Former surgeon general: Health equity required for a healthy nation

The United States can only become a healthy nation if it first becomes an equitable one regarding opportunities for healthy living, a former surgeon general under Presidents Bill Clinton and George W. Bush said Thursday during an address at the University of Arkansas for Medical Sciences.

Dr. David Satcher was appointed by Clinton to a four-year term in 1998 and later became the founding director and senior advisor for the Satcher Health Leadership Institute at the Morehouse School of Medicine in Atlanta. The institute develops health leaders and creates strategies to eliminate health disparities.

He appeared at UAMS on the same day the university was honoring one of his predecessors as U.S. surgeon general, Dr. Joycelyn Elders. On Thursday, Jim Raczynski, dean of the UAMS Fay W. Boozman College of Public Health, was being invested with the Elders Chair of Health Promotion and Disease Prevention.

After Satcher’s remarks, he was joined on stage by Elders for a question and answer session. Satcher was asked to speak on the subject, “Can the U.S. become the healthiest country in the world?”

For that to happen, he said, “It would mean that we have a long ways to go.” Despite the United States’ wealth and scientific prowess, it lags other countries in important indicators, including infant mortality, maternal mortality, under-five childhood mortality and life expectancy.

To improve its standing, the country needs more emphasis on health promotion and disease prevention, and it needs to be committed to health equity, or equal access to health care and healthy living opportunities, including universal health care.

“We ought to believe that everybody in this country deserves to have access to health care, quality health care. We ought to believe that and we ought to be committed to it,” he said.

Satcher said public health programs must serve everyone and improve health opportunities. Policymakers must address social determinants of health, or the conditions where people live, work and age. He said it’s hard for people to live a healthy lifestyle if their neighborhood is too dangerous for them to venture onto their front porch. He encouraged audience members to get involved in the policymaking process.

“Health equity is giving people what they need when they need it in order to be healthy,” he said.

Satcher referenced the infamous “Tuskegee Study of Untreated Syphilis in the Negro Male,” where the Public Health Service studied the disease’s progression in 399 African-American men from 1932 to 1972 without treating them with penicillin, which was known to be effective, or informing them of the nature of the study. President Clinton apologized for the study on behalf of the nation in 1997. Satcher quoted Donna Shalala, secretary of Health and Human Services under Clinton, in saying the country’s ethics must be as sophisticated as its science.

During the question and answer session, Elders said schools must have comprehensive health and physical education and said the entire community must be educated.

“What good is reading, writing and arithmetic if you’re not physically, emotionally and psychologically fit?” she asked.