Washington, D.C. - September 9, 2009
Remarks as prepared for delivery
Thank you for that introduction, Leslie. And thank you for inviting me to visit with you today.
I know you heard yesterday from Dr. Peggy Hamburg. Peggy’s dedicated her career to using science to improve Americans’ lives…whether it was serving as New York City health commissioner or working to prevent bioterrorism. And we’re so glad she’s joined us as Commissioner of the FDA.
We’re also lucky to have another New York City Health Commissioner as part of our team. Many of you know Dr. Tom Frieden from his trailblazing work in New York. And we’re very grateful to have him as the Director of the Centers for Disease Control and Prevention.
Peggy and Tom have actually worked together before. They collaborated in New York to fight tuberculosis. And while they were working together, the number of cases was cut in half. So we know good things happen when they join forces. And we’re glad to have them on our team.
The Obama administration’s approach to public health
Yesterday, you heard about some of the specific actions we’re taking on food safety and child nutrition from Dr. Hamburg.
Today, I want to focus on some of the broad principles that are going to guide our public health policy going forward.
But first, I want to talk a little bit about the two issues you’re focusing on today.
Here’s what we know about child nutrition:
First, we know that not enough of our kids are eating healthy. One in five is overweight or obese.
Second, we know that childhood obesity leads to a wide range of health problems. According to the Robert Wood Johnson Foundation: “Childhood weight problems can lead to complications such as elevated blood pressure and cholesterol, joint problems, type 2 diabetes, gallbladder disease, asthma, depression and anxiety.”
Third, we know that these problems are getting worse. The share of children who are overweight is four times what it was 40 years ago. Type 2 diabetes used to be called “adult-onset” diabetes. But doctors have stopped using the term because so many kids are getting it.
Fourth, we know that overweight children tend to become overweight adults. About seven out of every ten overweight adolescents will become overweight or obese adults.
Fifth, we know that adult obesity has huge health costs. It increases your chances of heart disease, stroke, and certain cancers. It’s the single greatest predictor of diabetes. And by the way, if you have diabetes, you’re also more vulnerable to infectious diseases like the 2009 H1N1 flu.
Sixth, we know it also has huge costs for our economy. Earlier this year, the CDC studied this issue. They found that obesity costs us nearly $150 billion a year…almost twice what it did in 1998.
Let me put that number in perspective for you. The American Cancer Society estimates that if you add up the cost of every cancer…it’s $93 billion a year. So, in other words, ending obesity would save our health care system fifty percent more than curing cancer.
Those are the huge costs of bad childhood nutrition.
But the flipside of those numbers is how much we have to gain from good childhood nutrition.
If we can make even a small improvement in how well our kids eat, there would be huge benefits for their health and for our economy.
It’s the same story for food safety. You all know the human costs: 76 million foodborne illnesses a year…325,000 hospitalizations…5,000 deaths.
Let me give you one specific example: each year, more than 142,000 people get sick from eggs contaminated with a strain of Salmonella. These illnesses can be devastating. The symptoms range from gastrointestinal upset to chronic arthritis. In some cases, it’s fatal.
Earlier this year, the FDA created some new rules to attack this problem. They said, first, if you’re an egg producer, you need to test for salmonella regularly and you can only buy eggs from suppliers who test regularly too. Second, eggs have to be refrigerated while they’re being shipped the same way they are once they arrive at a supermarket.
The FDA believes that with these new preventive rules, we can cut the 142,000 illnesses that occur from eggs contaminated with that strain of Salmonella in half.
These regulations won’t be free. But in economic terms, they’re a very good deal. The rules will cost less than 1 cent per dozen eggs produced in the United States. And it’s estimated that they’ll produce $1.4 billion in public health benefits a year – more than 17 times the cost.
When the potential benefits are this big, we can’t afford to be reactive when it comes to public health. We can’t sit back and wait for a dangerous outbreak or epidemic…and then do something.
We need to be proactive and prevent these crises from happening in the first place.
Which brings me to the first major principle that will guide our public health strategy: we’re going to focus relentlessly on prevention.
Prevention isn’t as exciting as a life-saving surgery after a heart attack. It doesn’t create headlines like a massive food recall. Success often doesn’t show up until many years later. And even then it’s hard to see.
But the potential benefits are huge. Chronic disease causes 70% of deaths in this country. It accounts for 75% of health care costs. If you can give a kid a healthy diet for a few thousand dollars that lowers their chance of needing $500,000 of care for heart disease fifty years later…that’s a great investment.
That’s why the President and the First Lady have emphasized prevention over and over again, whether it’s planting a White House garden or trying to pass health insurance reform. And by the way, I’d encourage any of you who have questions about reform or where the President stands to tune in tonight to his primetime address to Congress.
