December 19, 1998

President Diana Natalicio, other esteemed guests, and most importantly, our graduating students, good afternoon. I bring you greetings from Washington, DC, and the Office of Public Health and Science, and I extend my warmest congratulations to each of you. I am honored to deliver the Winter Commencement Address for the University of Texas—El Paso.

Not just because Dr. Natalicio is one of the people I respect most in higher education.

Not just because you are the largest Mexican-American-majority university in the nation.

Not just because the Department of Education ranked you second in the nation for the total number of bachelor's degrees, and eleventh in the number of master's degrees awarded to Hispanics.

Not just because you have been designated by the National Science Foundation as a Model Institution for Excellence, based on your success in creating educational opportunities for non-traditional students.

Not just because you are committed to offering culturally competent educational opportunities to a diverse and underserved population.

Not even because you ranked number one in health professions by Hispanic Outlook in Higher Education as the best college for Hispanics.

But I came to UTEP, because I heard that a very special class was graduating, and I wanted to be here to witness it!

Let me congratulate you for the progress you have made in developing the Border Biomedical Research Center and the Border Health Research Institute.

This is an exciting year for you, and 1998 is also an important time in the Public Health Service. This year marks our 200^th Anniversary. It was in 1798 when President John Adams signed the act of Congress in Philadelphia, giving rise to the Marine Hospital Service. The idea was to provide for the health needs of merchant seamen. At that time in this country, the sea was extremely important for trade and security. When merchant seamen would return home after setting out to sea, they often brought illnesses with them, endangering not only their health, but also the health of their families and the nation.

Since that time, the Public Health Service, which started as a response to those needs, has grown to 50,000 employees and 6,000 members of the Commissioned Corps.

Two centuries later, the driving principle remains the same: to the extent that we provide for the health needs of the most vulnerable among us, we do the most to protect the health of the nation.

I believe that's also true for education. To the extent that we provide for the educational needs of the most vulnerable among us, we do most to advance this nation.

I am happy to be in El Paso—the city the Spanish originally named "El Paseo del Norte," which means "the Passage to the North." The very name implies that those who have arrived here are on a journey somewhere. And that is especially poignant today, when we think of you, the graduates. Today marks for you a major milestone in your journey, and you should feel very proud.

But don't be misled. In no way is this an ending. It is perhaps the most important beginning thus far in your life. That's why these ceremonies are called "commencements" and not "conclusions." And while you may think that the finals you faced these last few weeks were tough, they are in no way "final." Life is a series of tests, and you are about to undergo some of the most exciting ones of your life, as you leave this place and face the future. As the old adage goes, "The best is yet to be."

And as with every journey, this course through life requires some essentials you will want to carry along with you. I should warn you—these items are often hard to come by on the way, and you will be much better off if you carry them than if you search for them. They are hope, heart, and help.

Let me begin with hope, since it plays such a crucial role. William Sloane Coffin, Jr., said that "Hope arouses, as nothing else can arouse, a passion for the possible." The best illustration of this can be found in your own autobiographies and the biographies of your classmates.

For many of you, your graduation was made possible because someone in your family—your grandmother or grandfather, your mother or father, an aunt, uncle, or your teacher—somebody had enough hope to believe that you could do it. And they inspired in you that same hope. They believed, despite it never having been done before, that it was possible. And you have shown that, through perspiration, determination, and despite frustration, it can be done. You must never give up hope.

As a child, I was very ill with whooping cough and pneumonia. I can remember gasping for breath and I remember the presence of many family and friends and neighbors who had gathered to pay, what was to be, their last respects. But more than any of that, I remember the look of determination and hope in my mother's eye. Since that time many years ago, I have come to know over and over again just how powerful hope can be, even in the direst of situations. Hope is infectious. Hope is strong.

More than half of you who are graduating today are the first in your family to do so. Let me encourage you to not let this be the last of your firsts. I said this during my swearing-in ceremony, but it bears repeating today: "The American dream does not end when it comes true; the next challenge is to help it come true for others."

The next essential is heart. By this I mean, you must have compassion. As you leave this great university to enter the work world, you must never forget those who are left behind, those who are without the opportunities you have had, and those who are looking up to you. So, behave responsibly. Be caring and kind. In the great words of the Desiderata: "As far as possible, without surrender, be on good terms with all people."

Finally, you must have help. Help works both ways. You must be willing to take time to offer help, and you must realize that it is okay to ask for help. Find a good mentor, who can share with you the trials and triumphs of their journey. Don't ever be too proud or too afraid to seek the help you need. And don't ever be too busy or too important to offer help to someone in need.

My mentor, the late Benjamin Elijah Mays said that "If it falls your lot in life to touch the lives of others, then be sure to touch them in such a way that you leave them better than you found them." Remember to seek help from others and to be of help to others.

Let me share with you my priorities for Surgeon General, because in them are some lifelong lessons for healthy living. Also, we're going to need help from all professions—engineering, business, education, nursing and the health professions—if we are going to realize these goals. You hold the nation's future in your hands, and I'm going to need your help in so many ways.

First, I want to make sure that every child has an opportunity for a healthy start in life. When I raise that topic as Surgeon General, I am referring to babies being born to parents ready to be parents and being born into nurturing environments. But to you I want to say "well done." You have seized the opportunity, and are well on your way to a healthy start in life. These credentials you have worked so hard for are the key. Not only have you just ensured that you will have a chance at a better environment and a better future, but you also will be able to offer your children that same healthy start.

