REMARKS BY: | Steven Galson, Acting Surgeon General |
PLACE: | Portland, OR |
DATE: | Wednesday, April 09, 2008 |
"Medical Reserve Corps: Improving Public Health Through Public Service"
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 at "Medical Reserve Corps Training and Leadership Conference"
April 9, 2008
Portland, OR
"Medical Reserve Corps: Improving Public Health Through Public Service"
Thank you, Patrick (RADM Patrick O’Carroll) for that gracious introduction.
I am thrilled to have the opportunity to open up this MRC conference today and to spend this time with members of the Medical Reserve Corps.
H-H-S Secretary Michael Leavitt and Assistant Secretary of Health Dr. Joxel Garcia join me in extending their best wishes to you.
For historical reference, I wanted to put up this photograph of the first MRC Team. I know you thought the MRCs were just a few years old, but styles change very fast in this century!
Seriously, this is a photo of the Yellow Fever Control Team back from the era where tropical diseases were a scourge of public health in the US. These officers are to remind us of the roots of the MRC and the roots of the Commissioned Corps of the Public Health Service and the proud tradition that you are now part of.
In preparing for this conference I looked over the report that outlines MRC activities over the last month. It is truly impressive!
From responding to flooding in TEXAS, to helping with drinking water contamination in COLORADO, to assisting with a hepatitis screening and vaccination campaign in NEW YORK you are active and engaged around the country.
That’s why your conference theme - “Prepared Volunteers, Resilient Communities, Strong Nation” - describes you so well.
The men and women of the MRC are strengthening communities and improving our public health infrastructure - all over the USA every day.
I am happy to be here with you!
In just one month’s report I see your dedication…your commitment…your selflessness…your service…
In a short period of time, M-R-C units have become integral players in the conduct of local public health activities.
MRC leaders have a unique position within their communities. By providing health education and promoting health related activities, you have helped to improve the lives of countless people.
We’ve come a long way in the last few years in this country in strengthening our emergency preparedness and public health infrastructure…from
... the health fairs, diabetes detection and flu vaccination clinics… …To
… Tuberculosis or blood pressure screenings, & blood drives…
When duty and service call - YOU have answered that call:
… From service that MRCs provided after the Minneapolis bridge collapse to help provided to flood victims in Oklahoma.
I share your accomplishments in speeches I give across the country because I am so proud that you’re part of the Office the Surgeon General.
You are A KEY part of my public health ARMY.
For all you have done, all you have given, and for the service you will continue to provide to fellow citizens in need of help, I thank you and I am pleased to continue to support you.
Before I go forward in this talk, I want to discuss the focus and mission of 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.
My first priority is Disease Prevention. Right now, we spend the vast proportion of our health care dollars in this country treating preventable diseases.
Prevention is the cornerstone of what we do in my office. Our emphasis on prevention is premised on the understanding that we need to change the way we think about health care in America.
I am talking about the need, over time, for cultural change.
H-H-S Secretary Leavitt and the leadership of the Department have been talking about …
…about the critical need for change in American health care…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.”
Today, providers cannot offer the best care they are capable of and consumers do not have the ability to consider value when they make their health care purchasing decisions.
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.
I know many of you embrace this vision of systemic change… from a treatment-oriented and value driven framework of care - where too little time, money and effort are invented tin preventing disease - to a prevention-centered society.
Chronic disease prevention should be our # 1 priority in health care.
Seven of 10 Americans who die each year die of a preventable chronic disease such as heart disease, diabetes and many forms of cancer.
The medical care costs of people with chronic diseases account for more than 75 percent of the nation’s $1.4 trillion medical care costs.
Yet, a modest increase what we invest to prevent chronic diseases will save lives and in some cases save precious health dollars.
Yet, much work remains if we are to move from a treatment-based system of health care delivery to one which emphasis preventive medicine.
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.
Of course, emergency preparedness has increasingly become a major part of our mission to protect, promote, and advance the health and safety of the nation.
As many of you know, 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 each and every day to respond to all-hazards emergencies.
The Commissioned Corps and you - members of M-R-C units - are vital to the achievement of this mission.
Preparedness must also involve planning by every level of society, including every family.
One important area that we continue to work on is pandemic flu preparedness. For pandemic flu, we have preparedness checklists you can use on our website.
Yet our need to prepare doesn’t stop there.
That is why the President has requested $507 million in his fiscal year 2009 budget to achieve the goals of his pandemic flu preparedness plan and another $313 million for ongoing pandemic flu preparedness efforts across H-H-S.
“Bird Flu” and “pandemic flu” may have slipped from the headlines but the threat remains real.
Our work to prepare the country for a possible flu pandemic is just as focused today as it was when the President released the National Pandemic Plan more than two years ago.
There’s a role for everyone and that’s why we created a program called Pandemic Flu: Take the Lead.
