The Year of the Healthy Child
The Year of the Healthy Child
The Boy Scouts of America has been asked to assist in promoting the US surgeon
general's 2005 agenda, The Year of the Healthy Child. Being an organization that
is focused on the mental, physical, and emotional health of youth, the BSA is
happy to provide a copy of the speech outlining the vision. Surgeon General
Richard Carmona delivered the speech on January 11, at the J.P. Morgan 23rd
Annual Healthcare Conference outlining his vision.
Vice Admiral Richard H. Carmona, M.D., M.P.H., FACS
United States Surgeon General
U.S. Department of Health and Human Services
J.P. Morgan 23rd Annual Healthcare Conference
Tuesday, January 11, 2005
San Francisco, California
"2005: The Year of the Healthy Child"
Thank you, David, for that kind introduction. [David Golden, Director of
JP Morgan Western Region]
It is an honor to be our nation's 17th Surgeon General and have the
opportunity to meet with and address distinguished audiences. I've served
in this position for nearly two-and-a-half years, and have delivered more
than 500 speeches to audiences throughout the world.
I'm fortunate to work for two bosses who understand the importance of
health. Across America and around the world, President Bush and Secretary
Tommy Thompson insist that evidence and the best science always guide our
policy and what I do.
When President Bush and Secretary Thompson nominated me to be Surgeon
General, they asked me to focus on three priorities. All three of my
priorities are very strongly evidence-based. They are:
- First, Prevention. What each of us can do in our own lives and
communities to make ourselves and our families healthier.
- Second, Public Health Preparedness. We are investing resources
at the federal, state, and local levels to prevent, mitigate, and
respond to all-hazards emergencies. and
- Third, Eliminating Health Care Disparities. I am so proud that
President Bush charged me with working with him and all of you to
eliminate health disparities. Notice that he didn't just charge me
with reducing health disparities. He said we will eliminate health
Woven through each of these priorities is improving Americans' health
literacy. The greatest science in the world isn't worth the paper it's
proved on if it can't be translated into real use.
Science for the sake of science is nice for scientists, but not for the
general population. I want to ensure that medical discovery doesn't languish
in the laboratory. I want to bring it to the people.
For those of you who don't know me, I'm a "recovering" surgeon. I say
that because I strongly believe, and many of you may agree, that at times
surgery can be considered a barbaric process, especially in light of the
new scientific knowledge that is rapidly evolving. Someday, med students
may cringe in horror at the tactics that we use today in an attempt to save
human life. Someday, simply by altering the genotype of a host, an organ
will resist disease or heal itself.
It was a tremendous honor for me to be appointed by President Bush, and
it's great to be able to do the things that a Surgeon General does. Like
coming here to talk with some of the greatest minds in business and healthcare.
To think that just a couple years ago, I was just another guy in Tucson,
Arizona, working as a trauma surgeon, a professor, a public health officer,
and on the development of the Southwest region's bioterrorism response plan.
We don't always know what the future holds. We don't in our lives, and we
certainly don't in science.
One of my duties as the United States Surgeon General is to find the best
science and articulate it to the public for better health. My greatest
challenge is getting people to realize that health -- whether good or bad --
doesn't just happen to them. It's a result of the choices they make every
There is tremendous challenge in healthcare for the nation and the world
in the next few decades. We must understand that leadership in scientific
research and education, in scientific investment and development, in
innovation, and in competitive entrepreneurship is an enduring quest, an
The Year of the Healthy Child
In many ways, the men and women in this room hold the keys to a healthier
America. You affect change every day; you make leadership decisions that
impact individuals, families, and communities across America.
For all those reasons, and because it's the beginning of the year, I want
to take this opportunity to announce the 2005 agenda for the Office of the
Our theme for 2005 is "The Year of the Healthy Child." I believe that it
is the most comprehensive agenda ever set forward by any U.S. Surgeon General
for a single year.
It includes all aspects of a child's life: body, mind, and spirit, starting
with prenatal care and going through the developmental stages of childhood and
What the Office of the Surgeon General will highlight throughout "2005: The
Year of the Healthy Child" is that as a nation, we can and must do more to
ensure that every baby is born healthy and that all children have the chance
to achieve their full potential for healthy and productive lives, free from
disease or disability.
Working together as a nation that cherishes its children, we will ensure
the best possible health, and the greatest productivity and independence for
every individual child. This will lead to a healthier America for generations
The prosperity and the future of our nation rests upon the health and
well-being of our children.
