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

Remarks at the Salvaging the African American Village Summit
Saturday, June 16, 2007
Hartford, CT

"Approaching Youth Violence as a Serious Public Health Issue"

Opening and Acknowledgements
Good afternoon.

Thank you, Chuck (Cumming) for that gracious introduction, and to all of you for that warm welcome.

I particularly want to note the presence of so many of our youth in the audience. It is important that you are here, and it is important that we listen to you. Because this is a matter that affects you, your health, and your safety; and I believe in the principle, “Nothing about me, without me!”

I appreciate how so many of you have chosen – you have voted with your feet – to be here at this very important meeting on Salvaging the African American Village. Each of us could be elsewhere, but we decided this was important.

So why are you here? Because you care – you care about this issue, you care about your community, you care about the African American Village.

And why am I here? Because I care. And I want to show you by my presence that I, and your Federal government, does care; and I vote with my feet to be here with you, as we work together to learn more about, and to address this issue.

Thank you to the people of Connecticut for inviting me here today. It is an honor to be here in your great state.

My bosses, Department of Heath and Human Services Secretary Mike Leavitt and the Assistant Secretary for Health John Agwunobi, asked me to bring you their best wishes.

I know we are here today to address a serious issue. Youth violence and infant homicide are critical public health problems.

The most enduring responsibility of any society is to ensure the health and well-being of its children.

“Salvaging the African American Village” -- your summit name – is so befitting.

Young people are future residents of the ‘Village’ and therefore, salvaging this village MUST begin with the Nation’s youth.

And that’s why you are here today. I hope today, during this summit, you will listen to our young people.

Our youth need to know that what they are saying is being heard. But our youth also need to know that we understand what they are telling us.

I encourage you to really listen today. Listen to what our youth are telling you. And to our youth: speak out! You may have the answer, and you have an intimate perspective on this matter. The answer must come from within the communities, and you are that community.

Our youth are the key to salvaging the village.

The recent accounts of youth violence victims resonate with me:

• 17-year-old Julian Ellis, who was killed in front of his mother’s friend’s house after returning from the store.
• A 17-year-old was recently shot in the hand while riding his bike in New Haven.
• 16-year-old Cavel Banton and 17-year-old Javon Shippy who were both shot after school in Bridgeport last month.
• 13-year-old Jajuana Cole, who was killed by a stray bullet last summer by two teenagers who were gunning for a member of a rival gang.
• And earlier this month in New Haven, a 15-year-old was shot in the head while playing basketball in a park.

Unfortunately, the world remains a threatening, often dangerous place for children and youths.

Statistics have shown that youth homicides and related injuries have a disproportionate impact on racial and ethnic minorities.

• For instance, in 2002, 45 percent of juvenile murder victims were African American.
• Among 10 to 24 year olds, homicide is the leading cause of death for African Americans. It’s the second leading cause of death for Hispanics.
• Homicide rates among non-Hispanic, African-American males 10-24 years of age (57.7 per 100,000) far exceed those of Hispanic males (21.2 per 100,000) and non-Hispanic White males in the same age group (3.7 per 100,000).

This must stop

Too many youth are needlessly dying. We can and must do more.

As the nation’s Acting Surgeon General, I am charged with a critical public health mission: to protect and improve the Nation’s health.

It is important to partner with the community, and particularly with the faith community. Many of us are toiling to protect, promote, and advance the health and safety of our people; we have got to work together, outside our silos, and connect the dots. Working together, we can accomplish much more than working alone.

Priorities
I want to take a few moments to tell you about one of our priorities, why we feel this is so important.

Prevention is the cornerstone of everything that we do at H-H-S.

It is a priority for us because every year millions of Americans get sick and die from preventable causes.

We want to change that.

But, right now our nation has it backwards.

We live in a treatment-oriented society, where too little time, money, and effort are invested in preventing diseases.

We wait years and years, doing nothing about unhealthy eating habits and lack of physical activity, until people get sick.