The purpose of this program - now being tested in 9 communities - is to help community leaders learn more about pandemic flu and how they can help citizens take a few steps now to prepare.
We’ve created resources and tools for community leaders such as faith leaders, doctors and nurses, and business leaders to help them raise awareness of pandemic planning within their community.
This is underscored by the Pandemic and All Hazards Preparedness Act and its all-hazards approach to public health readiness.
And of course, the law confers formal statute to your work through its authorization of the Medical Reserve Corps.
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.
For instance:
- 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, cancer is the number one killer.
- Hispanics were 1.5 times as likely as non-Hispanic Whites to die from diabetes; Hispanic men and women have higher incidence and mortality rates for stomach and liver cancer than non-Hispanics.
And these are just a few examples. Unfortunately, these statistics go on and on.
It is imperative that this change, and we need to work collaboratively to improve health care access.
And 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.
We need to steadily improve the ability of an individual to access, understand, and use information and services to make appropriate health decisions.
We cannot make improvements in health care and prevention if our messages aren’t being understood because of language and education barriers.
Basic health literacy is fundamental to the success of each interaction between health care professionals and patients - every prescription, every treatment, and every recovery.
It is fundamental to putting sound medical guidance into practice.
The ability to understand and put advice into action is fundamental to your ability to effectively serve communities and patients.
Think, for example, how important it is that young people understand food labels….
Consider 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…
The long term consequences of such health literacy could be profound.
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.
Reducing the prevalence of childhood overweight and obesity is among the foremost health challenges of our time.
This is a challenge that cuts across state boundaries, geographic areas, age groups and socio- economic status.
One way that you can bring attention to this issue is to ensure that accurate, useful, easy-to-understand information reaches your community.
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 CTA remain; some would save they are even MORE pressing today.
We know that 12.5 million children and adolescents - 17.1 percent of people ages 2 to 19 years - are overweight.
And, as they grow older, overweight children and adolescents are more likely to have risk factors associated with cardiovascular disease such as high blood pressure, high cholesterol, and Type 2 diabetes.
This is a slide of ….
Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*Body Mass Index ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Healthy Youth for a Healthy Future
These dramatic changes are why I am visiting communities across the country to share this information and encourage adoption of best practices to address this alarming crisis.
This is one part of an initiative called “Healthy Youth for a Healthy Future”
During this “Healthy Youth” tour, I will recognize and bring attention to communities with effective prevention programs that motivate organizations and families to work together to on THREE overriding themes:
- 1) Help Kids Stay Active
- 2) Encourage Healthy Eating Habits
- 3) Promote Healthy Choices
It seems easy to say and much more difficult to do.
However, anyone can help: whether a physician, nurse, medical reservist, or active in another public health capacity, we each have a role.
And it is vitally important that each of you do what you can, as M-R-C members.
You are positioned and able to encourage good nutrition, exercise, maintaining healthy weight, regular health screening and discourage tobacco use.
Our efforts to reduce overweight among our Nation’s children are critical.
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 which is half the time recommended for youth.
Oregon offers an illustration of what we are facing:
- Some 24.5 percent of Oregon 8th graders were overweight or at risk of becoming overweight in 2005 (Oregon Overweight, Obesity, Physical Activity and Nutrition Facts, January 2007)
- The number of Oregon 11th graders who played video games more than 2 hours a day increased 76 percent during a 4 year period ending in 2005 (Oregon Overweight, Obesity, Physical Activity and Nutrition Facts, January 2007).
THOSE numbers are going the wrong way, OREGON.
Later today, I am going to honor one of most exciting bicycle partnerships - the Bicycle Transportation Alliance - that’s working to fight this trend by making this part of the country more bicycle friendly
Another way to fight this trend is National Turn Off the TV week, which starts April 21.
I’m saying that kids should spend less time inside with the remote and more time outside moving around…getting exercise.
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.
Our “Healthy Youth for a Healthy Future” initiative seeks to change children’s eating and activity habits.
The initiative concentrates on those who influence our children, including parents, providers of health care like you, schools, the food industry and local community leaders.
Everyone has a role - every person and every organization.
It is critical that we identify and share information about approaches that work.
Our success in addressing overweight and obesity will depend on our ability to communicate and collaborate effectively.
For that reason, we must actively recruit parents, families, community organizations, teachers and mentors of kids if we are going to make real progress against the national overweight epidemic.
Our approach must be multi-faceted: clinical, educational, and ultimately transformational.
One example is a new national fitness challenge initiated by the President’s Council on Physical Fitness and Sport; I am so pleased that M-R-Cs involved in it.
This “National President’s Challenge” is a 6 week physical activity challenge to get America moving - 30 minutes a day, five days a week. Of course, the “Healthier M-R-C” group is a valuable part of that.
Already, there are amazing reports being submitted on the activities of your units. Walks and hikes have been held already and more are planned.
