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Remarks as prepared; not a transcript. RADM Kenneth P. Moritsugu, M.D., M.P.H Thank you, Marilyn, for the gracious introduction [Marilyn Roberts, Deputy Administrator, Office of Juvenile Justice and Delinquency Prevention]. Good morning, ladies and gentlemen. I am honored to be here today. It's a privilege to deliver this plenary address during your annual conference. I want to give a special thanks to O-J-J-D-P for extending the invitation and giving me an opportunity to share this hour with you. I'd also like to thank Administrator J. Robert Flores and your staff for all of the time and work that went into putting together this conference. As the Acting Surgeon General, I am charged with all matters related to promoting the health and wellness of Americans. Everyone in this room shares an understanding and a passion for improving the well-being of our Nation; I especially enjoy the opportunity to be among professionals who understand health as it relates to the justice system. I would like to mention a couple of top H-H-S priorities in particular. The first is Prevention - what each of us can do in our own lives and communities to make ourselves and our families healthier. Prevention also means stopping drug and alcohol abuse before they start - I don't have to tell you that prevention is the best strategy for reducing the tragic public and individual health consequences that are associated with drug and alcohol abuse. Because alcohol misuse and drug addiction are such complex and pervasive health issues, we must continue to strengthen our public health approach to addressing these problems. That is where you come in. At the same time, while overall our nation's health has improved, not all populations have benefited equally. The second priority upon which we are especially focused is Eliminating Health Disparities. Many Americans who are members of racial and ethnic minority groups experience disparities in health outcomes and health care. It need not be that in our great nation, with our global leadership in science and medicine, we still have major disparities in health and health care delivery. It is imperative that things change. The interaction of health, social services and the justice systems is very familiar to me and correctional health is especially important to me personally. I had the honor of serving as the assistant bureau director and the medical director of the U.S. Department of Justice Federal Bureau of Prisons. I've had a great deal of experience administering health policy and providing care to individuals involved with the justice system, whether in custody or in connection with other functions of law enforcement and criminal justice. For more than a decade, I saw firsthand the realities of correctional health in our prisons. These memories will be with me forever, and they continue to influence my work as Acting Surgeon General. I understand the challenges faced by those who work in corrections and those who work directly or indirectly in the arenas of juvenile and adult justice. I know that law enforcement, the administration of justice, ensuring public safety, and promoting public health is a tough job. Yet, many of you combine elements of all four disciplines in your work. And, many of you have chosen to serve "at-risk" young people - though many are perhaps only dimly aware of their own vulnerability. Thanks to the work you do, of course, this is changing. Accordingly, my bosses, President Bush, U.S. Department of Health and Human Services Secretary Mike Leavitt, and Assistant Secretary for Health Admiral John Agwunobi, and I truly appreciate your service and dedication to our nation. I applaud you for the work you do - on behalf of our Nation's young people to help preserve their promise, promote their health and protect their futures. The Office of the Surgeon General is pleased to have you as its partner. In a sense, we represent here today anyone with a professional or personal interest in reducing and preventing underage drinking among the American population. The number of people committed to this vital public health pursuit is surely in the tens of thousands. My message today is relevant not only to you - conference attendees and professionals who work every day to reduce underage drinking - but to them: the families of underage drinkers, and the broader audience of Americans who lives are affected and diminished by alcohol misuse. As the nation's Acting Surgeon General, I am charged with a critical public health mission: to protect and improve the Nation's health - and this Enforcing Underage Drinking Laws (EUDL) (pronounced you-del) 9th Annual Leadership Conference is consistent with that responsibility. That gives a simple answer as to why I am here. However, the explanation is insufficient. I - like O-J-J-D-P, its Federal and non-Federal partners, and everyone here in the audience today - recognize the benefits of successfully curbing underage drinking. We understand the issue of underage drinking. We are familiar with its perils. That's why in March we released the Surgeon General's Call to Action to Prevent and Reduce Underage Drinking. Underage drinking is not about spring break and it's not about parties. As early as ages 8 and 9, our children are confronted with decisions about alcohol on a regular basis in many settings - including at home and in school. The 2005 National Survey on Drug Use and Health estimates there are 11 million underage drinkers in the United States. Nearly 7.2 million are considered binge drinkers, meaning they drank more than five drinks on occasion, and more than two million are classified as heavy drinkers. This needs to stop. 