Then we spend lots of money on costly treatments to try to make people well, often when it is already too late.

We need to refocus our efforts on preventing illness and injury.

The good news is that there are six key steps that can help prevent disease:

1. Good nutrition,
2. Physical activity,
3. Maintenance of a healthy weight,
4. Regular health screenings,
5. Vaccinations,
   and
6. Preventing exposure to tobacco and secondhand smoke.

Prevention takes on an even more urgent imperative when discussing our youth.

Disease prevention saves lives and produces healthy minds.

Although we must produce healthy minds and bodies for our children, we must understand that the greatest threat to the lives of children and adolescents is not disease or starvation or abandonment --- BUT the terrible reality of violence.

That’s why I also want to talk to you about the prevention of youth violence.

Approaching youth violence as a public health issue compliments the more traditional view of youth violence as a criminal justice concern.

We need to stop the overuse of the criminal justice system and create more effective intervention programs instead.

And we need to shift to a proactive focus instead of a reactive focus.

The effectiveness of a program depends as much on the quality of implementation as on the type of intervention.

Many programs are ineffective not because their strategy is misguided, but because the quality of implementation is poor.

We must identify the behavioral, environmental, and biological risk factors associated with violence and take steps to educate individuals and communities.

Communities should implement programs that address both individual risks and environmental conditions.

This is best learned and maintained when it is part of the everyday life of individuals within their community.

Myth vs Fact
The 2001 Surgeon General's youth violence report challenges a number of false notions and misinterpretations about youth violence and debunks myths about violent youth.

For instance some people believe that future offenders can be identified in early childhood.

The truth is exhibiting uncontrolled behavior or being diagnosed with a conduct disorder as a young child does not predetermine violence in adolescence.

The majority of children with mental and behavioral disorders do not mature into violent adults.

Another myth is that African American and Hispanic youths are more likely to become involved in violence than other racial or ethnic groups.

While there are racial and ethnic differences in homicide arrest rates, data indicates that race and ethnicity have little bearing on the nonfatal violent behavior.

Yet we see an overrepresentation of these groups in U.S. jails and prisons.

Some believe that most violent youths will end up being arrested for a violent crime when the truth is most youths involved in this type of behavior will never be arrested for a violent crime.

These false ideas are dangerous.

And the high visibility of this issue in the media sometimes perpetuates the myths surrounding youth violence.

The failure to recognize that a problem does not exist, or failure to recognize the true nature of the problem, can obscure the need for intervention.

Myths can trigger public fears and lead to inappropriate or misguided policy.

Safe Schools/Healthy Students Initiative
One program in the federal government, the Safe Schools/Healthy Students initiative – a joint effort by the HHS Substance Abuse and Mental Health Services Administration and the Departments of Justice and Education – is a unique program designed to prevent violence and substance abuse.

The Initiative is an unprecedented collaborative grant program that seeks to develop real-world knowledge about what works best to promote safe and healthy environments.

An environment where our Nation’s children can learn and develop.

Since 1999, more than 240 urban, rural, suburban, and tribal school districts have received grants.

They have done so in collaboration with local mental health and juvenile justice providers.

The initiative draws on the best practices of education, juvenile justice, law enforcement, and mental health systems.

These grantees are implementing comprehensive programs that address all of the following six elements:

• A safe school environment
• Alcohol and other drugs and violence prevention and early intervention programs
• School and community mental health preventive and treatment intervention services
• Early childhood psychosocial and emotional development services
• Supporting and connecting schools and communities
• Safe school policies

The school districts in Hartford, Waterbury, and New Haven have all been funded through this program.

I encourage you today to talk to people from these communities and ask them what they’ve done to prevent and reduce violence and other behaviors that can endanger schools and students. And listen!

As I said earlier, it takes everyone, focused on the same goal, and working together, not separately, who can and will make a difference.

THERE IS HOPE!
Underage Drinking
We know that individual characteristics such as the early exposure and use of substances and alcohol increase the risk for youth violence.

