Smoking and Health. I want to thank Howard University for hosting us today.
The issues we're meeting to discuss are community issues, and it's great to have
our first field visit here at Howard a community that is as respected for its
scientific work as for its commitment to community involvement. This meeting will focus on Tobacco-Related Disparities Among Racial and Ethnic
Groups.
The Problem
Tobacco use remains the leading preventable cause of death and disease in the
United States and continues to pose a formidable challenge to the public health
community.
Each year more than 440,000 adults die of a smoking-attributable illness in this
country.
But this is only one part of the story, because for every person who dies, there
are 20 people suffering with at least one serious illness from smoking. In
addition, the burden of tobacco use is not evenly distributed throughout the
population.
Differences exist among specific population groups along a number of key
measures including:
- differences in the risk of starting to use tobacco;
- differences in quit rates;
- differences in the incidence of tobacco-related diseases;
- differences in morbidity and mortality from these diseases;
and
- differences in exposure to secondhand tobacco smoke.
In addition, there are important differences in the capacity and infrastructure
of organizations to address tobacco control and in people's access to prevention
and cessation resources. For example, American Indians and Alaska Natives smoke
at higher rates than any other group.
HHS Efforts Eliminating such disparities in health has been highlighted in many federal
initiatives. During my interviews with President Bush and Secretary Thompson for
this job, they impressed upon me the importance of eliminating health
disparities. Not just reducing them but eliminating them. One key HHS initiative is called
"Closing the Health Gap." It's an educational
campaign designed to help make good health a critical priority among racial and
ethnic minority populations. In the specific area of smoking cessation, last month Secretary Thompson
announced a national network of smoking cessation quit lines to provide all
smokers in the United States access to the support and latest information to
help them quit smoking. In addition, the recently published National Healthcare Disparities Report,
developed by the Agency for Healthcare Research and Quality, is the first
national comprehensive effort to measure differences in access and use of health
care services by various populations.
The report provides 7 key findings:
- Inequality in health care persists.
- Disparities come at a personal and societal price.
- Differential access may lead to disparities in quality.
- Opportunities to provide preventive care are frequently missed.
- Knowledge of why disparities exist is limited.
- Improvement is possible.
and
- Data limitations hinder targeted improvement efforts.
These findings were consistent with those published in a 2002 Institute of
Medicine report, titled "Unequal Treatment: Confronting Racial and Ethnic
Disparities in Health Care."
The IOM report concluded that to reduce racial and ethnic disparities in health
care, we must increase awareness about them among the general public, health
care providers, insurance companies, and policymakers. The report also
recommended that consistency and equity of care should be promoted through the
use of evidence-based guidelines.
On the specific issue of tobacco-related disparities, I'd like to mention two HHS publications of special interest.
The first is the 1998 Surgeon General's report on smoking, which was entitled
"Tobacco Use Among U.S. Racial/Ethnic Minority Groups." The report concluded
that cigarette smoking is a major cause of disease and death in each of the four
population groups studied in the report African American, Hispanic, American
Indians and Alaska Natives, and Asian Americans and Pacific Islanders.
Today's meeting will serve as an informal update to that report. The 1998 report
emphasized that no single factor determines the patterns of tobacco use among
racial/ethnic minority groups, but rather, multiple factors are at work.
It went on to say that we need to improve our understanding of racial and ethnic
smoking patterns and to identify strategic tobacco-control opportunities. Only
then can we be most effective in developing appropriate community-based programs
to address the factors involved.
The second publication I'd like to mention is very recent an article in the
January 30, 2004, issue of CDC's Morbidity and Mortality Weekly Report. The
article was entitled, "Prevalence of Cigarette Use Among 14 Racial/Ethnic
Populations — United States, 1999 to 2001."
Information from the HHS National Survey on Drug Use & Health from 1999, 2000,
and 2001 was used to develop this article. The Survey provided a first-ever
snapshot of national smoking prevalence data for youth and adults.
The conclusions of the article are consistent with the conclusions of the 1998
Surgeon General's Report and offer an even finer level of detail that we had 6
years ago.
Closing In closing, I want to mention that today's meeting is an opportunity for us to
better understand the magnitude of the tobacco-use burden in communities of
color by looking at scientific data and hearing from communities.
There are many partners who work on the issue of tobacco-related disparities.
- Some are represented on the distinguished panel of speakers you will be
hearing from this morning and afternoon.
- There are also committee members, representatives from organizations, and
members of the public here today.
- And others are back in their communities working to reduce the burden of
tobacco-related disparities.
I want to acknowledge all the efforts of our partners in the private and public
sectors. Addressing tobacco-related disparities is a large and complex issue.
There are many areas of discussion, and we have chosen to focus on four
populations that represent the major demographic groups in the United States.
Today's discussion is just one piece of a large puzzle and we are open to having
further discussions on this topic. Now let's begin by having each of the members
introduce themselves.
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Last revised: January 9, 2007
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