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

Friends of the National Institute of Nursing Research 2003 Conference

Wednesday, September 10, 2003

"Nursing Research: A Key to the Nation’s Health"

Thank you, Greg, for that kind introduction. [Gregory L. Eastwood, M.D., President of Friends of the National Institute of Nursing Research]

It’s good to be here with nursing colleagues and friends.

Being a nurse made me a better person and a better physician.

One of the reasons that President Bush and Secretary Thompson nominated me to be Surgeon General was because I had been a nurse.

They know that it’s always good to have a nurse in your corner!

It’s a tremendous honor to serve in this position. And to think that a little over a year ago, I was just another guy in Tucson, Arizona, working as a trauma surgeon, a professor, and a public health officer.

We don’t ever know what the future holds. We don’t in our lives, and we certainly don’t in science.

Being Surgeon General gives me an unbelievable platform, and as a former nurse, I often emphasize the importance of nursing care and nursing research. Nurses are the true caregivers.

I want to thank all of you for being here to support nurses and nursing research.

Years ago, nursing was exclusively about bedside care. Now the fact is that the nursing role has evolved to one that is a much more proactive part of the health care team, as well as the disease prevention team. That has broadened to nurse practitioners and nursing specialties, and nursing research has been the catalyst for many of these advances.

Because of nursing research — because of NINR’s intramural and extramural programs — the important work that nurses do is underscored by scientifically valid findings.

Because of nursing research, there is increased respect for the nursing profession.

Because of nursing research, there is greater recognition of the importance of nursing in the care of the patient.

For those of you who don’t know me, I’m a "recovering surgeon." I say that because I strongly believe, and many of you may agree, that at times surgery can be considered a barbaric process, especially in light of the new scientific knowledge that is rapidly evolving.

If a patient has an injured or diseased organ, or a cancer growing in her body, what do we surgeons do? More often than not, we cut her open, remove the organ or the cancerous area, and clamp off the bleeding. All the while subjecting her body to trauma, shock, and the possibility of infection.

But thanks to biomedical research and the great imaginations of scientists in academic, private, and federal laboratories, treatments are being developed that will make some surgery a thing of the past.

We are already beginning to screen genetic information and target appropriate interventions to help people avoid physical and mental conditions and diseases years before their first symptoms would have otherwise appeared.

Someday, nursing students may cringe in horror at theat tactics that we use today in an attempt to save human life. Someday, simply by altering the genotype of a host, an organ will resist disease or heal itself.

This is the future of nursing and the future of medicine. It’s exciting to be alive right now, and to be able to look forward to this exciting future.

President Bush and Secretary Thompson asked me to focus on three priorities for our nation. I’m fortunate to work with two leaders who understand the importance of health. Two leaders who insist that evidence and the best science always guide policy.

All three of my priorities are evidence-based. They are:

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

    and
     
  • Third, Eliminating Health Care Disparities.

    • Nursing research supports all of these priorities because it focuses on individual behaviors and choices that people can make every day to prevent illnesses and injury. It addresses factors such as diet, exercise, genetic screening, substance abuse, environmental toxins, and ethnic and cultural risk factors.

  • For example, one NINR-supported research program conducted by Martha Hill at Johns Hopkins University School of Nursing with colleagues from the Schools of Nursing, Medicine, and Public Health relates both to prevention and eliminating health care disparities.

    As you know, the death rate from heart disease is significantly higher for African-American males than for any other racial or ethnic group. This research, conducted in Baltimore’s inner city and focused on high blood pressure among young African-American men in Baltimore, is bringing us important new information and understanding about this population.

    Following an intensive prevention intervention over a 5-year period, the Baltimore men’s blood pressure control rates improved by almost 50%. This is significantly better than the overall national control rate of 27%.

    This was the first time that many of the young men had ever been contacted by any health care organization or offered any preventive health care.
    •

    Thanks in great part to this and other NINR research, we are on the brink of our next major evolutionary wave in public health. Think of the incredible evolution of public health over the past century.

    One major wave was the struggle against infectious disease. In 1900, our leading killers were influenza, pneumonia, diphtheria, tuberculosis and gastrointestinal infections. We fought these illnesses through sanitization, the development of effective vaccines, and mass immunization.

    And while we are still struggling with emerging infectious diseases such as SARS and persistent diseases such as HIV/AIDS, for the most part that cycle in public health is now complete.

    Another major evolutionary wave in public health has been the struggle against chronic disease. We are still in the middle of this fight.

    As we made progress fending off mortality from infectious disease, the "new" killers became cancer, heart disease, diabetes, and other chronic illnesses.

    In terms of numbers, chronic illnesses have replaced infectious diseases in their lethal force. However, the difference is that through behavior and lifestyle choices, individuals can exert more control over the occurrence and outcome of these chronic illnesses.

    Most chronic diseases that Americans suffer and die from today are preventable through diet, exercise, and avoiding risky behaviors.

    One of my greatest challenges is getting people to realize that health — whether good or bad — doesn’t just happen to them. It’s a result of the choices they make every day. As Surgeon General, I work to communicate the prevention message in such a way that people will not only understand, but will become willing to change their behavior.

    After all, we have heard the good health message over and over:

  • Make healthy choices,
  • Don’t smoke.
  • Eat healthy foods every day.
  • Exercise.

    • How do we communicate this prevention message in a culturally competent way, and in such a way that people will do it? That is one of our biggest challenges: developing messages that effect true behavioral change.

    Public health for the past 150 years has been largely concerned with keeping people alive and alleviating suffering. But recent scientific discoveries will translate into our ability to help people avoid illness entirely and get the most out of life.

    As this exciting science moves forward, medical researchers and all health professionals must ensure that Americans are informed, that they understand the context of scientific advancements, and that they know that policies are based on knowledge and science, not ignorance and hype.

    We must always keep improving the scientific process with fresh ideas and a fundamental commitment to serving humanity. And we must involve the public, through clinical trials and through health education and outreach.

    Nursing research does this. It helps to shape the future of nursing, and with it the future of medicine and the future of life.

    Let me leave you with this: Please keep thinking imaginatively and critically. Keep educating, innovating and collaborating. Keep asking the right questions.

    Be bold, embrace the unknown, decipher life’s mysteries. . . but let the world you serve experience your awesome feats as you compassionately shape the future of nursing!

    Thank you.

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    Last revised: January 9, 2007