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Remarks as prepared; not a transcript. RADM Kenneth P. Moritsugu, M.D., M.P.H Good afternoon Thank you, Mona for that gracious introduction. [AANP President Dr. Mona Counts] It is an honor to be here. I am always delighted to spend time with fellow health professionals who dedicate their lives to serving others. And I am especially grateful to have the opportunity to be here with you at this very important annual meeting of the American Academy of Nurse Practitioners. My bosses, Department of Heath and Human Services Secretary Mike Leavitt and Assistant Secretary for Health Admiral John Agwunobi, both asked me to bring you their best wishes. We are very grateful for your work on behalf of all Americans. We know that for many of you the practice, research, and teaching of nursing is a calling. It is a calling:
Because of you, we are reducing the risk of disease for countless Americans; and improving their quality of life as well. Because you understand that health is health of body, health of mind, and health of spirit. Thank you for your service and dedication. Nursing Being the Acting Surgeon General gives me a visible platform, and I often emphasize the importance of nursing. It is the first thing I think of when I awake, and the last thing I think of when I go to sleep … I am married to a nurse! Nurses have always played a major role in the health of our nation, and today your role is rapidly expanding, as it should. You care for patients in hospitals, clinics, emergency rooms, urgent care sites, doctor's offices, your own NP practice, schools, and public health departments. You provide the 'round-the-clock assessment, and you use your voice to communicate the needs of your patients. This requires compassion, skill, and continued training in health care technology, where new advances are made every day. Nurse practitioners are also patient advocates. Your voice protects the safety, dignity, and best interests of all people. Your voice is large, your voice is loud, and your voice matters. Moreover, there are two Senior Health Fellows in the Office of the Surgeon General, sponsored by the Nurse Practitioner Foundation - two senior nurse practitioners who are spending one to two years with us, assisting me in communicating the best science and health information to America. They are Dr. Mary Beth Bigley, and Dr. Cathy Wisner. We are grateful for their perspective, and the perspective of nurse practitioners in what we do. Evolution of the Nursing Profession The nursing profession has evolved into a multidimensional profession. Specialties that include pediatrics, trauma care, intensive care, organ recovery and transplantation, rehabilitation, and long-term care - just to name a few - provide patients with the right care at the right time. The advanced practice nurse has also become a key player in many settings; and nurse practitioners are proving to be a tremendous asset, as we protect, promote, and advance the health and safety of our nation. Today you find nurses in all aspects of health and public health-beyond the clinical work--including communications and policy-setting. Your knowledge and experience -and your perspectives -- are crucial in these arenas. Keeping up with technology has created other specialties for nurses, including health IT. Schools of nursing and health care facilities are recognizing the role that nurses can play in developing and maintaining health IT infrastructures so that in the future, things such as electronic health records and telemedicine become standard. At HHS, we are working with health care organizations and leaders throughout the nation to help implement the President's vision of a seamless health care IT infrastructure. The broad use of health information technology will improve health care quality and help reduce medical errors. It is the key to reforming health care in America, and to improving health. How often does a patient sit in your office, writing health information on yet another set of paper forms? Then waited for lab results to be sent back to you? And then hand-carried X-rays from one office to another? When information can be shared electronically, it impacts every step in the health care process. For all of you who are involved in this effort, it is one of the most exciting aspects of health and health care today. Value Driven Health Care Initiative Health Information Standards are one of the four cornerstones of Secretary Leavitt's Value Driven Health Care initiative. These four cornerstones are:
The Secretary believes that consumers have the right to know the cost and quality of their health care, because providing reliable cost and quality information empowers consumer choice. That is at the core of the Value Driven Health Care Initiative -- changing the marketplace and the way U-S consumers access information about health care quality and cost. Health I-T will be important for gathering and using the best information for consumers. These standards are also crucial to the goal of achieving electronic health records for all Americans. Priorities of the Surgeon General I am very impressed by the agenda that the American Academy of Nurse Practitioners developed for this meeting. Many of the topics addressed during this conference intersect with the priorities that are assigned to the Office of the Surgeon General. I want to take a few moments to tell you about those priorities.
Prevention Let's look at Priority number one: Prevention. Like many of you, prevention is the cornerstone of everything that we do at H-H-S. It is a priority for us because of the fact that each year millions of Americans die from preventable causes. These deaths, as well as the health care costs related to caring for our fellow Americans who are suffering from completely preventable diseases, are causing tremendous strains. Most health care costs are focused on treating chronic diseases and conditions such as diabetes, obesity, cardiovascular disease, and asthma.
