Remarks as prepared; not a transcript.

Vice Admiral Richard H. Carmona, M.D., M.P.H, FACS
United States Surgeon General
U.S. Department of Health and Human Services

Remarks by the Surgeon General at the 2005 Senate Hispanic Leadership Summit

Wednesday, September 28, 2005
2:40 p.m.
Washington, D.C.

"Improving Healthcare in the Hispanic Community”

Thank you, Senator Hutchison, for the wonderful introduction. I’m honored to be here today, surrounded by so many of our country’s Hispanic leaders.

I was raised to believe in the power of our community, in the need to help others, and to give back.

Being the Nation’s Doctor is a tremendous responsibility, one that I could not do without a great support team. Luckily, one of my duties as Surgeon General is to lead the United States Public Health Service Commissioned Corps on behalf of the Secretary of Health and Human Services, and I could not do my job without them.

U.S. Public Health Service Commissioned Corps
The Public Health Service is one of our nation’s seven uniformed services, like the Army and Navy. We are a Corps of 6,000 public health professionals, dedicated to our mission of protecting, promoting, and advancing the health and safety of the nation.

Our officers work around the world to help in times of disaster and to provide day-to-day healthcare for underserved populations in our nation.

Right now we are responding to the unprecedented natural disaster in the wake of Hurricane Katrina and now Rita. Over the last month, over 1,400 of my Public Health Service officers have deployed to Louisiana, Mississippi, and Texas to support the needs of the people affected by Hurricanes Katrina and Rita. Their contributions have been as diverse as their professions and training, and I could not be prouder of their efforts than I am at this defining moment.

We've sent clinical teams to support special needs shelters, hospital staffing, primary care outreach, and the mass immunization of evacuees. We've deployed engineers, environmental health officers, veterinarians, epidemiologists, pathologists, pharmacists, mental health professionals, and even food inspectors to affected areas.

Our officers are coordinating HHS resources across three states and in major cities like Houston, New Orleans, San Antonio, Dallas, and Baton Rouge. They are manning state and Federal emergency operations centers, and doing whatever it takes to protect the public health of the American people.

Many of the officers deployed are Hispanic or Spanish-speaking, and they have been helping our Hispanic citizens displaced by the hurricanes who cannot communicate their needs to English-speaking doctors.

However, there is still a great need for Hispanic Public Health officers. The Public Health Service is a great way to serve your country and a great career opportunity for those interested in public health, particularly given the level of support that we receive from President Bush.

Priorities and Health Literacy
When President Bush nominated me to be Surgeon General, he asked me to focus on three priorities. They are:

  • First, Prevention. - What each of us can do in our own lives and communities to make ourselves and our families healthier.
  • Second, and new to the Office of the Surgeon General, is Public Health Preparedness. We are investing resources at the federal, state, and local levels to prevent, mitigate, and respond to all-hazards emergencies.


  • Third, Eliminating Health Disparities. I am so proud that President Bush charged me with working with him and all of you to eliminate health disparities. Notice that he didn’t just charge me with reducing health disparities. He said we will eliminate health disparities.

Woven through these priorities is health literacy. It is the currency for success in everything that we are doing in the Office of the Surgeon General.

Health literacy is the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions. People of all ages, races, incomes, and education levels are challenged by low health literacy. Even the seemingly simple things that we can all do to stay healthy and safe, such as getting regular medical check-ups and eating healthy foods, can be struggles for many people. The reality is that to be able to do these things, we must have a basic infrastructure and understanding of why these choices are important.

Low health literacy is a problem in the Hispanic community. Health care professionals from other cultures sometimes have difficulty communicating necessary information to their patients, and messages aren’t always as clear as they could be. It’s partly a matter of not understanding culture - of believing that all that’s needed is translation services.

The situation is improving. The Department of Health and Human Services and the Office of the Surgeon General are creating materials and reaching out in other ways to Hispanics in both Spanish and English.

HHS recognized the changing demographics of the older Hispanic population and has consciously increased outreach efforts to better inform older Hispanics and their caregivers of health resources that are available in Spanish.

I’m sure you all remember our Go Red Campaign to promote heart health from the National Institutes of Health with the American Heart Association. Over half of the subsequent calls for information on cardiovascular disease were from people who spoke Spanish.