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. The reality is our young people are being harmed by underage drinking. That's why this Call to Action is attempting to change the culture and attitudes toward underage drinking in America. Beyond the numbers, there are the human consequences of alcohol misuse. These costs are all-too-familiar. Underage drinking is an ongoing contributor to violent crime, traffic accidents, burns, drowning, alcohol poisoning, addiction and dependency, and suicide attempts. The National Academy of Sciences (NAS), Institute of Medicine (IOM) Report estimates that underage alcohol use costs the nation an estimated $53 billion annually. This is unacceptable. It is also preventable. Together, we can reduce the prevalence of underage drinking. We are change agents for juvenile health. That's why you are here. It is why I am here. It also explains why this gathering is so important. This National Leadership Conference has long served as a platform for leaders from across the country. It is a primary vehicle through which stakeholders come together and share how their states and communities are addressing underage drinking problems through law enforcement. This gathering is timely. In the summertime, youth are out of school and have large amounts of unmonitored free time to hang out with friends. Summer is the season when youth are likely to engage in risky activities. Compared with almost all other months, June and July have higher rates for youth's first-time use of alcohol. About a third of first time underage drinking occurs in the summer months. This conference also represents a real opportunity -- a chance to compare notes, exchange information, learn scientific research findings as they emerge, discuss related public policy developments and consider prospective next steps to further our common purpose. This environment encourages -- and enables -- discussion of other strategies designed to make alcohol less available to youth and community attitudes about underage drinking less tolerant. Working together, we can accomplish much more than working alone. Put another way, it is here that we "connect the dots." Our common interest is given voice by the Call to Action. In turn, response to the call is given substance by the Federal Justice, Health and Human Service, and Education systems - and our many allies and partners. I commend the Department of Justice and O-J-J-D-P in particular for your leadership in making the Call to Action real. To use a familiar sports analogy, you are the "go to guys." I say that because, at a basic level, the work done by the O-J-J-D-P and your colleagues in the broader justice and substance abuse service systems has helped us elevate awareness of underage drinking in communities and its impact on kids, families, and futures. You know change is possible. You are bringing it about. You are bringing people together. You are systematically mobilizing people who care. I thank you for "pushing back" against what has long, and wrongly, been regarded as an inevitable feature of popular culture - that young people, adolescents will drink alcohol. Through the EUDL (pronounced You-del) initiative, O-J-J-D-P devotes program dollars and resources to enforcement of laws, to holding young people, parents and communities accountable. However, you do something more: you promote and advance public understanding of underage drinking, its risks, and its consequences. You regularly and routinely collaborate with other organizations "outside of your silo" to share information about the insidiousness of alcohol misuse. While some may see EUDL's mission as something akin to administering "tough love" to young people at risk, EUDL reaches out to them and their parents, using accurate information to offer alternatives and help. Allow me to briefly reviewing what we know:
These data send a clear message. 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! Enforcement of Underage Drinking Laws - EUDL's essence - is a critical element in a comprehensive plan to reduce youth access to alcohol and prevent and reduce underage drinking. Social availability of alcohol to youth is the challenge we face. We must work to convince parents and other adults that underage drinking today is anything but a harmless "rite of passage." Rather, it is a dangerous and potentially lethal practice. It casts a wide net. Consider its reach. Think again of the spike in violent crime, suicides, injuries, and traffic fatalities directly attributable to underage alcohol use; the increased numbers of young people taken into custody, incarcerated; the costs of addiction treatment; families and lives disrupted; futures of young people lost. Underage drinking is multi-dimensional. To effect change we must approach underage drinking from many different levels. Rather than working separately, we need to "connect the dots" from all sectors of society: federal, state, and local levels. We need to "connect the dots" between public health-to law enforcement-to correctional health-to public safety-to public education-to parental involvement - and of course, to the children. Together we can accomplish more. As I mentioned before, alcohol is the most widely used and abused substance among our Nation's youth-more than tobacco and illicit drugs COMBINED. And over the past few years, there has been a significant decline in tobacco and illicit drug use among teens, while underage drinking has remained at consistently high levels. Our JOINT efforts in lowers rates of tobacco and illicit drug use are working. But there is still more to be done with regard to underage drinking. And by tackling an issue-a public health issue, law enforcement issue, mental health issue-from a group perspective rather than an individual perspective, we can save more lives. The work that you all do encompasses areas that the Office of the Surgeon General and the Department of Health and Human Services have formally identified among our priorities. Moreover, the Call to Action to Prevent and Reduce Underage Drinking articulates the Federal commitment to the underage drinking issue. The goals include:
To date, I am quite encouraged by the response to these 6 goals. The Federal effort to address underage drinking is coordinated by the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD) and chaired by the Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA). The committee's member agencies support a wide range of programs in a comprehensive response to the challenge of preventing underage drinking. I would like to take a few moments to highlight certain initiatives in particular. The EUDL program's support of partnerships between law enforcement agencies and underage drinking prevention advocates in all 50 States and the District of Columbia and its training and technical assistance efforts are models for stakeholders in the field. Youth courts, also called teen, peer, and student courts, are those in which youthful offenders are sentenced for minor delinquent and status offenses or problem behaviors by their peers. Federal funding supports training; technical assistance; program development guides; operational materials for adults and youth; data collection; research; and other efforts to support local youth court programs. In 2004, OJJDP assumed management of the juvenile and family drug court program for the Office of Justice Programs (OJP). The drug court approach operates within the juvenile justice system to address the unique needs of juveniles with alcohol and drug disorders and within the civil justice system, to address the substance misuse of parents who are charged with abuse and neglect of their children. The drug court program system combines sanctions with drug, testing, treatment and aftercare to promote abstinence and appropriate behavior. The Call to Action alludes to several activities which have been associated with state EUDL programs. Among them:
Programs like these can be established in any community. The National Highway Traffic Safety Administration, within the Department of Transportation, partners with Students Against Destructive Decisions (SADD) to develop numerous program materials to address underage drinking and driving. New materials apply prevention principles learned through SADD programming for high school youth. At the same time, indicative of its own pro-active efforts to reach parents, teens, educators and others, SAMHSA's contributions to the dialogue have been ongoing and far-reaching. In fall 2005, the ICCPUD agencies held a one and a half day national meeting on the prevention of underage drinking. The meeting informed State teams about the most recent research; and provided an opportunity for each team to start planning how they could strengthen their own efforts to reduce underage drinking. SAMHSA convened more than 1,200 Town Hall Meetings in all 50 states last year. Its theme, a message to parents, teachers, clergy and mentors alike, was "Start Talking Before They Start Drinking." The meetings provided an opportunity for communities to learn more about new underage drinking research, and to discuss how their community could best prevent underage alcohol use. The Ad Council and SAMHSA have developed an underage drinking prevention campaign directed at parents of 9- to 15-year-olds. Products include four television PSAs as well as PSAs for radio, print, and Internet. Another SAMHSA collaborative project, "Reach Out Now" is a unique school-based underage drinking prevention initiative designed specifically for use by fifth- and sixth-grade students, their families, and their teachers. Each year, Reach Out Now, materials are distributed to public, private, and parochial schools nationwide to provide teachers, students, and their families with easy-to-use, informative alerts to the dangers of underage alcohol use. The Department of Education's Office of Safe and Drug-Free Schools (OSDFS) program provides funding to local schools to implement evidenced-based programs to prevent and reduce underage drinking. The program targets the reduction of binge drinking and attitudes and beliefs about alcohol use through school-based model programs involving schools, families and communities. OSDFS has also funded campus and community-based prevention programs for two decades, in response to alcohol and other drug abuse and violence on college campuses and in their surrounding communities. The programs I have just mentioned are illustrative, only a snapshot. For more exhaustive information on Federal programs relevant to underage drinking, I urge you to visit www.StopAlcoholAbuse.gov. It is important to remember that the degree of success we achieve in reducing underage drinking will be only as good our ability to effectively communicate with young people "wherever they are." In order to adopt our message, young people must first listen