One way you can help us elevate the awareness of public health issues in your communities is to talk about the impact underage drinking has on your communities.

In March, the Office of the Surgeon General issued a Call to Action to Prevent and Reduce Underage Drinking.

Alcohol is the most widely used (and abused) substance among our Nation’s youth.

A higher percentage of young people between the ages of 12 and 20 use alcohol than tobacco or illicit drugs.

The physical consequences of underage alcohol use range from medical problems to death by alcohol poisoning.

Alcohol also plays a significant role in risky sexual behavior including unwanted, unintended and unprotected sexual activity.

Such behavior increases the risk for unplanned pregnancies and for contracting sexually transmitted diseases.

It increases the risks of physical and sexual assault AND underage drinking is a risk factor for heavy drinking later in life.

Our science tells us that our youth who begin drinking before age 15 are five times as likely to have alcohol problems after age 21.

Underage drinking is everybody’s problem, and its solution is everyone’s responsibility.

Unfortunately, too many Americans see underage drinking as a rite of passage-kids just being kids.

As with every Surgeon General's publication, this Call to Action is grounded in science.

The science indicates that underage drinking is putting our children at risk.

Recent research shows that the brain continues to develop well beyond childhood and throughout adolescence. So underage drinking harms not only our youth, but also our future!

You can help us by becoming familiar with this new information and by communicating this information within your communities.

With this Call to Action, I am asking every American to join in a national effort to change attitudes and behaviors regarding underage drinking.

And again, no one segment can do this alone. It takes everyone, working together – parents, families, friends, schools, community organizations, public safety and law enforcement ... and youth themselves. We need to connect the dots!

Secondhand Smoke
Healthy youth also means eliminating their exposure to smoking and to second hand smoke. We in the Surgeon General's Office want to make sure you have the health information you need so that you can inform your communities.

Just last summer, the Office of the Surgeon General released a Report about the harmful health effects of secondhand smoke.

Eliminating the exposure of secondhand smoke to our youth is a critical component of health prevention. The research in this Report shows us 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.

And children who are exposed to secondhand smoke potentially have dozens of health issues as a result. More than 126 million nonsmoking Americans, including both children and adults, are exposed to secondhand smoke in their homes and workplaces.

And our children are more heavily exposed to secondhand smoke than adults.

Think about it.

You see it all around you.

The infant strapped to the car seat in the back seat of the car, the parent is smoking and all of the windows in the car are rolled up.

Or you’re in someone’s home and they light up a cigarette with children playing nearby, because it’s what they’ve always done – or their parents did it in front of them.

Well, today we have the science that tells us it’s not okay.

Almost 60 percent of U.S. children aged 3–11 years — or almost 22 million children—are exposed to secondhand smoke.

And babies whose mothers smoke while pregnant and babies who are exposed to secondhand smoke after birth are more likely to die from sudden infant death syndrome (SIDS) than babies who are not exposed to cigarette smoke.

Given the extensive evidence on the serious health risks posed by secondhand smoke exposure, the involuntary nature of this exposure, and the availability of a proven method for eliminating these risks, we cannot be satisfied until all Americans are aware of the health hazards caused by secondhand smoke on their families and loved ones.

Guides to Action
As many of you know, the Office of the Surgeon General is committed to providing the best scientific information in a way that people can use and understand.

By making health information easier to understand, we allow people to actively take steps to increase their health and wellness and to actually prevent disease as a result of healthy choices.

In addition to the Call to Action to Prevent and Reduce Underage Drinking, I recently released several “Guides to Action” with the science presented in a way that Americans can understand and apply to their individual and family circumstances.

And last summer the Office of the Surgeon General released a magazine-style, full color “Consumer Guide or People’s Piece” to compliment the Secondhand smoking report.

I am confident that the information in this Call to Action To Prevent and Reduce Underage Drinking; and in the secondhand smoking report, when broadly disseminated and discussed among parents, teachers, community leaders, and young people themselves, embraced and put into action, will literally save lives.

Our children deserve nothing less.