And when you follow the money trail, you will see that it is heavily weighted toward treatment and end-of-life care. Many of you know that too little is spent on preventing these conditions. Right now we've got it backwards. We live in a treatment-oriented society. We need to change to a prevention-oriented society. We must refocus our efforts on preventing disease, illness, and injury. The good news is that most of the illness, suffering, disability, death, and resulting economic and human costs can be entirely prevented by effective public health programs. Five key steps can prevent most chronic diseases:
We have evidence-based strategies to address each and every one of these factors. We need to put these strategies into ACTION. And nurse practitioners can be part of that ACTION orientation. After all, that is the hallmark of nurses everywhere - ACTION! The challenge is to elevate public health as a discipline, as a profession, and as a cause for our focused attention and advocacy - to move our research and knowledge into action. Nurses and nurse practitioners are at that critical node of our health system, where you can help those we serve, hear, understand, and embrace these health messages, and put these messages into action, for their individual health and well being. Two Examples Let me give you two very specific examples of prevention activities in which you can become directly involved. 1. Preventing and Reducing Underage Drinking About three months ago, in early March, I released The Surgeon General's Call To Action To Prevent and Reduce Underage Drinking. The science and the evidence drove this decision. Why? Because 11 million of our youth (about 24%) are drinking; with 7.2 million engaging in binge drinking, and 2.3 million drinking heavily. The impact is that there are 5,000 deaths of our young people every year - 1900 from motor vehicle accidents, 1600 from homicides, and 300 from suicides, associated with underage drinking. And these are all preventable. Further, the science is clear that our brains and cognitive functions do not stop developing at age two, as had been originally believed, but continue to develop well into the twenties. Also, youth who begin drinking before age 15, are five times as likely to have drinking problems after age 21. To address this, we need to work together, to connect the dots, among our parents, our families, our community organizations, our health providers, our schools, our public safety and law enforcement personnel, everyone, including our youth themselves, to prevent underage drinking, and to prevent these horrible long term effects. 2. Second hand smoke Last year, we released the Surgeon General's Report on Second Hand Smoke, a 20 year reprise on the original report we issued in 1986. Back then, there was concern that second hand smoke affected non-smokers. Today, the debate is over; the science is clear. Second hand smoke affects the health of non-smokers, causes serious and significant illness, and death. Just as we have made great strides in reducing smoking, we need to work to reduce the impact of second hand smoke within our communities. And you can have great impact on this as well. Eliminating Health Disparities As I mentioned, another public health priority is the elimination of health disparities. While overall our nation's health has improved, not all populations have benefited equally. Many Americans who are members of racial and ethnic minority groups experience disparities in health outcomes and health care. 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. A closer look at some of the challenges that minority communities face reveals that:
All Americans - regardless of their race, heritage or gender - should have access to good health information and health services. We are addressing these issues with numerous programs and initiatives and by increasing public awareness through various programs such as the Heart Truth Campaign, A Healthy Baby Begins with You, and the Closing the Health Gap Campaign - all of which you can engage in your practices, your research, and your teaching. I encourage you to visit the H-H-S Office of Minority Health website to learn more about what we are doing in the Department to combat disparities in health delivery. The web address is www.omhrc.gov, Office of Minority Health Resource Center.gov. Health Literacy Health literacy is another priority which spans across all of the other priorities; without health literacy, all other efforts are futile. Nurse practitioners continue to improve Americans' health literacy. You are responsible for much of the patient teaching in this country. Patients and their families depend on you to explain procedures, treatments, medications, and aftercare in ways that they can understand. People listen to you and use the information you provide to make educated decisions about their health. Health literacy - or should I say, illiteracy - can have a tremendous impact on our minority communities. Health literacy is the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions. More than 90 million people cannot adequately understand basic health information. And health illiteracy is not only impacting our minority communities, it is impacting those from all ages, races and education levels. How can we expect people to beat - or even control - chronic illness if they can't understand basic health information? Here in the United States, much attention has been paid to health literacy. For instance, The Institute of Medicine's 2004 report, Health Literacy: A Prescription to End Confusion, found that nearly half of all American adults have difficulty understanding and using health information, and there is a higher rate of hospitalization and use of emergency services among patients with limited health literacy. Building upon that report, last year the Institute of Medicine convened a quarterly Roundtable on Health Literacy. The roundtable brings together various H-H-S agencies, and professional organizations. Participants this year will continue to discuss challenges facing health literacy practice and research AND to also identify approaches to promote health literacy. As nurse practitioners, you understand the importance of being able to translate complicated health information into easy to understand information that is communicated clearly, accurately and effectively. You know it's important for your patients so they can make the best decisions about their health. We depend on the communication skills of providers - like many of our nurse practitioners who are here today. It's important that in your mission to care and to cure - that your health messages are understood by the individuals you serve. This is especially important when preparing our Nation for a public health emergency. Many of you will be on the front line when disaster strikes. We all have a