The good news is that 82 percent of our nation's 70 million children are
in very good or excellent health. Childhood immunization is at an all-time
high. Our children are less likely to smoke and less likely to give birth
These are important gains in pediatric health. But we also have some very
troubling issues -- some new, some that have plagued us for years.
That is why we are focusing this year on children. We are partnering with
government leaders, academics, health care professionals, corporations, and
communities. We are especially determined that the messages will resonate
across all regions, and all cultures.
We have already encountered tremendous enthusiasm and support from a wide
range of partners, including the March of Dimes, The American Academy of
Pediatrics, Nike, Shaping America's Youth, The Boy Scouts of America, NASA,
SAFEKIDS, the Department of Education, and of course our colleagues across
the Department of Health and Human Services, from the CDC to the National
Institutes of Health.
And today I'm here to ask you to join us.
Since becoming Surgeon General, I've traveled the nation and world meeting
with healthcare professionals, business and political leaders, public health
leaders, first responders, moms, dads, and lots and lots of kids. The kids
are my favorite. Maybe because I'm a dad, maybe because I just like to hear
what kids are saying and check on what they're into.
As part of my "50 Schools in 50 States" initiative and because of
partnerships with organizations such as the Boys & Girls Clubs of America
and the YMCA, I have visited with tens of thousands of children to talk
about health and how they can help themselves, their families, and their
communities be healthier every day.
It's the same message I bring to adults, but with the kids ... there's
more cheering. And a whole lot more hugging and laughing.
To improve the health of all children, we need to start before pregnancy,
with their mothers.
Next month I will participate in a live television show called Birth Day
Live! on the Discovery Health channel. Discovery Health will broadcast this
10-hour program to follow deliveries in three U.S. hospitals. I will focus
much of my on-air time talking to Americans about steps they can take to
prevent birth defects.
Unfortunately, birth defects affect 150,000 new babies in our nation every
year, and are the leading cause of infant death in the United States. Some
racial and ethnic groups are affected more than others. Today, more than 25
percent of African American women and more than 30 percent of American Indian
women receive no prenatal care in the first trimester.
While we are ensuring access to prenatal care, we must also do a better
job of ensuring that all American women recognize the importance of prenatal
care and follow the advice their doctors give them.
In addition to birth defects, nearly half of a million babies are born
pre-term. That's one in eight babies born in this country. The complications
of preterm birth cause death, disability, and tremendous sorrow for many
We must redouble our efforts to find causes of preterm labor. We need to
look at where the needs are greatest. For example, why do African Americans
have the highest rate of premature birth? Premature birth is leading cause
of neonatal mortality and morbidity in African-Americans. It is the
second-leading cause of infant death among all Americans, of all races.
We must rededicate ourselves to ensuring that all children have a healthy
start in life. We already know that simple preventive measures can help
reduce the risk of many birth defects. For example, vaccinations against
measles, mumps, and rubella prevent birth defects by reducing the risk of a
pregnant woman becoming infected with these diseases that can increase her
baby's risk of being born with deafness, developmental disabilities, heart
defects, and blindness. Thanks to high rates of immunization, these infections
are now rare occurrences in America.
We also know that good nutrition can help reduce the risk of birth defects.
Serious defects, including spina bifida and anencephaly, can be prevented when
women get 400 micrograms of folic acid each day. Two-thirds of women in the
United States do not consume enough folic acid. All women of reproductive age
should consume folic acid.
And women who are pregnant or planning a pregnancy should not smoke or drink
alcohol, and should consult a healthcare professional before taking any medicine
-- prescription or over-the-counter.
We must remember, there is no safe cigarette during pregnancy or at any other
time in life -- and if you won't stop smoking for yourself, the least you can
do is keep your smoke away from pregnant women and children.
Tobacco and Children
On the topic of smoking, we are also going to focus this year on preventing
and reducing smoking among teenagers. To put the problem into perspective, more
than 4,000 teens will try their first cigarette ... today. Every day, more than
2,000 kids become new regular, daily smokers. That's unacceptable, and
We are also going to continue working to reduce childhood obesity. Today,
15 percent of our children are overweight -- that's more than 9 million
children. One out of every seven kids. And the problem doesn't go away when
children grow up. Nearly three out of every four overweight teenagers will b
ecome overweight adults.
The facts are staggering:
- Today, obesity is the fastest-growing cause of disease and death
in our nation -- and we are now seeing that it is a growing problem
around the world.
- In the year 2000, the total annual cost of obesity in the United
States was $117 billion.
