Prevention Matters

Yesterday, the U.S. Navy announced a change in policy – smoking will be banned aboard all submarines. Obviously, prohibiting smoking in such confined spaces makes sense. The question for me was “Why did it take so long?” One can reason that both smoking and non-smoking sailors would be exposed to unacceptable levels of secondhand smoke. Although prior Surgeons General and tobacco control advocates have presented evidence of the health consequences of second-hand smoke, it wasn’t until a 2009 study by the Naval Submarine Medical Research Laboratory confirmed risk to nonsmoking submariners that a policy change was successful.

Accompanying the smoking ban will be tobacco cessation education and access to nicotine replacement therapy products. Kudos to the Navy for recognizing that forcing submarine sailors to go “cold turkey” would not be a smart move. Hopefully, the cessation programs will be expanded to adhere to the Public Health Service Guidelines’ comprehensive mix of counseling and medications.

Diane M. Canova
Vice President, Policy & Programs

US Surgeon General, Regina Benjamin told Congress yesterday that obesity “may dramatically impact the quality and longevity of life for an entire generation of children.” In forceful testimony before the Senate Committee on Health, Education and Pensions, Benjamin noted “the prevalence of obesity has increased dramatically in the United States, tripling among children and doubling among adults. Today, two-thirds of adults and nearly one in three children are overweight or obese.” She explained that from 1980 to 2008, obesity among adults rose from 13.4% to 34.3% and among children, rates rose from 5% to 17%.

The solution isn’t easy or quick but it is obvious and encouraging that the Obama administration is engaged. The Surgeon General explained that last month the President established a new Task Force on Childhood Obesity and charged it with reviewing all Federal programs dealing with child nutrition and physical activity and developing a national action plan. The National Action Plan is scheduled to be completed by May 9. Perhaps no less important, is the very visible role and support to this effort being given by First Lady Michelle Obama and her commitment to end “childhood obesity within a generation.” Her “Let’s Move” campaign is being supported by an innovative series of new web-based tools including the next generation Food Pyramid and USDA’s Food Environmental Atlas. These projects will help families make healthier food and physical activity choices and better understand national and local trends on food decisions.

Benjamin concluded her testimony with a simple but powerful message. “Instead of bombarding people with lists of what not to do, we need to empower them with what to do to promote health. Healthy eating and physical activity should be something all Americans want to do, not something they feel they have to do. We need to encourage people to take up activities that they enjoy, like swimming, dancing, or biking. We need to show them how healthy foods can be affordable, accessible, and delicious.”

Sage advice from the nation’s Family Doctor.

Posted by:
Ripley Forbes
Director, Government Affairs, Partnership for Prevention

Dr. Regina Benjamin, a MacArthur "genius grant" recipient who founded a clinic to serve the poor along Alabama’s Gulf Coast, was named by President Barack Obama as his choice for U.S. surgeon general. The nomination requires Senate confirmation.

Matthew Holt asks in The Health Care Blog: "Anyway we may not have enough general surgeons according to their trade group, but why should the head of public health for the nation be a surgeon. Shouldn’t they be an epidemiologist? And why are they a general? Don’t we waste enough money on the military as it is?"

While Matt meant it in jest, these are actually pretty common questions. Actually, the term "Surgeon General" does not mean that the holder of the title must be a surgeon or that he/she is a general. The office was established in the 1870s, when the term "surgeon" was commonly used to refer to any physician. And "general" is not meant as a military reference, but as a title that means "supervising" - the same way it's used in "Attorney General," "Postmaster General," or "Inspector General."

That inevitably begs the question: if he/she is not a general, why does he/she wear a uniform? That is because the Surgeon General is a member of the Commissioned Corps of the U.S. Public Health Service, which is one of the federal government's seven uniformed services, along with the Army, Navy, Marines, Air Force, Coast Guard, and Secret Service. The uniform closely resembles that of the Navy, because the Commissioned Corps was originally begun as a government network of hospitals for merchant seamen. The Corps reports to the Secretary of Health and Human Services.

To top it off, there are no generals in the Navy ranking system, and the Surgeon General actually holds the rank of admiral in the Commissioned Corps.