Our Administration on Aging publishes Spanish-language materials on their website, and their Eldercare Locator, which connects older Americans and their caregivers with sources of information on senior services, is staffed with Spanish-speaking information specialists. These efforts have resulted in a 43% increase in Hispanic participation in AoA funded programs over the past three years.

Secretary Mike Leavitt has ushered in a new era in public health: one that embraces and promotes prevention-oriented medicine. Through HHS initiatives such as Steps to a HealthierUS, Healthy Lifestyles & Disease Prevention, and the Small Steps Campaign, we are encouraging American families to take small, manageable steps within their current lifestyle - versus drastic changes later on- to ensure long-term health.

7 of 10 Americans who die each year die of a chronic disease.

Most of these diseases are preventable by taking relatively simple steps: healthy eating, being physically active, and not smoking.

We need a paradigm shift in American health care.

There is no greater imperative in American health care than switching from a treatment-oriented society to a prevention-oriented society.

Nearly 8 million minority Americans are covered by Medicare, a fact that undeniably impacted the formation of the Medicare Modernization Act that President Bush signed in 2003. Improving Medicare improves healthcare for people of color. The proof is in the benefits:

  • Beginning this year, new Medicare beneficiaries are covered for a "Welcome to Medicare" physical exam. The exam is an excellent way to get up to date on important screenings and immunizations, and to talk with a healthcare professional about family health history. Beneficiaries will not pay deductibles or co-pays for the screenings or tests.
  • Included in the free screenings are cardiovascular blood tests-- total cholesterol, high density lipoprotein, and triglycerides tests. Cardiovascular disease disproportionately affects Hispanics, many of whom forgo initial treatment because they are unaware of free screenings.
  • The “Welcome to Medicare” physical exam also includes diabetes screenings. And for the millions of minority beneficiaries, who are at a heightened risk for diabetes, this is not just unprecedented - it's about time. Time to diagnose the disease, and treat it.

As you know, when Medicare was created back in 1965, it only provided services to diagnose and treat illness or injury. The value of preventive services was not well understood 40 years ago, and preventive services to keep people healthy were not covered by Medicare.

Now, we know better. It's a cost-benefit equation. We know that a healthy lifestyle means not only doing things like eating right and staying active, but also using preventive services that can keep secondary health conditions from developing as well as find health problems early, when treatment is likely to work best.

A vital part of prevention medicine is the use of prescription drugs. HHS, with the support of Congress, has widened the Medicare safety net to bring prescription drug coverage to all people with Medicare. Medical practice has come to rely more and more on new drug therapies to treat chronic conditions such as heart disease, hypertension, and diabetes, and out-of-pocket spending on drugs has increased dramatically.

For the first time, Medicare is offering significant help with the costs of outpatient prescription drugs, with Medicare prescription drug coverage beginning in 2006. All seniors and people with disabilities are eligible for the new benefit, and there is special help for those who are low-income. We anticipate that over one million Hispanics will qualify for extra help.

Medicare is taking many steps to make sure our seniors get the maximum help from all these new benefits and options. Through our 1-800 Medicare helpline which offers a Spanish-language option, consumer publications in Spanish, and trained health information counselors, we’re dedicated to bringing older Hispanics and their caregivers personalized assistance with all of their Medicare questions.

We want to help seniors in our community make the most of Medicare’s expanded benefits and enjoy the best quality of life available from our increasingly modern health care system.

Medicare is changing with modern times, but we hope that one important thing will never change: Medicare is still a safety net that American seniors can count on.

Charge and Closing
You all have the ability to bridge gaps so that more Hispanic families will have access to good health information. You interact with families and with the community as a whole on a regular basis, you know them, and you know the culture.

Whether it is working with places of worship, community-based organizations, partnering with community health centers or other provider organizations, you can make a difference.

Congratulations on your successes to this point. Stay strong. Never forget or underestimate the immense privilege and responsibility you have as leaders in the Hispanic community.

We’re lucky-we are working under a President who understands the Hispanic community, who recognizes the need to tailor programs to be culturally appropriate for Hispanics.

We need to take advantage of this time, to act on the behalf of all Hispanic Americans, and to make their lives healthier and happier.

Thank you.


Last revised: January 10, 2008