Second, we must promote healthy lifestyles. That applies at any stage in life. It refers to good nutrition, physical activity, responsible sexual behavior, and the avoidance of toxins. A healthy lifestyle means taking care of yourself so that you develop a regimen of good habits, while eliminating bad ones. I often like to point out that it is just as easy to develop healthy habits as it is to develop harmful ones.

For example, I am hooked on jogging. I like to jog every day, but if not, at least several times a week. When I am unable to fit jogging into my schedule, I am not a pleasant person to be around. That's what I mean. You can get attached to good behaviors, like physical activity, as easily as you can to bad ones.

Nutrition is the same. By getting into the habit of eating at least five servings fruits and vegetables each day, you can much more readily turn away those foods that are not healthy. The American diet is too loaded with fats and sugar and too lacking in fruits, vegetables, and grains.

It never ceases to amaze me to learn of the unhealthy lifestyles our college students are keeping. Take smoking for instance:

• Each day, 3,000 teens become new smokers. Most of them will become addicted before they are 18. One-third of them will die from a smoking-related disease.
• Each year, 450,000 people die from smoking-related illnesses.

The misuse of alcohol is another major problem. Alcohol abuse kills and injures more of our young people and costs our society more than all the illegal drugs put together. On top of that,

• More than half of all college students drink primarily to get drunk.
• Two out of five college students are binge drinkers—that means they have at least 4 to 5 drinks in each setting.

We need your help in changing this trend.

The next priority deals with mental health. We must develop a mental health system that is caring and supportive. You are about to enter a high pressure, fast-paced, frenzied chaotic world—much like the one you are leaving behind. Think of it as finals week every week! Not only should you pay attention to your physical health, you must be mindful of your psychological and emotional health. Just as things go wrong with the heart, lung, kidneys, and liver, they also go wrong with the mind, and you must be aware of that.

Too many of our communities are environments of hopelessness. What we are trying to do with this priority is to remove the stigmas and shame that often surround mental health. These stigmas often prevent those who need help most from seeking it.

Fourth, we must strengthen support for an effective community health system. You can provide a great deal of help in this area. We envision a health system that is based on health promotion, disease prevention, early detection, and universal access to care. We must re-think our health system so that we focus more of our efforts on prevention so that we'll have to devote less time to care. Currently, we spend $1 trillion each year on health care, and yet only 1 percent of that amount is spent on population-based prevention.

The fifth of the five priorities is this: We must view health from a global perspective. Living here in a binational region, you know better than most how important it is to recognize that every health concern is global and requires a global perspective.

We cannot afford to view our health as if diseases stopped at borders. Not only do the illnesses and diseases that affect Mexico have the potential of affecting El Paso and vice versa, so do the health conditions of Madrid, Martinique, and Mozambique. In other words, the threat of disease in one part of the world is a serious threat to another part of the world, thanks to the ease and rapidity of transportation methods. A few years ago, as a part of the childhood vaccine program, El Paso and Juarez declared: "Somos una sola communidad," which means "We are one community." That's the right spirit. We live in a global community.

A final, but important, point to note is that we must eliminate disparities in health. This priority refers to the president's initiative to not just reduce, but eliminate, disparities in health by 2010.

Six areas have been targeted as starting points. They are cardiovascular disease, cancer, infant mortality, immunizations, HIV/AIDS, and diabetes. These are areas in which we see a great deal of disparity between majority and minority populations and areas where we believe we can make a measurable difference. For example, a Hispanic person is twice as likely to become diabetic as their white counterpart. And an African-American baby is twice as likely to die in the first year than a white baby.

Let me return again to this theme of hope. Frederick Douglass said: "You are not judged on the height you have risen but from the depth which you have climbed."

When I left home for college, my parents did not have a lot to offer me in the way of material things, but what they did offer me amounted to much, much more. In my hands was placed not wealth, not clothing, not even a solid plan for success, instead, what they gave me was hope.

I started out in medicine, wishing to do biomedical research. So I completed the M.D. and Ph.D. in cytogenetics. I wound up doing research in sickle cell and starting a sickle center.

It was hope that led me to want to teach community health; but I wound up chairing the Department of Family Medicine at Drew and Community and Family Medicine at Morehouse.

It was hope that prodded me to want to become involved in medical administration; but I wound up as President of one of the greatest medical schools in the country, Meharry Medical College.

It was hope that inspired me to want to understand and improve the health of the poor; and I wound up leading the world's premier prevention agency at the CDC.

And it was hope that brought me here today. And now, I challenge you to hold on to your hope and to inspire hope in others. In the immortal words of Langston Hughes: "Hold fast to dreams."

You hold in your hands each day the future of this nation.

Let me close with this story about a wise old sage. This man was known throughout the community for his wisdom and impeccable knowledge. People would come from far and wide to try to stump him, but nobody ever was successful. Finally, one man devised a surefire plan to stump the old man. He would get a live dove and place it behind his back. Then, he would ask the man if the dove were alive or dead. If the sage said the dove was alive, it would crush it and kill it. If the sage said the dove was dead, he would show him the still fluttering dove. The moment arrived and the man posed the question. "Is the dove behind my back dead or alive?" The sage paused a brief moment and replied: "Its in your hands. Its life in your hands."

I challenge you to hold fast to hope, heart and help. They are essentials for the journey. The future of our nation and, indeed, the world may well be in your hands. Cherish them, and treat them with love and care.

Let me leave you with this poem called "God's Minute."

God's Minute

I have only just a minute,
only sixty seconds in it,
forced upon me, can't refuse it
didn't seek it, didn't choose it
but it's up to me to use it.
I must suffer if I lose it,
give account if I abuse it.
Just a tiny little minute
and yet eternity is in it.

                -unknown

Godspeed.