Surgeon General Regina Benjamin Q&A: Implementing the National Prevention Strategy
This summer the National Prevention Council, made up of 17 federal departments that are incorporating prevention into their activities, released its first annual report detailing successes in implementing the National Prevention Strategy and laying out next steps to help achieve its goals.
At the release, Surgeon General Regina Benjamin, MD, MBA, who is also chair of the Council said, “This Action Plan highlights how the National Prevention Council departments are working together—in conjunction with state, tribal, local, territorial, public, and private partners—to begin to move our health system from one based on sickness and disease to one based on wellness and prevention.”
As part of our conversation series on the National Prevention Strategy, with key leaders in federal agencies who are shaping the Strategy, NewPublicHealth spoke with Dr. Benjamn about the regional meetings she is spearheading across the country to implement the strategy and her vision for healthier lives for all Americans.
Listen to a short podcast with Dr. Benjamin, and read the full interview below.
NewPublicHealth: One year after the launch of the National Prevention Strategy, what successes are you seeing in uptake and implementation?
Dr. Benjamin: We’ve made really big strides both at the federal, state and local levels as well as with some of the tribal levels. One of the most exciting things I’ve seen at the federal level is that our departments are working together on prevention efforts to tackle issues like sustainable housing and childhood obesity, environmental justice, and the prevention of heart disease. At the state and local level, we’ve seen communities finding ways to implement the National Prevention Strategy and make it their own. For example, the City of Chicago developed Healthy Chicago 2020. In the county of San Diego, they initiated something they call Live Well San Diego, and both of these are modeled on the National Prevention Strategy. And, in Rhode Island and California, the states are planning to implement their own statewide prevention councils based on our National Prevention Council. So, we’re seeing organizations and policy groups and funders trying to base their work on the National Prevention Strategy.
NPH: What are some of the ways that you are moving the National Prevention Strategy into action?
Dr. Benjamin: Each year, we have to present to the president and to congress a status update on the National Prevention Strategy and this summer, we released the National Prevention Council Action Plan. The departments have come together to align their strategic directions and priorities with our National Prevention Strategy. And, these department actions represent a balance of innovative programs and proven initiatives. A couple of examples: the Department of Health and Human Services and the Veterans Administration are working together to prevent a million heart attacks and strokes over the next five years as part of our Million Hearts campaign. We also have a Partnership for Sustainable Communities, and they’re working to improve access to affordable housing and increase transportation options and lower transportation costs, while at the same time protecting the environment of communities nationwide.
NPH: How well do you think the collaborations have worked so far and how do you model those kinds of partnerships for the community level?
Dr. Benjamin: One thing we found is that it’s very important for collaboration across sectors to get all the players at the same table. With the National Prevention Council, we do this by bringing 17 federal departments together. We also know that it’s very important to have shared goals, so I’m particularly proud of the efforts the National Prevention Council is making to takea lead and be an example for the nation around the importance of prevention. All of our 17 departments have come together to identify and make commitments. This gives us the opportunity to combine our efforts and learn from each other.
We’re all at different stages, but the first thing we’ve committed to is looking at everything we do through a prevention lens. The second commitment is to create more tobacco-free environments where we work. While that sounds simple, it’s really hard because oftentimes, if an agency is renting a property, they don’t have control over tobacco use there. But, all the agencies have committed to try to offer tobacco-free environments to their employees. And, the third initiative is to increase access to healthy and affordable foods.
These 17 agencies can reach millions and millions of people, and just by putting these things in our policies and focusing on prevention, we really can make a major change in people’s lives.
NPH: What feedback have you received about the National Prevention Strategy over the last year?
Dr. Benjamin: We’ve been going out and doing regional meetings and we’ve seen a number of communities and organizations that are starting to use the National Prevention Strategy to make their communities healthier.
These meetings bring together state and local leaders, public health officials, health care professionals, funders, businesses, community groups, academics, representatives from the faith community, the media, local partnerships and grassroots organizations. In Chicago, for example, we saw local philanthropic organizations commit to using the National Prevention Strategy to include prevention in their funding decisions. And across the country we’ve seen a lot of young people come together as campaigners against tobacco use.
NPH: And what are some examples of how agencies are putting prevention into practice?
Dr. Benjamin: We’ve seen some amazing examples of the departments incorporating the National Prevention Strategy into their missions. The Department of Defense, for example, launched their new obesity and nutrition awareness initiatives, aimed at improving the health and the wellbeing of our troops and our retirees and their families. For the first time in 20 years, the Department of Defense is improving their nutrition standards military-wide. I think that’s a pretty big move. These improvements will directly affect more than 1,000 dining facilities and almost a million and a half troops, with the goal of reducing the department’s health care costs related to obesity and diabetes and heart disease by $1.4 billion a year.
At the Department of Housing and Urban Development, they’re making great progress in expanding tobacco-free environments. In 2011, at least 230 public housing authorities had adopted smoke-free policies for some or all of their buildings. And in partnership with the Department of Health and Human Services, the American Academy of Pediatrics and the American Lung Association, HUD recently released a collection of resources for property owners, housing managers, landlords, and resident organizations to facilitate and implement smoke-free environments. HUD’s been working really hard with HHS and other partners to increase resident access to proven tobacco cessation services. That is such a good example of what great progress can be made when we work together across the federal government with our partners.
NPH: What do you hope to accomplish by the next anniversary of the National Prevention Strategy?
Dr. Benjamin: We know that moving a nation from a focus on sickness and disease to one based on wellness and prevention is going to require a lot of leadership, not only from the federal government, but also from public and private partnerships. In the next year, we’ll continue to engage communities and partners in working together to make prevention part of our everyday lives. We want to empower people to make better health choices, and we want to lead by example. We want to stay focused on our ultimate goal of increasing the number of Americans who are healthy at every stage of life. We want to use the best available science to monitor our nation’s progress and how well prevention achieves positive health outcomes. The ultimate outcome over the next year and the next few years is to prevent those five leading causes of death—heart disease, stroke, chronic lower respiratory disease, cancer and unintentional injuries. Most of those things are caused just by three or four modifiable risk behaviors—decreased physical activity, smoking and poor nutrition. If we could just improve those things, we could certainly improve our outcomes tremendously.
NPH: What do you see as some of the most critical health issues facing our nation?
Dr. Benjamin: Tobacco. Every Surgeon General has warned us about that, and we’ve made good strides in tobacco. We cut down the rates by about a half since 1964, but one of the things we’re seeing now is a problem with our youth and young adults. Every single day, 1,200 Americans die from smoking. Each one of those deaths is being replaced by two young smokers. We call them replacement smokers; 90 percent of all smokers start before the age of 18, and 99 percent start before the age of 26. So, if we could simply get our young people not to take that first cigarette, we have less than 1 percent chance of them ever starting to smoke. We also know that marketing is very successful in this particular group. Over $1 million an hour is being spent on marketing of tobacco products—$27 million each day. The good news is that we have a lot tools available to address this critical issue, and if we work together, we can make our next generation tobacco free.