The health crisis of childhood obesity can be solved -- and it will take a
wide range of adjustments in the lives of our children. To maximize the
likelihood of success, all sectors of our society need to have access to the
most current information.
I encourage you to join the fight against childhood obesity. We must teach
our children to enjoy healthy foods in healthy portions. We must encourage all
children to be physically active for at least 60 minutes a day. Not only
sports, but simple things like taking the stairs, riding their bikes, and
just getting out and playing.
The average American child spends more than four hours a day watching
television, playing video games, or surfing the web. We are seeing a
generation of kids who grew up off the playground and on the PlayStation.
And this weight gain has long-term health consequences. For the first
time in history, we're seeing kids in doctors' offices with type 2 diabetes
and high blood pressure. We must reverse this trend, or we will have an
overburdened healthcare system that simply cannot afford to treat the
maladies of the day.
Another area that we will focus on this year is childhood injury. Death
from unintentional injury among children has declined more than 40 percent in
the past 15 years. The problem is that this isn't nearly enough progress.
Injuries are still the leading cause of death in the United States among
children ages 14 and under.
Each year, approximately 5,000 children die from motor vehicle injuries,
including being struck while walking or riding a bike; drowning; fires and
burns; suffocation and choking; firearm injuries; falls; and poisoning. Injury
rates vary, and younger children, boys, and poor children suffer
disproportionately. In addition to the more-than 5,000 children who die each
year from injury, more than 90,000 are permanently disabled.
Injury is the leading cause of medical spending for children. In one year,
injuries to children ages 10 and under result in nearly $6 billion in direct
medical costs. The prevention message is that as many as 90 percent of
childhood injuries can be prevented through child safety seats, bicycle
helmets, poison control education, smoke and carbon monoxide alarms, pool
alarms and pool fences. We will need your help to increase awareness of
these simple preventive steps.
An issue that we will also explore is the high rate of crashes among teen
drivers. Some of the crashes are due to alcohol or other substances -- the
driver is high -- some are due to inexperience behind the wheel. We owe it
to our kids to address this public health problem before it gets any worse,
and the Office of the Surgeon General will work with the National Highway
Transportation Administration and other partners to address the questions,
and find the answers.
Another area that leads to death and disability for children is one that
we must shine a light on more effectively, and from which we cannot ever,
ever turn away. While most American children grow up healthy and happy,
some are deeply wounded by emotional, physical, and sexual abuse.
While child maltreatment has traditionally been thought of as a criminal
justice issue, it is also very much a public health issue. I've seen it from
both sides: as a law enforcement officer and as a trauma surgeon. The
cycle of abuse is debilitating. I have known adult abusers who were abused
as children, and are continuing the cycle of violence that was visited on
them decades earlier. For too long, we have hidden child abuse in the
locked room of family secrets for generations. It's time to break open that
door, to shine the bright light of hope and healing for children and
It is a problem within American families that can affect any race,
ethnicity, or socio-economic group. And the wrenching mental and physical
health effects of child maltreatment continue long after the abused child
is placed in a safe environment. The child who is abused becomes the
teenager who is violent toward his peers, and then the man who is violent
toward his wife and children.
Young people who experience maltreatment are at increased risk for
experiencing adverse health effects and behaviors as adults, including
alcoholism, drug abuse, physical inactivity, severe obesity, depression,
suicide, and sexual promiscuity.
While our children should be equipped to face potentially threatening
situations, we must also determine how adults can intervene more effectively
to prevent the abuse from occurring.
That is why next month I am convening some of the best minds in criminal
justice, medicine, child welfare, and education in a Surgeon General's
Workshop on Child Maltreatment, to help determine next steps to end this
scourge on our society.
Tomorrow, I will convene a different workshop designed to protect children's
health. The first-ever Surgeon General's Workshop on Healthy Indoor Environment
will bring together national experts in producing healthy indoor space. We've
all heard of "sick buildings."
We as Americans spend between 85 and 95 percent of our time indoors --
including at home, in a vehicle, in school, or at the office or other
workplace. As you know, secondhand smoke, lead, radon, and asbestos are
threats to the indoor environment.
But the reality is that our work is just begun. For example, we now
know that one in five schools in America has indoor air quality problems.
That is affecting millions of children who don't even realize it. We need
to get to the bottom of the problem, then work with engineers, designers,
architects, and builders to solve this troubling issue.
Speaking of schools, that takes me to our next priority. About 18 months
ago, I announced my "50 Schools in 50 States" initiative. In 2005, the Office
of the Surgeon General will continue to work with partners and school districts,
to reach into classrooms across the country to encourage students to stay in
school. In addition, we will encourage more students, especially minorities,
to focus on excelling in math and in the hard sciences.
