Preventing Obesity and Promoting Healthy Choices in Students

Remarks as prepared; not a transcript.

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

Address to the “Healthy Leap Into Summer” Health Expo

June 3, 2008
Elizabeth, NJ

Thank you, Pablo (Elizabeth Public Schools Superintendent Pablo Munoz) for that gracious introduction.

I am honored to address your 2^nd annual Preventive Health Expo.

Department of Health and Human Services Secretary Michael Leavitt, and Assistant Secretary for Health Dr. Joxel Garcia, extend their greetings and best wishes to everyone in the audience today.

Personally, I am especially pleased to be among such a large number of high school students. I’m a dad: My three children are teenagers.  They’re not much older than most of you.

Two of my children are in college; one is still in high school.

I watched from grow; I’ve learned from them just they’ve learned from their mother and me.

My own children have helped me understand (something) about what adolescents are about, about how you think and what makes you tick.

They - and you - have exciting futures to look forward to…futures filled with promise, potential and possibility.

The healthier they and you are, the greater the chance they and you have of reaching that potential.

Superintendent Munoz: I believe the interest of Elizabeth Public Schools in improving the health of its students is commendable for many reasons.

You are spreading the word that good health results from a mix of individual choices and preventive health practices that young people can make over a period of years.

You understand the value of health education and you are showing your students how they can apply and benefit from it.

Is through events like this one today that students identify how to change behavior and adopt healthy habits that last a lifetime.

Of course, it is well established that certain key actions can prevent most chronic disease:

• Tobacco control,
• Good nutrition,
• Physical activity,
• Maintenance of a healthy weight, and
• Regular health screenings.

The workshops featured here, the important information you emphasize and share here, show that Elizabeth Public Schools “gets it.”

You are doing everything possible to create a culture of wellness.

More particularly, health expositions like this one mark Elizabeth Public Schools and your collaborating partners as:

• Farsighted players in the effort to improve public health
• Leaders in the fight to combat overweight and obesity in young people.

 Before I elaborate on that critical topic I want to talk about the H-H-S vision for American health care, and then briefly discuss the focus of the Office of the Surgeon General.

Value-Driven Health Care

[Slide 2: Value Driven Health Care]

H-H-S Secretary Michael 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.”

This leads me to discuss the priorities that we have in the Office of the Surgeon General - and where they fit within the Secretary’s vision of value-driven health care.

My Priorities

As Acting Surgeon General, I serve as our nation’s chief “health educator”- responsible for giving parents, children and families the best scientific information available on how to improve their health and reduce the risk of illness and injury.

[Slide 3: Disease Prevention]

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.

We stress prevention because we need to change the way we think about health care in America.

I’m talking about real change, so that when students in the audience today are parents of school age children, you’ll receive health care services in a different, but just as effective way.

Right now, we spend tremendous amounts of money treating illness and disease after someone gets sick.

I hope, and I believe, that the health care system in place tomorrow - when today’s students are raising your own families and paying your own bills - will be part of a prevention-centered society in which healthy lifestyles are promoted and sustained.

There are financial, social and human reasons why chronic disease prevention should be our # 1 priority.

Seven of 10 Americans 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.

A modest increase what we invest to prevent diseases will save lives dollars and heartache.

Yet, much work remains as we move toward greater emphasis on preventive medicine.

[Slide 4: 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.

Emergency preparedness has increasingly become a major part of the H-H-S mission to protect, promote, and advance the health and safety of the nation.

In fact, my office 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 emergencies.

And preparedness must involve planning by every level of society, including every student’s family.

One important area that we continue to work on is pandemic flu preparedness.

[Slide 5: Pandemic Preparedness/Checklists]

For pandemic flu, we have preparedness checklists you can use on our website.

Still our need to prepare doesn’t stop there.

“Bird Flu” and “pandemic flu” may have slipped from the headlines but the threat remains real.

For that reason, we have created and maintain resources for doctors and nurses, the faith community, educators, business people and others to help raise awareness of pandemic planning within the community.

[Slide 6: Health Disparities]

My next priority is the Elimination of Health Disparities.

Of course, we live in a nation in which there is increasing ethnic, racial and cultural diversity.

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:

• In 2004, African American men were 30 percent more likely to die from heart disease, as compared to non-Hispanic white men; African Americans are also 50 percent more likely than non-Hispanic whites to have high blood pressure.
• Hispanics are 50 percent more likely than non-Hispanic whites to die from diabetes.

And these are just a couple of examples.

This is unacceptable. It is imperative that this change.

[Slide 7: Health Literacy]

And woven through all of these priorities is an issue we call Health Literacy.

Too few Americans - adults and adolescents alike - know “how to improve their health and keep it good.”

Improving health literacy is relevant to everything that we are doing in my office.

In 2003, it was estimated that approximately 33 million adults could not, for example, read a set of short instructions and identify what is permissible to drink before a medical test.

We can do better.

We must steadily improve the ability of an every American to obtain, understand, and use information to make the right health decisions.

When a high school student - it might be any one of you in my audience - fails to understand the potentially long-term consequences of underage drinking, it is a problem.

When a student does not understand the damage done by second-hand tobacco smoke or the reality of alcohol poisoning, it is a problem.

Those are among the reasons why health literacy principles are being incorporated into more and more written and electronic health information prepared within H-H-S. 

