Remarks as prepared; not a transcript.

RADM Kenneth P. Moritsugu, M.D., M.P.H
Acting Surgeon General
U.S. Department of Health and Human Services

Communities in Action for Asthma Friendly Environments National Asthma Forum

Thursday, May 31, 2007
Washington, D.C.

"Today, We are Leaders Bringing Asthma Under Control"

Good morning.

Thank you Elizabeth for that kind introduction. (Elizabeth Cotsworth, Director, Office of Radiation and Indoor Air)

[Standard remarks following the organ donation video edited to 50 seconds provided by Dennis Wagner - emphasizes importance of clear goals and community involvement]

It is a pleasure and a privilege for me to participate today in the Communities in Action National Asthma Forum.

And it is a pleasure to join you who are so dedicated to protecting and improving the health and well being of individuals and families with asthma.

As our Nation's doctor, my goal is to do everything that I can to protect and advance the health of the people in our great Nation.

And asthma has been taking its toll on our health care system, on communities, and on families and individuals for far too long.

What are our national goals for asthma control?

These goals are the Healthy People 2010 goals: an increased quality of life and elimination of health disparities.

Living well with asthma means …

Fewer school and work absences, fewer emergency room visits, and fewer hospitalizations.

More people will get better care, the right medications, tools and resources they need to avoid environmental risk factors.

Better care also means understanding health information so individuals with asthma understand the risk factors.

Health literacy - or its converse - health illiteracy - can have a tremendous impact on individuals with asthma.

Health literacy is the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions.

Working within your communities, I urge you all to remember the importance of being able to translate complicated health information into easy-to-understand information - information that is communicated clearly, accurately, and effectively. So that information can be heard… understood… embraced… and ultimately put into action.

More than 90 million people cannot adequately understand basic health information.

I'm happy to note that EPA has taken the lead in ensuring that attention is being paid to controlling asthma triggers. AND it is an integral part of comprehensive asthma care.

Thank you Elizabeth for the work you and your EPA colleagues are doing to equip our Nation's health care providers.

We know that providers must be able to assess their patients for trigger sensitivities and exposures.

It's important for individuals and families to feel empowered to take action to manage their exposures.

And it's easier for them to feel empowered when they understand the information being presented to them, and when the health care provider can communicate easy-to-understand information to the asthma patient and to family members.

One of those asthma triggers -secondhand smoke-is a risk factor that continues to impact our nation's health.

Before I go further, however, I think it's important to mention that today is World No Tobacco Day.

Tobacco is the second major cause of death in the world.

It is well known that half the people who smoke regularly today - about 650 million people - will eventually be killed by tobacco. (WHO statistic)

Equally alarming is the fact that hundreds of thousands of people who have never smoked die each year from diseases caused by breathing second-hand tobacco smoke.

Last year, my Office released our Report: The Health Consequences of Involuntary Exposure to Tobacco Smoke.

This report shows that smoking not only harms the smoker, but it also harms the people in close proximity to the smoker.

Usually this includes the smoker's spouse, children, and friends.

Each year, secondhand smoke causes tens of thousands of heart disease deaths and nearly 3,000 deaths among our nation's nonsmokers.

Our nation's children continue to be exposed and subjected to the serious health effects of secondhand smoke exposure.

And 20 percent of children with asthma are exposed in their homes, and as Acting Surgeon General, this troubles me.

All children, and especially those with asthma, deserve smoke-free homes and cars.

And I know many of you share my concern.

EPA has led the nation in raising awareness of the dangers of secondhand smoke exposure -beginning in 1992 with the important risk assessment and continuing today with the Smoke-free homes education campaign.

Efforts such as these are helping to drive us toward our national goals for asthma control.

So how are we doing?

What is our progress toward those goals-quality of life and elimination of disparities?

Our national data surveillance system, managed by my colleagues at the CDC, suggests we may be making some gains.

Nationally, asthma deaths have declined, as have hospitalizations and emergency department visits.

Perhaps this seems encouraging, but I think you would agree with me that we still have more work to do.