I look forward to a full report on the activities you’ve completed and the success you reach as the entire MRC network.
Value of Partnerships
As useful as the Challenge may be, the federal government cannot be alone in the fight against overweight and obesity.
This week is “National Public Health Week” and today, April 7 has been designated “Eat Differently Day.”
So, it is especially appropriate that I am here to talk about the epidemic of childhood overweight and obesity…and discussing the role that daily physical activity and nutritious eating must play if we are to be successful in addressing it.
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.
Local communities are doing likewise.
For instance:
The Austin, Texas School District offers another ‘front’ the fight against childhood overweight. The 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.
During my recent visit to last week to North Carolina, I learned more about one such program which enables kids to have fun and stay healthy at the same time.
The “Be Active HOPS” initiative trains, evaluates, educates and entertains students of all ages while delivering critical health awareness information they need to live healthy, active lives.
Similarly, the state of West Virginia has declared certain of its counties DRY - and it’s not what you think; these are counties throughout the state who have removed high calorie beverages from school vending machines.
There is also the ‘Big Fat Industries and Kidz Bite Back,’ a public awareness campaign in Pinellas County, Florida. Participants learn about food marketing practices and good health science; they are also taught techniques to increase their physical activity and healthy nutrition choices.
A good way to get messages to kids - of course NOT during National Turn Off the TV week, is through television messages; At H-H-S we worked with the Ad Council and the Hollywood people to produce this example of how to do send messages this way:
(Public Service Announcement is shown here).
We can all get on board with this message, I know.
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.
In April of 2007, the Robert Wood Johnson Foundation 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, 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.
…It starts with the promotion of healthy lifestyle activities in local settings…like the community in which you live and which your M-R-C unit serves.
…It is enhanced when an interested partner formally becomes a “WE CAN” community or participant organization, like more than 600 others in the United States. WE CAN is an NIH/NHLBI program to motivate people on the local level to ‘get up and move.’
H-H-S, for our part, is working on a number of fronts to do the same.
Later this year H-H-S will issue an 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 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.
Underage Drinking
There is another issue which you can help me with - and that is to elevate in the public mind the severe problem we have in this country with underage drinking.
A new report,Quantity and Frequency of Alcohol Use among Underage Drinkers, released by the federal Substance Abuse and Mental Health Services Administration (SAMHSA), underscores that underage drinking continues to be a serious public health problem.
According to the report, combined 2005 and 2006 data indicate that an annual average of 28.3 percent of persons aged 12 to 20 in the United States (an estimated 10.8 million annually) drank alcohol in the past month.
Underage youth who drank in the past month used alcohol an average of nearly 6 days monthly and consumed an average of nearly 5 alcoholic drinks on the days they drank.
We also know that alcohol is the most widely used and abused substance among our Nation’s youth: a higher percentage of young people between the ages of 12 and 20 use alcohol than tobacco or illicit drugs.
Nationally, approximately 5,000 young people under the age of 21 die every year as a result of underage drinking; this includes about 1,900 deaths from motor vehicle crashes,
Findings like these are one reason we released the "Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking" last year.
They illustrate that underage drinking is hardly an innocent right of passage: rather, underage drinking is a dangerous activity.
The data I just shared are the reason that communities across the country are hosting town hall meetings…to share accurate information about the risks of underage drinking.
The good news, again, is that you can help.
You are a familiar face where you live and work.
M-R-C units are respected. Your work reaches across communities.
Our message can - and should -- be yours too.
Your message… that underage drinking is risky business…a practice that injures and kills…can reach just as far.
For more information about the underage drinking campaign, you can go to www.stopalcoholabuse.gov
The capacity of Medical Reserve Corps units to engage countless fellow citizens in the fights against childhood overweight and underage drinking is yet another reason you are such a tremendous resource.
M-R-Cs bring added value to everything that we do.
You offer a model of public service to our Nation.
The Medical Reserve Corps: Today and Tomorrow
…And I truly expect the contributions that M-R-Cs make to better public health will increase in value and number….,. for many years to come.
Already, the growth of M-R-Cs since inception is impressive.
- M-R-C started in 2002 with 42 units, adding 124 in 2003
- Growth spiked over the next few years, reaching record high numbers of unit applications for registration during and following the 2005 hurricane response and recovery in the Gulf Coast.
- Today, M-R-Cs number 730 units with more than 150,000 volunteers.
Your annual conference has seen similar growth in attendance, types and formats of sessions, length of the conference, and the results show in the reports we receive throughout the year.
There is no doubt that your story is one of success.
Closing and Vision
You - all of you in this room - have repeatedly proven your individual and collective value through many types of public health activities - all over this country
Keep up the GREAT work.
I commend you…
And I salute you.
Our Nation is better stronger and better because of your work.
Thank you.
- END -
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Last revised: March 23, 2009
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