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Surgeon General Visits, Touts Oral Health

By Carla Garnett

On the Front Page...

Back in 1964, Dr. Luther Terry, then U.S. surgeon general, was understandably a bit nervous. He was about to release the first-ever Surgeon General's Report, which confirmed several long-suspected theories regarding the detrimental effect of smoking on health. As he was riding to the news conference, thinking about what he would say, he lit up a cigarette. Noting the cigarette, an adviser, who knew Terry was a chronic smoker, suggested that the surgeon general be prepared for the first question reporters were certain to ask: Do you smoke, Dr. Terry? Terry could not believe reporters would be interested in his personal habits. Sure enough, though, following Terry's announcement of the landmark SG report and his comments about the health dangers of smoking, a savvy reporter asked Terry if he smoked. "No," Terry replied. The reporter — convinced he had done his homework — double-checked his notes. Knowing Terry's history, the writer pressed further, "Dr. Terry, when did you quit?" A smiling Terry responded, "About 30 minutes ago." He never smoked again.


Seven surgeons general and more than 50 SG reports later, the man who currently holds the job, Dr. David Satcher, said he tells the Terry story to make a point.

"There is something special about a surgeon general's report," he remarked genially, during a recent visit to NIH. "Not only do the reports aim to change the behavior of the American people, but surgeon general reports also sometimes change the behavior of the surgeon general."

Surgeon General David Satcher

Satcher's Mar. 19 visit capped a day filled with panel discussions, briefings and tours of NIH facilities for more than 100 medical officers from CIGNA health organizations nationwide. Satcher said his visit to address the group was two-fold. He wanted to talk about how federal health agencies could team up with health maintenance organizations like CIGNA to improve the nation's overall health, and he wanted to pitch one of his latest releases — the Surgeon General's Report on Oral Health, which came out last May.

Several major points were outlined in the report, which was prepared in large part by researchers and other experts at the National Institute of Dental and Craniofacial Research. Satcher emphasized a few key findings: oral health involves much more than healthy teeth and is, in fact, integral to general health; safe and effective disease prevention measures — fluoridated drinking water, for example — exist that everyone can adopt to improve oral health and prevent disease; profound disparities exist in the oral health of Americans, especially among children and the elderly; and general health risk factors, such as tobacco use and poor dietary practices, also affect oral and craniofacial health.

"Poor oral health interferes with quality of life," Satcher stressed.

The surgeon general also talked briefly about Healthy People 2010 — the health promotion and disease prevention agenda for the nation — and how difficult it has been to get such an all-encompassing, wide-ranging message effectively distributed to a large and diverse population.

"Healthy People 2010 is supposed to be a 'people document,' but no matter how good you are at communicating, you can't engage people to receive 467 objectives," he said, recommending that instead of trying to bombard the public with too many messages, health providers should promote the shorter list of 10 leading health indicators summarized from HP2010.

During a question-and-answer period, Satcher fielded comments and queries about everything from the high cost of providing health insurance to all Americans, to the oft-times less-than-nutritious foods provided to children through schools, to the difficulties in translating clinical study data to medical practice.

"Getting research results to the people is a real struggle," he admitted, "but it's a struggle that we must continue, and one we must continue together."

According to Satcher, the major problem with healthcare in the United States is lack of balance. He believes the nation needs a community health system that balances health promotion, disease prevention, early detection and universal access to care. "It's in America's best interest to work towards universal healthcare," he observed.

There are no easy solutions to balancing costs and access to medical care, he said, but discussions like these — among health providers, advocates and researchers, in both private and public sectors — are crucial; the bottom line is that "we need a health system that provides for the needs of the American people."

Acknowledging the daunting challenge of achieving optimum healthcare that is affordable for an entire nation, Satcher concluded by quoting former Health, Education and Welfare Secretary John Gardner: "Life is full of golden opportunities carefully disguised as irresolvable problems."
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