For example, after extensive research, www.healthfinder.gov - a site with valuable health information maintained by the Office of Disease Prevention and Health Promotion - is being redesigned to reach people with limited health literacy.

Think about what a difference it makes when a young person is able to identify Nutrition Facts on a food container.

When you are able to do this, you can better manage your diet.

In turn, you are likely to feel better, appear and actually be healthier and increase your chances of remain healthy down the line.

I use the food label as an example because it relates 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 overweight and obesity.

Overweight and Obesity

Reducing the prevalence of childhood overweight and obesity is among the foremost health challenges of our time.

Childhood overweight and obesity is a challenge that cuts across geographic areas, age groups, ethnicities, and socio- economic status.

[Slide 10: 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 CTA remain; some would save they are even MORE pressing today.

We know that, nationally, 12.5 million children and adolescents - 17.1 percent of people ages 2 to 19 years - are overweight.

The same situation exists among you and your peers.

Some 11 percent of New Jersey high school students were reported overweight in 2005 (Youth Risk Behavior Survey).

At the same time, 34 percent of Indiana high school students did not meet recommended levels of physical activity (Youth Risk Behavior Survey).

And as overweight children and adolescents grow older, you are more likely to have risk factors associated with cardiovascular disease such as high blood pressure, high cholesterol, and Type 2 diabetes.

What does this mean? It means more patients on dialysis, more premature blindness and disabilities of many other types.

Unfortunately, it means today’s young people may not live as long as your parents.

The last thing I want to do is frighten or preach to you. 

My interest is:

• sharing accurate information with you about what we know, and
• having you make the right choices…decisions that will result in good health that you can maintain over time.

Healthy Youth for a Healthy Future

[Slide 11: HYHF Tour Map Slide]

These statistics on overweight and physical activity that I just described are a major reason 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 a federally supported effort that we call “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:

[Slide 12: Healthy Quadrants Slides]

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

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.

Kids - you, your siblings, and students of every age -should spend less time inside with the remote and more time outside moving around…getting exercise.  

That’s a start.

However, improving the health of students - again, I could be talking about ANY or ALL of you - will require more than simply getting up and moving around.

Obesity is complex, so reversing the epidemic will take concerted action.

Our “Healthy Youth for a Healthy Future” initiative seeks, for starters, to change the eating and activity habits of young people.

To do so, we need more health expos, more educational and instructional events like this one.

Everyone must get and stay involved if we are going to make real progress against the national overweight epidemic.

I am here to give you accurate information.  I am here to “share the evidence’ with you.  I am urging you to follow where it leads.

You will be healthier as you do.

Value of Partnerships

However, the federal government cannot be alone in the fight against overweight and obesity in young people.

The food, sports, beverage and entertainment industries must each step up to the plate and do their part.

One example of this:

The American Beverage Association has worked with public schools to establish guidelines which limit beverages available in public school vending machines during the school day.

Local communities are setting the same kind of example as you are in Elizabeth, New Jersey.

I’ve seen creative programs from Texas to North Carolina, from West Virginia to Pinellas County, Florida, Baltimore, MD and Wilmington, DE.

High school students there are acquiring information that will serve their health well for decades – just as you are doing at this health expo today.

Like you, they are learning about food marketing practices and good health science; they are also taught techniques to increase their physical activity and healthy nutrition choices.

People who care – like the sponsors of this event – are teaching students the value of:

• Eating food in moderation.
• Having at least five servings of fruits and vegetables a day,
• Choosing two or fewer hours of screen time a day,
• Getting one or more hours of physical activity a day,
• Drinking almost no sugary beverages.
• Walking up stairs instead of taking the elevator.
• Bicycling to a destination instead of driving or being driven.

The National Football League is helping too. The league and individual players are supporting our efforts to prevent obesity and encourage good health.

Stars like Eli Manning of the New York Giants are getting involved.  When he is not winning Super Bowls, Eli is active with the President’s Council on Physical Fitness and Sports.  

The President's Challenge is a program that encourages all Americans to make being active part of their everyday lives.

[Slide 14: NFL Video Clip]

[Slide 15: NFL Slide]

Few organizations have the visibility, resources or stature of the National Football League, but anyone can get on board and join our effort.

Always, the process begins in places like Elizabeth, New Jersey.

It starts with the promotion of healthy lifestyle activities as you are doing here.

Later this year H-H-S will issue inaugural Physical Activity Guidelines for Americans.

The guidelines will provide not just adolescents, but the entire American public, with the RIGHT MESSAGE.

It is that wellness is a hard-won habit, physical activity is important, and the adoption of a healthy lifestyle begins with simple steps.

Closing

In closing, remember that dramatic change is slow to take place in the best of circumstances.

[Slide 18: Closing slide with family]  

The process of making the kind of change we required may not be glamorous and is certainty difficult.

But remember, everyone here has a stake in improving public health. 

Remember: each of us can and should spread the word:

About the importance of diet and nutrition,

About the wisdom of getting daily exercise,

About practicing portion control by pushing away from table, and

Making healthy choices will add years and quality to an individual’s life.

I look forward to working with you - and with high school students and young people everywhere - to help you make healthy choices.

Those healthy choices are the RIGHT choices.  They are choices that ANYONE can make.  The PAYOFF from making those healthy choices will last YEARS.

The choices are YOURS to make.

I encourage you to make them.