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Remarks as prepared; not a transcript. RADM Kenneth P. Moritsugu, M.D., M.P.H Thank you, Rachel, (Rachel O'Conner, DWI Coordinator, New Mexico Governor's Office) for that gracious introduction. Good morning, ladies and gentlemen. It's a privilege to deliver this keynote address. I want to give a special thanks to the Office of the New Mexico First Lady and your State Department of Health for extending the invitation and giving me the opportunity to share this time with you. I have the pleasure of spending a second consecutive day in your state; I spent yesterday in Santa Fe, where I enjoyed the opportunity to meet and listen to people from across the spectrum, passionate in their efforts to reduce underage drinking. I am quite impressed with what I have heard. Your state's prevention activities are thoughtful, they are coordinated, and they address the underage drinking issue on many fronts. I was joined yesterday by Mrs. Barbara Richardson, your state's First Lady. While her schedule does not permit her to be here today, I want to commend Mrs. Richardson for her activism to reduce underage drinking. Mrs. Richardson is a member of the "Leadership to Keep Children Alcohol Free." The organization, made up of more than 50 current and former First Spouses, serves as a catalyst for change. Its' focus is to combat underage drinking in children ages 9-15 years of age. The Leadership is collaborating with my office to promote the Call to Action To Prevent and Reduce Underage Drinking at the state level. In February 2007, Mrs. Richardson joined young people from 12 counties across the State to launch New Mexico's 2007 Sticker Shock campaign. As many of you already know, the Sticker Shock campaign involves placing warning stickers on multi-packs of beer, wine coolers and other alcoholic beverages that might appeal to underage drinkers. Her work with this campaign is representative of her commitment to the issue. Also here and representing the Leadership is former first lady Hope Taft of Ohio, who now serves as Executive Director of the Leadership. I would also like to recognize staff from the DC area with me today. Steve Wing is from the Substance Abuse and Mental Health Services Administration. Steve is the Associate Administrator for Alcohol Prevention and Treatment Policy. Trish Powell from the National Institute on Alcohol Abuse and Alcoholism's Office of Science Policy and Communications is also here today. As I've traveled throughout the United States to bring attention to underage drinking, Steve, Trish and Hope have been very supportive in our efforts in the Office of the Surgeon General. It has also become clear to me that countless numbers of people in New Mexico are likewise committed to reducing underage drinking. In the past 24 hours alone, I have met many dedicated people who are committed to ending the serious personal, social, and economic consequences that are caused by underage drinking. I thank them and I thank you. The use of alcohol by young people is, of course, a pressing public health concern. Many in the audience today are familiar with the association between youth alcohol use, the prevalence of driving while intoxicated (DWI) and traffic crashes. You know better than most that underage drinking is a critical public safety issue. Whether you are a state government official,
you know that underage drinking must remain an issue of paramount concern. Quite simply, the future well-being and productivity of our kids are at stake. Priorities As the Acting Surgeon General, I am charged with promoting the health and wellness of all Americans. I want to take a moment to discuss some of our top priorities in the Office of the Surgeon General. The first is Prevention - what each of us can do in our own lives and communities to make ourselves and our families healthier. According to the C-D-C, more than 90 million Americans live with chronic disease. Chronic disease causes seven out of 10 deaths every year. And treating people with chronic disease accounts for about 75% of the $2 trillion America spends on health care each year. Our health system is focused on treatment instead of prevention. We must place more emphasis on prevention. Keeping people healthier longer reduces the cost of care and can contribute to a longer life. Five key steps can prevent most chronic diseases:
We need more Americans to embrace these steps to a healthier life. The second priority which we are especially focused is Eliminating 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. In our great nation, we still have major disparities in health and health care delivery. It is imperative that things change. I can assure you that the Department of Health and Human Services is committed to eliminating health disparities. Change is likewise vital when we discuss Health Literacy, the ability of an individual to access, understand, and use information and services to make appropriate health decisions. Improving health literacy is another priority of my office. Nearly 9 out of 10 American adults lack the skills needed to take care of their own health, or know how to prevent disease. We know that low health literacy impacts health. As health care continues to become more complex, the importance of being health literate will increase. More than 90 million people cannot adequately understand basic health information. And health illiteracy is impacting people of all ages, races and education levels. Yes -- even seemingly highly educated patients can have trouble understanding basic health information. So what can you do? Or better yet, what can we do? Well, in order to most effectively support substance abuse prevention, your messages must be truly We all have a responsibility 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. Not every American is a scientist or a doctor or a health care professional, and we can't expect them to understand what it took us years of training to learn. I know that my mechanic doesn't expect me to know how to change the transmission in my car. And