But President Obama and I don’t think prevention can wait for a reform bill to pass. And neither does Congress. That’s why they made a historic $1 billion investment in prevention as part of the American Recovery and Reinvestment Act.
Some of this money will go to immunizations. Some will go to prevent patients from getting infections during surgeries and other medical treatments.
But most of these funds will be used for a prevention initiative that was jointly developed by the CDC and the Office of Public Health and Science. We aren’t ready to make an official announcement yet. But I can tell you that a significant chunk of the money will go to help states and communities attack obesity and other public health challenges.
Prevention is also at the heart of our food safety strategy. As you know, this spring, the President created a Food Safety Working Group, which I co-chair with Secretary Vilsack. Earlier this year, we came up with three core principles.
The first of these principles is prioritizing prevention. And it’s already guiding our actions…from the new guidance on leafy greens, tomatoes, and melons to the Agriculture Department’s new standards for inspecting the meat that goes into ground beef for E. coli.
We didn’t develop these guidelines in response to a specific crisis. We didn’t wait until something went wrong and then say, “oh, we better do something on E. coli.” Our goal is to anticipate and prevent these crises before they start.
Another principle that’s going to guide our approach to public health is building partnerships. One way to come up with ideas is to put a lot of experts in a room and have them come up with a list of policies. But this administration is committed to casting a wider net.
So for example, earlier this year, the CDC came out with a report on how to reduce obesity. And what they did is travel all around the country and ask: what are the strategies that actually work?
And what they found was pretty incredible. There’s a school district in Southern California that got almost half their kids to start getting lunch from the salad bar. Try to picture a school lunch table where half the kids have salad on their trays. It’s almost unbelievable.
But they did it by serving fresh, local produce.
Here’s another example. There was a city in Northern California that was trying to get kids to be more active. They decided to see if they could get more kids to exercise doing something as small as providing a bus to take them to their activities. It worked. They got twice as many girls to go to dance class as the next community over.
We heard from communities all across the country. There were cities that built supermarkets in inner-city neighborhoods…or slashed the prices for fruits and vegetables in school cafeterias…or changed physical education classes so that kids ran around the whole time instead of standing around waiting to use a piece of equipment.
These are ideas that are already working. And we think there are great ideas out there on food safety too. As Dr. Hamburg told you yesterday, we’re closely following the steps food producers are taking to secure the food supply. We don’t just want to work with these producers. We want to help promote their ideas so that best practices spread throughout the industry.
Working across agencies
And we’re not just working with non-profits and private companies. We’re also building partnerships across government. At HHS, we’re proud to be the main agency devoted to keeping Americans healthy. But that doesn’t mean we can do it alone.
So we’re partnering with the Department of Agriculture on food safety. We’re partnering with the Department of Education on child nutrition.
I saw that you have a panel today on “connecting the dots to improve children’s health.” That’s exactly what we’re trying to do whether it’s transportation policy that makes it easier for people to walk or ride their bike…or environmental policy that gives us cleaner air…or traditional public health policy like immunizations.
These principles – being proactive, focusing on prevention, and building partnerships – will continue to guide our work on public health.
Along with the Department of Agriculture, we strongly support reauthorization of the Child Nutrition Act. As Dr. Hamburg told you yesterday, we also support the food safety bill that was passed by the House earlier this year. And we look forward to working with the Senate this fall to pass a bill that is just as strong.
About a fifth of the food we eat comes from overseas. It’s over a third of our produce. And three quarters of our seafood. If we’re going to keep Americans safe in a 21st century global food market, we need 21st century food safety laws and enforcement.
Today, I’m excited to announce a big step forward towards that 21st century food policy. HHS and the Department of Agriculture are launching a new Web site: www.foodsafety.gov.
This Web site will be the best place to go for breaking news on the latest outbreaks. Consumers won’t have to bounce around from one website to another, trying to figure out which agency manages which food product. They can log in to foodsafety.gov and get all the information they need. They’ll also be able to sign up for email updates and RSS feeds that will automatically notify them about food safety news. We’re currently working with the USDA and others to incorporate mobile phone alerts too.
We’ll also have a widget that all of you can post on your own sites. And we’ve brought some information with us today about how to do that. The widget will be an easy way to update folks about the latest food safety recalls and I hope you will all take advantage of it.
Foodsafety.gov will have tips for consumers about how to practice food safety at home. It will be a clearinghouse for information on the latest FDA rules and guidance. And I encourage all of you to visit the site, take advantage of the resources, and let us know what you think.
Secretary Vilsack and I will be traveling around the country in the next few months to raise awareness about food safety and promote the site. We want to make it as simple and convenient as possible for people to get the critical information that will keep them healthy and well.
The highest mission of any government is keeping its citizens safe. In this administration, we see public health as an essential part of that mission. And we’re grateful for your support and your partnership as we work to build a healthier and more prosperous America.