responsibility - the nurses, the doctors, teachers, researchers, emergency preparers, and H-H-S leaders -- to ensure that we translate the science and data into medical and health information that can be heard… understood… embraced… and ultimately put into action. But remember that the fight to end health illiteracy shouldn't start in your office. It must start with programs to promote health literacy, education and promotion. These programs should be developed with involvement from the people who will use them. And these efforts must also take into consideration the cultural and language barriers many in our Nation face. Care systems, the media, and education and community programs can all join the effort in promoting a more health literate nation. Emergency Preparedness As I mentioned, our ability to communicate effectively will be particularly crucial when preparing our Nation for an emergency. Which brings me to another important component of our prevention efforts, and one of my Office's top priorities -- emergency preparedness. The terrorist events on 9/11, hurricanes Katrina and Rita, and the new threats of pandemic flu have firmly planted emergency preparedness on our nation's health agenda. September 11 was a tragic event in the history of the United States and the world. It was also a turning point for us in terms of homeland security. And the series of hurricanes that hit Florida's shores over the past few years brought another wave of awakening. We have learned through experience that disasters can strike at anytime, anywhere. Disaster takes many forms - a hurricane, an earthquake, a tornado, a flood, a fire, a pandemic flu, or a hazardous spill … an act of nature or an act of terrorism. A disaster builds over days or weeks, or hits suddenly, without warning. And every year, millions of Americans face disaster, and its terrifying consequences. We know that we cannot always prevent emergency situations, but we can be prepared so that they do not become large-scale disasters… and we can prevent some of the health consequences that arise from disasters. Over the past few years, emergency preparedness has become a major part of our mission to protect, promote, and advance the health and safety of the nation. The Office of the Surgeon General oversees the operations of 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 are becoming more highly trained each and every day to respond to all-hazards emergencies. We are actively recruiting nurses and nurse practitioners, and this is an unabashed recruitment message to all of you. Please visit our website, www.usphs.gov, to learn more. Medical Reserve Corps The Office of the Surgeon General also oversees the Civilian Volunteer Medical Reserve Corps. The M-R-C is a national system of community-based teams of medical and public health volunteers. They are a way to organize health professionals who want to donate their time and expertise to prepare for and respond to emergencies and promote healthy living throughout the year. In many ways, the M-R-C units across the country support the Commissioned Corps, strengthen the public health infrastructure, and improve emergency preparedness. And make no mistake about it: Nurse practitioners are an important part of this volunteer network. More than 121,000 volunteers across the Nation have joined their local M-R-Cs, because they want to support the public health missions in their communities. These units have taken on many roles and missions. For example, many of these M-R-C units were extensively involved following the devastating hurricanes in 2004, and several helped their neighbors following Hurricanes Katrina and Rita in 2005. Please consider joining your colleagues locally in this honorable work. For more information about the Medical Reserve Corps, please visit www.medicalreservecorps.gov Pandemic Flu Preparedness Another important area that we continue to work on - even as the media buzz has died down - is pandemic flu preparedness. Dozens of countries - across three continents - have seen H-5-N-1 claim poultry and wild birds. The disease is highly pathogenic, and it continues to spread. While we cannot be certain H-5-N-1 will be the spark of the next pandemic, we can be sure that pandemics happen. They have happened in the past and they will happen in the future. That is why we continue to take this threat so seriously. Preparedness must involve planning by every level of government, every school, every business, every church, every civic organization, and every one of our professional public health associations: including the A-A-N-P. Every family and every individual also need to have a plan. To make sure people have the information they need to have an effective plan, in February Secretary Leavitt announced two new initiatives. The Community Mitigation Guidance document helps communities understand appropriate steps to follow depending on the severity of the pandemic. These steps may include the closing of schools, canceling of public meetings and the need to stay home for an extended period of time. By anticipating the need for these activities, we can execute them more effectively. These steps can help reduce the spread of disease. And stopping the spread of disease means we will be saving lives. Nurse practitioners are an integral part of our communities across the US, and you can help spread the word. The second initiative the Secretary announced was a public service announcement campaign. This P-S-A campaign provides useful tips and helps people know what to do about pandemic flu. The bottom line is that at H-H-S we understand the continuing threat of avian influenza - as well as other influenza strains that could evolve into a pandemic - and we continue to take steps necessary for effective preparedness and response. Work must continue to ensure sustained actions that will minimize the morbidity, mortality, and social disruption that an influenza pandemic could cause. Closing and Charge I want to close this afternoon by thanking you for your dedication. Thank you for your continuing work, and for your commitment to improving the health of all Americans. Today I want to ask for your continued leadership in preparing our Nation for a public health emergency and for helping our nation to prevent deadly diseases. A final web address for your reference, one which I hope will be easy to remember. You can look up anything I have mentioned today, on the Surgeon General's website: www.surgeongeneral.gov. Looking around this room, I know that through your efforts, and our strong and growing partnership with A-A-N-P, we can ensure better health, safety, and security for all Americans. I look forward to working with you during this meeting and beyond. Thank you for your commitment and your service:
### Last revised: September 28, 2007 |
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