Thank you for that gracious introduction. I am thrilled to be with you today

Department of Health and Human Services Secretary Michael Leavitt sends his greetings to this organization and meeting. My boss, Assistant Secretary for Health Dr. Joxel Garcia -– a former board member of the National Hispanic Medical Association - asked me to send his greetings and best wishes.

I am honored to address an organization with such a long and storied history.

Through the decades, LULAC (Lew-lac) has advanced the economic well being, influenced policy, and promoted the health of Hispanic populations across the Nation.

When thinking about my remarks for today, I reflected upon the fact that, while H-H-S and LULAC are organizations with distinct missions, we actually share a lot.

Both organizations seek to foster communities in which individuals and families live longer, healthier and more productive lives.

We are both partisans for a better quality of life for millions of people whose names we will never know.
Our respective organizations understand that we can better advance our common purposes, and improve the health of Hispanic-Americans, by working together.

Because of all that you do, we are grateful to have LULAC as a valuable partner.

Whether it’s working with low income seniors on the Medicare prescription drug benefit or working with the provider community on cultural competency standards, there are many opportunities and reasons for us to collaborate.

Before I turn to my main subject - preventing childhood overweight and obesity - I want to start by sharing the H-H-S vision for American health care.

Value-Driven Health Care

H-H-S Secretary Leavitt and I, indeed the entire leadership of the H-H-S 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.”

At H-H-S, we are committed to bring about a future in which consumers:

…can compare doctors, not just on what they charge, but also in the quality of the care they give, and
…approach health care the way they would any other major purchase.

We foresee a future in which:

… Personalized health care - service delivery carefully tailored to meet an individual’s needs - is the norm.

… Every American is insured – every citizen, without exception, has access to basic health insurance at an affordable price.

This leads me to discuss the priorities that we have in 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.

There is a need to move from a treatment-oriented society to a prevention-centered society in which healthy lifestyles are promoted and sustained.

Seven out of 10 Americans die each year of preventable chronic illnesses such as heart disease, diabetes and cancer.

The medical care costs of people with chronic diseases account for as much as $1.4 trillion of the nation’s medical care costs.

A modest increase in the time, emphasis and resources we invest to prevent chronic diseases will save lives and potentially reduce healthcare costs.

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 preparedness is multi-dimensional. It must also involve planning by every level of society, individuals, families, and communities.

Another priority is the Elimination of Health Disparities.

This is an issue, I recognize, with which you are all very familiar. We know that:

1) Hispanics are 50 percent more likely than non-Hispanic whites to die from diabetes.

2) In 2003, Hispanic women were 2.2 times more likely than non-Hispanic white women to be diagnosed with cervical cancer.

Unfortunately, these statistics go on and on.

I know that H-H-S and LULAC agree that these trends must change. We must increase access to services and improve the health status of Hispanic-Americans of every age.

Federally funded Community Health Centers present a promising solution.

In 2006, Health Centers served 15 million patients. The number of Hispanic patients seeking care at these centers has grown to 36 percent, outpacing all other racial and ethnic groups.

Health Centers provide comprehensive, culturally competent, quality primary health care services - including access to pharmacy, mental health, substance abuse, and oral health services.

Because health centers are experienced in prevention and are connected to a variety of traditional and non-traditional partners, they are a particularly important agent in our nation’s fight to prevent childhood obesity.

A good example is the Greater Lawrence Family Health Center, a federally-sponsored Community Health Center in Lawrence, Massachusetts. Lawrence is the poorest city in the State and approximately 60% of the population in Lawrence are Hispanic.

The Greater Lawrence Health Center’s Latino REACH 2010 initiative successfully developed a program designed to address health disparities in the Latino population, with a particular emphasis on diabetes and associated cardiovascular disease.

As a result of the success of REACH 2010, the Greater Lawrence Health Center received CDC funding to create the Latino Center for Excellence in Eliminating Disparities.