to it. In order to effectively listen, to truly hear our message, they must first understand it. That's why the Office of the Surgeon General has created what we call Guides to Action for Families, Communities, and Educators. These documents [HOLD UP DOCUMENT] are available to empower families, communities, and educators with the knowledge and tools useful in delivering the underage drinking message in a way that is easy to hear…understand…embrace…and put into action. Published by HHS, the guides are premised on what we know. By making underage drinking information easier to understand and available in this way, we make it easier for our intended audience to become and remain receptive to our message. Young people are better positioned and better able to make sound and appropriate choices when the take- home message is clear. The Guides are written with the best sense of where our listening audience is coming from. These are plain-language guides to help people understand what the Call to Action says and what it means to them. We now issue a guide with every Surgeon General's Call to Action or Report, and have done so for several years. This speaks to the broader issue of health literacy - the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions. That's why H-H-S, as a Department, is taking what we know and creating tools to help health organizations, care givers, professionals, service and information providers - like you - improve health literacy all over the country. Health Literacy Website and Quick Guide For example, we've developed a Health Literacy Improvement portal. This portal is equipped with health literacy research, best practices, tools, and steps that you can take to improve the ability of young people, parents, and mentors to understand, for instance, just how consequential underage drinking is. Some of the best practices for health care organizations and providers include:
I am requesting that, in your work every day, you help us get more people on board. Whether you call it health literacy or not, you and your colleagues routinely help to break down communication barriers with young people, their parents, mentors, everyone with whom you come in contact each day. Please continue to promote health literacy in your communities. All of us - government, academia, justice system and health care professionals, corporations, and communities - need to work together to improve health literacy. In every interaction with kids, families, caregivers and others, look for ways to ensure that people understand that they can make the right choices, whether it pertains to drinking or - more broadly - what they need to do to stay healthy. We need you to be health literacy ambassadors and share this information with your colleagues and organizations. This will advance health literacy across America. Health literacy can save lives, save money, and improve the health and well-being of millions of Americans. I want to also make you aware that HHS has developed a Quick Guide to Health Literacy, a brief and easy-to-use manual for improving healthy literacy. The portal can be found at: www.health.gov/communication/literacy Closing and Charge I want to again thank you for all that you do to help young people make the appropriate choices when it comes to alcohol. Trust them. Trust yourselves. Trust your message. Continue to offer information, to discuss risks and consequences, even if the young people do not ask the questions. Continue to talk to parents, to encourage them to talk to their children about alcohol, to guide their kids, to get - and remain - involved with their decision-making. Remember: parents of teenagers often underestimate the extent to which their opinion matters to their children. Parents' disapproval of underage alcohol use is actually one of the key reasons young people choose not to drink. It is never too early to talk to your kids about alcohol. By reaching out, by creating and expanding coalitions, by working collaboratively, our efforts to curtail underage drinking will have a steadily wider reach. Everyone here will be ever more effective. I am confident that - when broadly discussed among parents, teachers, community leaders, and young people themselves - the goals of the Call to Action to Reduce and Prevent Underage Drinking, will be understood, appreciated, embraced and will literally save lives. I am asking you to redouble your efforts - then watch the results!!!!!! Our young people deserve nothing less. As I close, I want to remind you that the Call to Action encourages the criminal justice system to increase the knowledge of judges and those with whom they work about adolescent development and the nature and scope of underage drinking. Such knowledge will help adjudication and monitoring of cases involving underage drinkers. For that reason, the session following this plenary address, I believe, will be of particular interest to all of you. Members of the judiciary will participate in a panel discussion of the Underage Drinking Call to Action and its relationship to the justice system. I look forward to working with all of you as we build bridges and "connect the dots" in our fight to end underage drinking. Its human consequences, its lasting damage, are antithetical to what we all want for our healthy communities: healthy bodies, healthy minds, and healthy spirits ... healthy and safe communities, where our youth can grow and thrive! Thank you. ### Last revised: August 16, 2007 |
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