The recent progress review of the Healthy People 2010 indicators for respiratory health also suggests some gains:

• More people are receiving written asthma action plans from their providers.
• More people are receiving important asthma education to empower them to be active participants in their own care.
• And more are receiving help assessing and reducing exposures to environmental risk factors.

However, we are not making progress eliminating disparities in asthma.

One of our priorities in the Office of the Surgeon General is Eliminating Health Disparities.

Why have we made it a priority?

Because it is unacceptable that in our great nation, with our global leadership in science and medicine, we still have major disparities in health and health care delivery.

All Americans - regardless of their race, heritage, age, or gender - should have access to good health information and health services.

And asthma disparities are rampant.

Full achievement of our goals for asthma control depends on a health care system that reaches all Americans.

It depends on the integration of individualized care and community-based public health.

It depends on joining physician, clinic and hospital care to neighborhoods, schools, workplaces and families.

Bringing asthma under control means mobilizing a Network of committed leaders.

And you are the first of those leaders.

And you are making remarkable progress in the communities where you work and for the individuals whom you serve.

Let's hear about some of those outcomes.

[Microphone runners will call on people to share their outcomes, and you will make comments afterwards]

I'd like to ask Ms. Laureen Gray from Cambridge Health Alliance in Cambridge Massachusetts to please stand.

Ms. Gray, please tell us about positive outcomes for the children with asthma that your program serves.

[Laureen Gray gives 1-2 sentence response.]

Ms. Deborah Peartree from Monroe Health Plan; would you please tell us about the outcomes your program is achieving in Rochester New York;

[Deborah Peartree gives 1-2 sentence response.]

Dr. Stephen Teach from Children's National Medical Center here in Washington DC; Dr. Teach, please tell us about the improvements your program IMPACT DC has made for children and families with asthma here in our Nation's capital.

[Dr. Teach gives 1-2 sentence response.]

How can we spread these successful outcomes?

How can we grow our Network?

Here is my prescription, my challenge to you, EPA and to everyone in this room:

[show power-point slide of Rx]

Mobilize 1000 communities to deliver comprehensive asthma care.

I understand that there are about 150 communities enrolled in the Communities in Action Network.

Well EPA, I'd say we have some work to do.

Let's see if we can get some help.

How many of you represent Health Plans?

And how many of your plans provide coverage to more than one community?

I challenge you to each enroll 50 new community asthma programs in the Network.

How many of you represent state health departments?

I challenge you to each enroll 25 community coalitions from your state in the Network.

Is someone doing the math?

Hopefully, this time next year, there will be 500 communities in action.

And another 500 the year after that.

I also prescribe that you set bold program goals and drive toward the goals of quality of life and elimination of disparities.

And let's not forget to measure progress and document the outcomes.

And report back on those outcomes using the on-line Asthma Community Network so I can check on your progress.

I invite you to sign this prescription before you leave the Forum tomorrow as a mark of your commitment as leaders to bring asthma under control.

It is easy in a meeting like this to get in the spirit of making commitments, making requests and offers among colleagues, but then we go home and often wonder where to start.

I know the most important thing that keeps us going, keeps us moving toward those goals, is delivering care to individuals and families.

This is really why we are here.

A few moments ago you heard from Dr. Teach about the health improvements that his program is providing to District of Columbia families dealing with asthma.

I'd like to introduce you to someone whose family now knows how to live well with asthma, thanks to the help and good care they have received from Dr. Teach.

Would Ms. Neki (pronounced Ni - Kay) Swinton please join me at the podium?

[Ms. Swinton comes to the podium and tells her personal story].

Thank you … for reminding us of why we have gathered here today, and of the real difference that is possible when families, health care providers, and community organizations work together.

[presentation of the SG coin]

I am going to turn the podium over to our able facilitators, Tracy Enger and Dennis Wagner.

Thank you for your continuing work, and for your commitment to improving the health of those with asthma.

I know that through your efforts and our strong and growing network of communities we can ensure that every one with asthma will live well.

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Last revised: September 28, 2007