The Center will continue to address Latino health disparities in diseases such as diabetes, asthma, cardiovascular disease, and breast and cervical cancer.

There are a number of similar projects sponsored at other health centers.

The Community Health Center of Meriden, CT, organizes the innovative Food Smart and Fit program, which combines education, physical activity and goal setting to help high-risk young women.

A 2007 study followed 68 women from the Food Smart and Fit program. The average BMI of women in this group was 34.4, the majority had a family history of diabetes and hypertension, and 60% were Hispanic, Results from this study were promising: BMI decreased, fat intake decreased, aerobic activity increased; and knowledge increased.

Another one of my priorities that coincides directly with health disparities is a term we call Health Literacy.
In 2003, an estimated 77 million American adults, about 36 percent of the population, were reported to be at or below basic health literacy levels (Source: National Center for Education Statistics, Institute for Education Sciences).

We cannot make improvements in health care and prevention if our messages aren’t being understood because of language and education barriers.

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.

Overweight and Obesity

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

In 2001, the Office of the Surgeon General released a “Call To Action to Prevent Overweight and Obesity.”

The factors which brought about the CTA remain; some would save they are even MORE pressing today.

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

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

And, Hispanic-Americans have the highest rate of childhood overweight of any racial or ethnic group (37 percent). (News release: Johns Hopkins Children Center, issued Feb. 2008)

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.

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

Healthy Youth for a Healthy Future

The situation I just described is 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 the Healthy Youth tours, I recognize and bring attention to communities with effective prevention programs that motivate organizations and families to work together on THREE overriding themes:

1) Help Kids Stay Active
2) Encourage Healthy Eating Habits
3) 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.

We must actively recruit parents, families, community organizations, teachers and mentors if we are going to make real progress against the national overweight epidemic.

Our approach must be clinical, educational, and ultimately transformational.

Value of Partnerships

Clinicians, practitioners, and public health stakeholders everywhere must contribute to the effort for as long as it takes to curb the epidemic.

Similarly, industries that market products to young people must 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 unhealthy beverages available in public school vending machines during the school day.

There are other illustrations of how the private, public and non-profit sectors are “actively getting others active” to fight obesity.

In Miami, the Nautilus Middle School has built a cutting-edge, kid-friendly wellness center that has merged technology and fitness. Students vie for time on the video-game equipped treadmills, motion-sensor dance machines, and rock-climbing wall. The kids can also watch pod casts of math lessons as they enjoy the benefits of exercise.

In New Orleans, I learned how the YMCA-sponsored Trim Kids Program is helping local families develop a positive approach to lifelong weight management.

I met 8-year old Gabriella Villavicencio (vee-yah-vee-sen--see-oh) who now helps her Mom shop by scanning food labels and paying attention to the calories, sodium, carbohydrates, and sugar content of the foods they purchase.

In Maine, the Hannaford Brothers grocery chain has developed a successful “guiding stars” nutritional rating system. Using a scale of zero to three stars, they are helping to direct their shoppers to healthier choices.
In Austin, Texas, the School District prohibits sales of carbonated beverages and sweet products like hard candy and candy-coated popcorn during the school day.

Another good example is the National Football League (NFL), 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 NFL, 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.

H-H-S, for our part, is working on a number of fronts.

WE CAN is an NIH/NHLBI program to motivate people on the local level to ‘get up and move.’ It has formally partnered with more than 600 Community or participant organizations.

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 message 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, whether we are talking about creating a prevention-based health care system or getting a handle on the obesity epidemic, significant change is slow to take place in even the best of circumstances.

The process of bringing it about may not be glamorous and is certainly difficult.

But the challenge to create lasting cultural change is ours to meet.

LULAC as an organization can be an aggressive advocate for disease prevention…for health literacy…and for preventing childhood overweight and obesity.

You have the ability to make things happen. You've demonstrated it throughout your history.

You can make a difference again now.

Let’s work cooperatively to make it happen.

Thank you.