As technology increases, borders become less important. Disease does not
respect international boundaries, and in our global economy there is financial
fluidity between nations.
In the United States, elementary and secondary education in science and
math is not improving fast enough for an information society that is
increasingly dependent on those skills. All sectors -- higher education,
industry, and government -- must assume greater responsibility for achieving
The United States cannot be a victim of technology and science. We must
expand and improve because of it. With this leadership comes immense global
responsibility. . . to reach out and be compassionate while making the world
a better place. We have, we continue to do so, and we, the United States,
have an enviable and unparalleled record in this regard.
We will also join with others to promote the mental health of children
Mental illnesses affect almost every American family. It can occur at any
stage of life, from childhood to old age. No community is unaffected by mental
illnesses; no school or workplace is untouched.
Every year, between 5 to 9 percent of American children have a serious
emotional disturbance. These figures mean that millions of children are
disabled by mental illnesses every year.
President Bush has said, "Americans must understand and send this message:
mental disability is not a scandal -- it is an illness. And like physical
illness, it is treatable, especially when the treatment comes early."
Over the years, science has broadened our knowledge about mental health
and illnesses, showing the potential to improve the way in which mental health
care is provided. However, despite substantial investments that have
enormously increased the scientific knowledge base and have led to developing
many effective treatments, many Americans are not benefiting from these
Suicide is still the third leading cause of death among 15- to 24-year-old
Americans. Suicide costs us more than 30,000 lives each year. That's almost
one person every 15 minutes. And once every 45 seconds someone else attempts
suicide. And even if the life is spared, the heartache and pain is so severe
that the spirit may never fully heal. Like so much of the death and disease
in our nation, suicide is preventable. It's prevented by understanding and
identifying risks and then taking the necessary protective measures. Working
together, we can save these lives.
And finally, I want to touch on the spirit of our nation's youth. Their
optimism and hope carry the day.
I want to congratulate all the children and teenagers across our nation.
Too often, when we hear bad news about kids, we ask what went wrong with them.
Then, when we hear good news about kids, we congratulate the teachers,
counselors, and parents who made it happen. The teachers, counselors, and
parents certainly deserve praise.
But let me also say this to the young people -- and I mean it from the
bottom of my heart -- Thank you.
- Thank you for not smoking.
- Thank you for not drinking and doing drugs.
- Thank you for being good students and staying in school.
- Thank you for volunteering for good causes and helping younger
children in your family and your community to be safe, happy,
The enthusiasm of children and teens is often overlooked within their
communities. The Office of the Surgeon General will work to harness their
energy and partner them with local institutions to promote volunteerism,
civic responsibility, and patriotism.
Charge and Closing
John Whitehead said that "Children are the living message we send to a time
we will not see." What kind of message will we send? We share a common desire
to send children healthy and happy into their future. Let's redouble our
commitment to give them the tools they need and will one day use when we are
And my friends, the needs of children don't end at the water's edge. Today,
millions of children around the globe are struggling for survival. We think of
the 11 million children in Africa who have lost their parents to AIDS. And we
all have heard the stories of children orphaned by the tsunami who have been
taken captive to slave labor or put into the sex trade.
Unfortunately evil creeps in, when good fails to shine its light. As
Americans, we have the opportunity to be light in the world.
As you know, the United States is leading an international coalition to help
with immediate humanitarian relief, rehabilitation, and long-term reconstruction
efforts. President Bush announced on December 31 that the United States
government is committing $350 million toward the relief effort, which also
includes emergency response resources and military assets. The United States
is providing food, water, shelter and medical aid to the millions of people in
the affected region.
The business community has an opportunity to play a special role in
alleviating suffering in Asia, and I appreciate all of your leadership to
provide aid to the region. I want to congratulate the businesses that have
already come together to donate nearly $200 million to tsunami victims.
It is an honor for me to bring to you President Bush's personal thanks for
all that your companies and organizations have done. Your generosity,
individually and collectively, represents the best of America, and we thank
Looking around this room, I know that through your efforts, and through what
I hope will be a new partnership around "2005: The Year of The Healthy Child,"
we can ensure better health and greater happiness for all children.
I want to thank you very much for your dedication. I stand here ready and
prepared to work with you to improve the body, mind, and spirit of the newest
generation of Americans. This is one area in which we can do a lot of real
good -- for people who really need us. All of us must take action. As adults
and as a nation we have an obligation to be responsive to the needs of all