REMARKS BY: | Steven Galson, Acting Surgeon General |
PLACE: | Orlando, FL |
DATE: | Tuesday, May 06, 2008 |
"Childhood Overweight and Type 2 Diabetes: Twin Concerns"
Remarks as prepared; not a transcript.
RADM Steven K. Galson, M.D., MPH
Acting Surgeon General
U.S. Department of Health and Human Services
Plenary Address to the CDC Diabetes Translation Conference
May 6, 2008
Orlando, FL
"Childhood Overweight and Type 2 Diabetes: Twin Concerns"
Good morning. Thank you, Ana (Dr. Ana Viamonte-Ross, Florida’s Surgeon General) for that gracious introduction.
I’m pleased to be here at the C-D-C’s 31st Diabetes Translation Conference.
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 particularly enjoy the opportunity to address public health colleagues and stakeholders like you who:
- all around this country - promote health and disease prevention, and
- make those concepts real in the lives of those whom we all serve.
You share in the focus and vision of my office.
The work you do in diabetes control and prevention is absolutely critical to the health and future of this country.
I see you as part of the army of public health workers who are partners in the ambitious, longer-term undertaking to dramatically shift the culture of American medicine and public health.
We are in the common business of creating change in the way we think about and approach the delivery of care.
I am talking about systemic and cultural change.
We must move from a treatment-oriented society - where too little time, money and effort are invested in preventing disease - to a prevention-centered society.
And my office as well as the C-D-C and every public health professional in this auditorium today is in the business of chronic disease prevention.
This objective is reflected in the priorities we have in the Office of the Surgeon General.
Before I move forward, I want to first 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 C-D-C and our allies within and outside H-H-S must collaborate to create and sustain 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, businesses, hospitals, and community organizations.
[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.
There are other findings that you may be familiar with:
- 2 in 5 African Americans and Hispanics born in 2000 will develop diabetes in their lifetime
- 1 in 2 Hispanic women born in 2000 will develop diabetes in their lifetime
It is imperative that things change, and we need to work collaboratively to make change happen.
[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 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.
There has been a startling trend in adult obesity rates in our country just in the past decade.
[Slide 7: 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 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.
And, of course, the increased prevalence of Type 2 diabetes in young people is closely intertwined.
We know that a diet high in fat and processed foods as well as total calories, has been associated with a greater number of overweight persons in the United States when compared to a decade ago, especially within certain racial and ethnic groups, for example, African American females.
Obesity, improper nutrition (including increased ingestion of fats and processed foods), and lack of physical activity are occurring in persons under age 15 years.
These behaviors and conditions may explain the increasing diagnosis of type 2 diabetes in teenagers. Increased television watching associated with diminished physical activity also may contribute to the emergence of type 2 diabetes in youth.
(Source: Healthy People 2010; Objectives for Improving Health)
Within the United States, the prevalence of type 2 diabetes tracks closely with rates of overweight.
They are parallel challenges.
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.
We face of future of millions of more Americans on dialysis, suffering from retinal and peripheral vascular disease — a terrible legacy of the worsening situation in this country with childhood obesity.
And, of course, 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.
The host state for this conference offers an illustration of the challenge.
I know Dr. Viamonte-Ros is keenly aware and engaged in focusing on these numbers:
Approximately 11 percent of Florida high school students were reported overweight in 2005; (Youth Risk Behavior Survey, 2005), and
About 30 percent of Florida high school students met currently recommended levels of physical activity in 2005; (Youth Risk Behavior Survey, 2005).
However, Florida is not alone. We are seeing similar trends in other states too.
[Slide 9: HYHF Tour Map Slide]
Data like these suggest 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 HHS — shown here and is focused on recognizing and bring attention to communities with effective prevention programs that motivate organizations and families to work together to promote the goals of this initiative which are to:
[Slide 10: Healthy Quadrants Slides]
- encourage kids to stay active,
- eat nutritiously
- make healthy choices
To those ends, communities are coming together to address childhood overweight and obesity prevention. They are 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 stop includes discussion with public health professionals, community leaders, and other partners who are active in the fight against obesity.
We want to motivate and mobilize parents, kids and others who influence our children - mentors, caregivers, schools, public health leaders, and local community 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, 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 and obesity is critical.
Just as clinicians and public health professionals are trained and positioned to reach out with accurate information about the added value of physical activity, nutritious eating and maintaining a healthy weight...
... So too must we 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.
Again, the process starts in communities — the cities and towns you call home.
[Slide 13: We Can! Slide]
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 ‘become and remain” physically active.
It continues by setting the bar as high…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 that Dr. Viamonte Ross may be familiar 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.
It 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.
By taking a look at what each of us can do in our lives and communities - whether a parent, neighbor, or business person - to make ourselves and our families healthier we can begin to tackle this epidemic.
H-H-S, for our part, is working on a number of fronts to do the same.
[Slide 14: President’s Challenge Slide]
The President’s Council on Physical Fitness and Sports is encouraging kids, adults, and organizations 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 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.
Committee members are interested in making the key link between activity and overall health. Their work will be enormously helpful.
I know I can count on everyone in this room to be a strong supporter of the physical activity guidelines when they are released.
[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 Type 2 diabetes.
That means as long as required to diminish the prevalence of other chronic conditions that imperil kids’ future.
In closing: we are in this together and we need one another.
Government needs the help of businesses, industries, and associations, organizations and leaders who care in order to sustain progress in combating overweight and obesity.
And 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.
Together, let us resolve to make it happen.
Thank you.
- END -
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Last revised: March 23, 2009
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