Opening Remarks: The Weight of the Nation

Thank you Janet Collins for the kind introduction. But more importantly, thank you for your leadership of the Centers for Disease Control and Prevention Chronic Disease Center. You’ve been a fantastic professional partner, colleague and a driving force behind this conference. Before we go a moment longer I want to give Janet Collins a round of applause for all that she has done and is doing on this critical issue.

And a conference like this does not happen without the partnership of many people and organizations….thanks to everyone here who pitched in together to make this week happen.

You wouldn’t be here today if you didn’t already appreciate the magnitude of our national health crisis related to obesity.

And if you didn’t already appreciate it, I’m sure the talks you’ve just heard from Dr Jim Marx and Dr. Tom Freiden reinforced that with the growing burden of obesity in the United States we are shortchanging our future as a productive healthy nation and we are shortchanging our capacity for global leadership.  

Sadly, in spite of the enormous strengths of our public health institutions in this country – federal, state and local, public and private, our strengths have been no match – so far – for the powerful trends and  forces fueling the public health crisis that obesity represents. 

The toll of obesity is driving up healthcare costs and crippling the fabric of our communities.  As the Acting Surgeon General I have dedicated a large proportion of my time for the last two years to raising awareness and prompting action at all levels towards preventing  overweight and obesity. 

Over the past year and a half I have traveled the nation, leaving behind the federal buildings – and politics - of Washington, to visit communities and understand, first- hand - their challenges in addressing childhood obesity.  I have visited nearly 40 states to:

• learn about opportunities and challenges,
• facilitate dialogue among state, local, and other community leaders, and
• highlight those programs that are making a real difference in children’s health.

Our Healthy Youth for a Healthy Future outreach activities mobilized communities to work together towards the common goal of helping youth get and stay healthy.

It has been truly inspiring to lead roundtable discussions with government leaders, passionate community activists, parents and leaders in the business community.

BUT MOST of all  it’s been inspiring to participate in many events with children – in schools, YMCAs, Boys and Girls clubs, city parks – events with children who are being empowered to make a difference in their own lives and be part of a solution.

During these visits I’ve done a fair amount of speaking but I’ve done a LOT of listening, and it’s an honor for me to help open this conference by sharing with you some of the common themes I’ve heard, from Alaska to Florida; from California to Maine and lots of places in between in urban, suburban and rural settings.

There are three main messages I’ve taken back to Washington from these visits

First, that Americans from all walks - community leaders, parents, corporate and religious leaders – all of them are worried that we have a severe problem with obesity in this country. We’ve been largely successful in our public health proselytizing here.  Most people I’ve met don’t need more proof that obesity is a problem. We’ve got them convinced.

Second, more on this in a minute - they want and expect national leadership – from Washington - in helping to forge solutions.

And third, that when they have the tools and opportunities to produce positive change, they’re ready and able to jump into powerful action to make that change happen.

I’d like to make a few points related to these areas.

The initial question I am frequently asked when I talk to non-experts about obesity is “How did we get this way?”

My response, in the most general sense - as you can imagine - is that there is NOT one cause and that the solution must involve all sectors of the society.

And when I’ve spoken about the cross-cutting changes needed in national health, food, transportation and education policies and practices, the question is, well, that sounds reasonable, what are you waiting for back there in Washington, why aren’t you doing that already?

When I speak about inside-the-beltway type of challenges of getting federal departments to work together – for example on farm policy that supports healthy eating, the people around the country said, “Well, you’re in Washington, fix it.”

When people spoke about the difficulty of getting reimbursement for the care kids get in obesity clinics – and I started talking about Medicaid and CMS  and complex regulation– they said the same thing, well, you’re in Washington, fix it.

And when we talked about the alarming lack of sidewalks and playgrounds in newly constructed suburbs around the country and I responded about federal policies rooted in Congressional bill language, it was the same thing, “you’re in Washington, fix it.”

The people I spoke to around the country want policy change, they want leadership that understands the holistic nature of the solutions to obesity …………and they want action.

But the strength of this country is that they are not waiting for Washington…. they’re moving along - in frequently exciting ways - to empower themselves, local and state governments, organizations and schools to implement changes NOW – changes that can make a real difference in this epidemic. 

Let me give just a few examples of these local efforts:

Some grocery chains are taking bold steps to help shoppers navigate the aisles and fill their carts with healthy choices.  Hannaford Supermarkets in New England is one of these corporate stand-outs.

