Two Former U.S. Surgeons General Give Advice on Becoming the Healthiest Nation
| April 28, 2017 | Our ethics must be as sophisticated as our science, said former U.S. Surgeon General David Satcher on April 20 to UAMS faculty, students and staff.
Satcher, at UAMS to discuss how the United States could become the healthiest nation, was quoting from former U.S. Secretary of Health and Human Services Donna Shalala’s commencement address on the day of the president’s apology for the Tuskegee syphilis study.
Satcher said the country has a long way to go, whether talking about infant mortality, maternal mortality, childhood mortality or even access to health care.
“What’s the path to lead us to becoming the healthiest nation?” Satcher said. “We must get serious about health promotion and disease prevention and targeting the social determinants of health, and we must have a commitment to health equity.”
Satcher argued that this path must include finding a balanced community health approach between health promotion, disease prevention, early detection and moving toward universal health.
Satcher mentioned the Healthy People 2020 goals. These represent areas where action must be taken if the United States is to achieve better health by the year 2020. These goals are: to attain high-quality, longer lives free of preventable disease, disability, injury and premature death; to achieve health equity, eliminate disparities and improve the health of all groups; to create social and physical environments that promote good health for all; and to promote quality of life, healthy development and healthy behaviors across all life stages.
Satcher said that if we achieve these goals, we might one day be the healthiest nation, but it will require a lot of work. He also said that he prefers the goal of health equity.
In explaining the social determinants of health, Satcher discussed the conditions in which people are born, live and work as being most important to reducing health disparities.
“To change the conditions, it will require policy changes, and once we have policy change, change must happen in practice,” Satcher said. “Science to policy to practice, it’s what we do in public health.”
Satcher, who was appointed as the 16th U.S. surgeon general in 1998 by President Bill Clinton, served also as the 10th assistant Secretary for health in the U.S. Department of Health and Human Services, and earlier as director of the Centers for Disease Control and Prevention (CDC) and as the administrator of the Agency for Toxic Substances and Disease Registry. He was the first person to serve as director of the CDC and then as Surgeon General.
Satcher ended by giving his Surgeon General’s Prescription for a healthy lifestyle. It includes engaging in moderate physical activity; eating at least five servings of fruits and vegetables a day; avoiding toxins — tobacco, illicit drugs and abuse of alcohol; practicing responsible sexual behavior; and daily participation in relaxing and stress-reducing activities with adequate sleep.
After the lecture, Joycelyn Elders, M.D., UAMS emeritus professor of pediatrics and distinguished professor of public health who served as the 15th U.S. surgeon general under then-President Bill Clinton from 1993-1994, joined Satcher for a question-and-answer session with the audience.
Former U.S. Surgeon Generals David Satcher, M.D., Ph.D and M. Joycelyn Elders, M.D. answer questions.
Satcher’s advice for students to become leaders revolved around the McKinlay population model of prevention, which includes downstream, midstream and upstream approaches.
“By communicating with legislators, leaders use the upstream approach and can be effective in helping to make policy changes at the population level,” Satcher said.
Elders also had advice for students.
“You must remember the five C’s of leadership to be a good leader,” Elders said. “You must have clarity of vision, be competent, be consistent, committed and in control.”
Elders was the first African-American, second woman and first Arkansan appointed surgeon general.
Satcher and Elders both discussed the importance of better educating people about public health.
“We need to educate the whole community and make use of our schools,” Satcher said.
“We need to figure out what works best for each community and then educate the people better,” Elders said. “We must get public health into our school systems.”
Satcher was at UAMS not only to give this lecture, but also to speak in honor of Elders at the investiture ceremony of James N. Raczynski, Ph.D., dean of the Fay W. Boozman College of Public Health, as the inaugural recipient of the M. Jocelyn Elders, M.D., Chair in Health Promotion and Disease Prevention on April 20.