I shouldn't expect him to know how to perform a tracheotomy. We need to build bridges between what we know and what the people we serve understand. The more people know about health, the better they can take care of themselves, their friends, their families, and their communities. I am very passionate about health literacy because I firmly believe that by improving health literacy, we can save lives. In the State I came to your great state on the invitation of your First Lady. As I suggested earlier, she is very passionate about ending underage drinking and building a better quality of life for the youth of New Mexico. I know there are many of you who are just as passionate. That is why you are here today. You're here because you care. Underage drinking cuts across populations and geographic boundaries. We know that nationally, 5,000 people under age 21 die every year from alcohol-related injuries involving underage drinking. Of that number, about 1,900 are deaths associated with motor vehicle crashes, some 1,600 result from homicides, and approximately 300 deaths are from suicides. A snapshot of the situation here in New Mexico is telling.1 In 2005, more than a third of New Mexico 9th graders and roughly half of 11th and 12th graders reported drinking alcohol in the past month. Dangerous binge drinking -- drinking five or more drinks on a single occasion -- was the norm among certain youthful drinkers. Some 60% of 9th grade drinkers and more than 70% of 11th and 12th grade drinkers reported binge drinking in the past month.2 New Mexico has among the worst rates* (*Deaths per 100,000 population age-adjusted to US 2000 population) for each of the three leading causes of death in the underage population - suicides, homicides, and motor vehicle crashes. A significant proportion of each of these causes of death is attributable to alcohol. The motor vehicle traffic crash death rate in New Mexico ranks 6th among 10-19 year-olds.3 The suicide rate in New Mexico ranks 3rd among 10-19 year-olds.4 The homicide rate ranks 9th among 10-19 year-olds. The good news is that many of you have responded at the state level. In 2006 the administrative penalties for sales and service to underage drinkers were significantly strengthened in New Mexico. In 2007, New Mexico's Attorney General joined other state AGs in a successful effort to remove new alcohol products specifically targeted to youth. In addition, a variety of your state and local agencies are working harder than ever to enforce existing underage drinking laws, change community norms, implement environmental strategies, teach life-skills programs, and provide after-school and alternative activities for young people.5 The 2005 National Survey on Drug Use and Health estimates that there are almost 11 million underage drinkers in the United States. We also know that drinking and binge drinking ramp up during the teen years. Nearly 20 percent of 14 year olds say they have been drunk at least once. This needs to stop. It was with that understanding that we released the Surgeon General's Call to Action To Prevent and Reduce Underage Drinking in March. 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. Accordingly, the 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. You are well aware of the consequences of driving while intoxicated. But underage drinking also contributes to violent crime, traffic accidents, burns, drowning, alcohol poisoning, addiction and dependency, and suicide attempts. This is unacceptable. It is also preventable. All of us, from policymakers to parents, can be change agents for the health of young people and others at risk and in need. That is why I am here. Working together, we can accomplish much more than working alone. Put another way, we must "connect the dots." In a real sense, the Call to Action is given vision by YOU, stakeholders, activists and leaders at the state and community levels. YOU are best positioned to make good things happen, to bring about change among your friends, neighbors and children. YOU are positioned to bring people together and to create attitudinal change. YOU are positioned to influence young people and their families as we "push back" against what has long, and wrongly, been regarded as an inevitable feature of popular culture - that young people, adolescents will drink alcohol. Our common interest is reducing underage drinking and the cause is given a voice by this Call to Action. It is important to understand that our efforts to reduce underage drinking are meant to ensure that our children have the greatest opportunity to succeed. Our goal as parents, and caring adults, is to provide them with tools to make positive and healthy choices. Making healthy choices, such as delaying drinking, will help them achieve success. Recent research shows that the brain continues to develop well beyond childhood and throughout adolescence. When I was in medical school - many, many years ago - we all believed that the brain stopped developing considerably earlier. The reality is that alcohol is the most widely used and abused substance among youth. Among people under age 21, alcohol is a leading contributor to "death from injuries" - the main cause of death in that age group. Moreover, a higher percentage of young people between the ages of 12 and 20 use alcohol than tobacco or illicit drugs. Alcohol also plays a significant role in risky sexual behavior including unwanted, unintended and unprotected sexual activity. In turn, this behavior increases the risk for unplanned pregnancies and for contracting sexually transmitted diseases. It also increases the risks of physical and sexual assault. Alcohol use interacts with conditions such as depression and stress that contribute to suicide, the third leading cause of death among people between the ages of 14 and 25.6 In one study, 37 percent of eighth grade females who drank heavily reported attempting suicide, compared with 11 percent who did not drink.7 And underage drinking is a well-established risk factor for heavy drinking later in life. Youth who begin drinking before age 15 are five times more likely to have alcohol problems after age 21. In short, underage drinking is risky. Underage drinking is multi-dimensional. To effectively make changes we must approach underage drinking from many different levels. We need to "connect the dots" between public health - to law enforcement - to public safety - to public education - to parental involvement - and, to our youth. As I mentioned, 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. The Call to Action to Prevent and Reduce Underage Drinking articulates the Federal commitment to the underage drinking issue. The goals include:
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. The Federal policy effort to address underage drinking is coordinated by the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD). The committee's member agencies support a wide range of programs in a comprehensive response to the challenge of preventing underage drinking. I've had the opportunity to meet and consult with members of New Mexico's comparable state-level committee. I applaud its members for their focus and direction. I left the session struck by a singleness of purpose. I left convinced more than ever that our cause is a common one, Federal Initiatives I would like to take a few moments to highlight what we are doing at the federal level. Through the Enforcing Underage Drinking Laws (EUDL) initiative, the U.S. Department of Justice devotes dollars to enforcement, to holding young people, parents and communities accountable. Concurrently, SAMHSA has reached out to parents, their children, educators and others. SAMHSA convened more than 1,200 Town Hall Meetings in all 50 states last year. With the Ad Council, SAMHSA has 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. "Reach Out Now," a unique school-based underage drinking prevention initiative designed specifically for use by fifth- and sixth-grade students, their families, and their teachers, is another SAMHSA project. The National Institute on Alcohol Abuse and Alcoholism (NIAAA), a component of the National Institutes of Health, has been and remains invaluable in helping further the Call to Action. The agency is a co-founder of the Leadership to Keep Children Alcohol Free, the First Spouse organization in which your First Lady is so active. It is accurate to say the Federal effort to prevent youthful drinking would not be where it is without NIAAA's guidance and leadership. Publications To facilitate the cultural change we all seek, the Office of the Surgeon General has created Guides to Action for Families, Communities, and Educators. These plain-language guides help people understand what the Call to Action says and what it means to them. They 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. To extend reach of the message, we need to strengthen links - among public health, law enforcement, public safety, public education, parental involvement and circling back, always, to young people. When the American people rejected the use of tobacco and illicit drugs as a culturally acceptable behavior, the use of those substances declined, and the culture of acceptance shifted to disapproval. The same change process is possible with underage drinking. Parents are on the front lines and have the ability to make change happen. Parental opinion is actually one of the key reasons young people choose not to drink. Parents must talk to their children. Parents must talk with their children - often and early in life. When they do, parents must trust themselves, believe in their message [e.g., 'Underage Drinking Is Dangerous'] and trust their kids. Students perhaps should talk to your own younger brother or sister about alcohol. Parents need to become involved and remain involved with their children's decision-making. Parents must send a clear, unequivocal and consistent message that underage drinking is unhealthy, unsafe, and unacceptable. Period. When parents do so, they won't be popular. However, they will be responsible. This is called tough love. It is never too early to talk to kids about alcohol, to give them accurate information about drinking, to answer the questions, even those they do not ask. We are following the evidence where it leads. And it points to the risks of drinking for young people. Alcohol's worst consequences are not inevitable, but they are real and can be indelible. Think again of the spike in violent crime, teen suicides, promiscuity and pregnancy directly attributable to underage alcohol use; Think of the increased numbers of young people taken into custody, incarcerated; Think of the costs of addiction treatment; The families and lives disrupted; The futures of young people lost. Think about it. I strongly encourage each of you to continue to pursue a comprehensive approach to preventing and reducing underage drinking here in New Mexico. Continue your leadership. Redouble your efforts. Get others involved. Get parents involved. Talk to young people. Share the reasons to care about the perils of underage drinking. The consequences of underage alcohol use are not consistent with what we want for our youth, what we all want for our families, friends, loved ones and neighbors. They are inconsistent with a healthier New Mexico and a healthier Nation. I encourage you to engage in dialogue today that will lead to recommendations for community interventions or as a guide to local and state policy development. The poet and playwright, Henrick Ibsen, once said, "a community is like a ship; everyone ought to be prepared to take the helm." We should all take the helm and prepare our children for a healthy future. Together, we need to step up and push back in ever greater numbers. As we do, we can help our children attain what we want for them, and what they deserve: healthy bodies, healthy minds, healthy spirits ... healthy and safe communities! Thank you. 1 (Source: Fact Sheet compiled by Jim Roeber, Epidemiology and Response Division, New Mexico Department of Health) ### Last revised: October 1, 2007 |
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