Hannaford’s Guiding Stars program is a three-star system designed to simplify nutritious shopping.  Foods are labeled with one, two or three stars, corresponding to good, better and best levels of nutrition.   

Promising results were seen just after one year of implementation.   Selection of whole milk with no stars dropped, ---  while fat-free milk, three stars, increased.  Selection of breakfast cereals with stars increased three and a half times more than no-star cereals. Selection of fattier meats declined and starred chicken grew at nearly 5%. 

Hannafords is a powerful model that shows when consumers are empowered with simple, easy to understand information at the point of purchase, they make better choices – and it didn’t take the regulatory process or a lawsuit to have the company step up and do the right thing.

Another example is The Faith-based networks that exist all across this country and can also be powerful agents of change.  In Mississippi, the United Methodist Church’s Wellness Task Force launched the Amazing PACE health promotion program.  Currently there are over 500 faith leaders who are Amazing PACERs in Mississippi.  By wearing a PACE pedometer and sending the miles to the Amazing PACE database, a PACER travels along inspirational “virtual journeys” with measurable prevention goals. As a result, whole families and whole congregations are integrating healthy habits into their everyday lives. 

Corporations of all sizes are realizing prevention for their employees also makes good business sense.

IBM – through employee incentives - is helping its employees and their families live healthier lifestyles through its Wellness for Life program.  IBM has awarded more than 600,000 rebates for active participation in their preventive care, physical activity, nutrition, children’s health, and smoking cessation programs.  IBM is using technology to share resources and help employees track progress against personal wellness goals and get financially rewarded at the same time.

Also, individual schools and some school districts all across America – without a federal mandate - are reducing student access to sweetened beverages and increasing healthy choices in vending machines and cafeteria lines. 

Some schools are also combining fitness with learning.  The Nautilus Middle school in Miami – anybody here from Florida?   …….has treadmills and exercise bikes where the students watch podcasts of math lessons while they exercise.  It was an unbelievable sight to see young students lining the hallways – anxiously waiting their turn to use this fitness equipment.

In urban Birmingham, Alabama, the Jones Valley Farm works with area elementary schools to get children excited about gardening, proper nutrition, and healthy cooking.

These examples show the power of what can be done when communities, corporations, and individuals commit to better health for themselves and their families. Unfortunately these are still just examples, and not the norm.

At each visit around the country, I have made it a point to interact directly with kids and to model healthy behaviors.

And this has taught me that anyone who CAN model healthy behavior should, because we know it makes a difference to young people.

I have biked across Portland, gardened in New Hampshire, enjoyed playground time in Mississippi, and challenged youngsters to Dance-Dance revolution in several states.

Please ……….if you have any video recordings of my dance exploits, destroy them.

My travels and hundreds of conversations with people all around the country have reinforced that educating kids about healthy habits and then providing opportunities for them to follow through is a winning combination.

You’re going to hear about many examples of these opportunities this week at this meeting. How are you going to take these great examples and move them into the next level of implementation? I look forward to hearing about many action-oriented agendas coming out of this meeting.

I want to leave you today with a sense of the optimism that I hope carries through the next few days.

In my 23 yr public health career we have not had a President mention prevention as much as President Obama. The American Recovery and Reinvestment Act passed this year offers a powerful opportunity to take many of our lessons about preventive health and show that we can implement them on a larger scale. I have been proud to play a role in the design of these efforts.

And the health care reform bills being considered would move prevention smartly into the mainstream of our medical system in game changing ways.  We need to take advantage of these opportunities. They may not come around again soon.

As I finish up my tenure as Acting SG I have the strong conviction that curbing the obesity crisis and improving the health of Americans IS doable.

A healthy future based on prevention is within our grasp.

Many of you in the room are national leaders, trend setters, key implementers of the changes in this country that will be needed to reduce obesity.

As a nation we stand to make and sustain progress because of commitments from people like YOU, who came to listen, to learn and to share ideas on how to help.

I also hope each of you, full of inspiration at the end of this conference --- will make a commitment to working even more furiously toward change in the conditions that have brought this country an obesity epidemic that we simply MUST turn around ….

This conference offers tangible evidence that the health policy leadership of this country does get it, IS organized around cross cutting solutions and is – finally – talking about promoting FEDERAL policy changes that can make a difference.

I look forward to hearing about the fruits of your meeting this week.

Thank you very much.

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