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M. Joycelyn Elders, M.D. NOT for PUBLIC DISTRIBUTION JUNE 2020 M. Joycelyn Elders, M.D. NOT FOR PUBLIC DISTRIBUTION Caitlin Radford My name is Caitlin Radford from Bristol, Virginia. And it is my honor to introduce Dr. Jocelyn Elders. Dr. Elders was the first person of the State of Arkansas to become board certified in pediatric endocrinology. She was the 15th Surgeon General of the United States, becoming the first African American and only the second woman to head the US public health service. As an advocate of Public Health, Dr. Elders was appointed Surgeon General by President Bill Clinton in 1993. Now retired from practice, she is a professor emeritus at the University of Arkansas School of Medicine and remains active in public health education. Dr. Elders, welcome to the Congress of Future Medical Leaders. Dr. Edlers Thank you. It's a real pleasure to have the honor of speaking to the future leaders and scientists and physicians of America. Thank you for inviting me to speak here today. It's a real pleasure. I know that you will be making the decisions for the future of the world. And I hope you will make all the right decisions for me. In a whirlwind of disasters, we in America have been barraged by worldwide pandemic of a new virus, medical unpreparedness sharpness, shortage of PPE equipment, hospital space, and medical personnel, government, recessions, unemployment, huge numbers of hungry Americans and police brutality. We're pinning our hopes for the future on you. Just this progeny carry the DNA of their parents. You carry out hopes and dreams for the future of the world, and you are just right for the task ahead of you. There are problems for you to face that no other generation has faced. These problems truly are opportunities in disguise. The opportunity to solve problems that no one has seen or recognized is yours. Change is here, and you will be a mover and shaker, inventor and scientist, leader in position. You are the ones who will move us to a better place. We need you. A preview of some of the things we know. Some of the things we know first of all is that population is changing. The nature of disease is changing. Disparities are persistent. We have an expensive health care system. And we must focus on prevention. When we think of the population, we are almost 8 billion people, more than, almost eight billion in America, and we are the most diverse population in the world. And we know by 2050, 50% will be people of color. As our diseases change, and we have a persistent up, the disparities remain persistent, we must begin to change. We must focus on prevention. We presently have what I call a sick care system. You have been transformational leaders of the next century will be what I call transformational leaders, and you must make a difference. And you must transform our sick care system into a healthcare system. OFFICIAL TRANSCRIPT NATIONAL ACADEMY OF FUTURE PHYSICIANS AND MEDICAL SCIENTISTS © 2020 ALL RIGHTS RESERVED 1 JUNE 2020 If we don't transform, change where we're going, we'll end up where we're headed. And most of you know, we don't like where we're headed because of the many problems that we're seeing and experiencing as we go along. I've just shown you that ancient proverb. Let's talk about some truths about health care in America. First of all, we spend more money than anybody, any other nation, more than $3 trillion. We have a shorter lifespan. We're not healthier. Our infant mortality rate, even in our highly developed, educated, well developed nation is twice as high as some developed nations. And our black infant mortality rate is more than twice as high in some developed nations. We've seen a lot of improvements in our, reduced high blood pressure and we are having less strokes. We have lack of access to health care; we do not have a universal access to health care for all of our people. We have a health illiterate society, we must educate them. And we have inadequate public health system, as been demonstrated by our response to the corona virus. Our underbelly has been exposed by this Coronavirus. The world has awakened to discover that huge numbers of people are dissatisfied, and disparities, because of the marked disparities. They're dissatisfied because of economic and justice. They’re dissatisfied because of on social injustices that they are seeing in our society, and the marked problems we're seeing in regard to medicine. It's obvious that most of the public feel that our health public health system is inadequate. I want you to look at this slide because it thinks this, I want to demonstrate the difference between equality and equity. Most of us think that we provide the same thing to all patients, that that's fair. But we all know different people need different things. And equality is not the same as equity. And we do our job well, we'll all have to. I can't see this too well on my end. But please, young people are looking at a ball field. And if you see the first young man is about six feet tall. The next one, next is about four feet. And the next two feet. Well, each one of them are given a box to stand on. The first does not need a box. The second maybe get a little bit better view. But it's only when you give two boxes to the young man who's only about two feet tall that he's able to see over the four foot fence. But if we remove the fence, they all would be able to see this side, and see it very well. So that's something that we must deal with. It will be your job to make sure that all people have equity, not just talk about our equality. This slide demonstrates what we consider the major determinants of health. We know that when we look at the major determinants of health, 50% are social and behavioral, 20% are environmental, 20% of genetic, 20% are related to access to care. We must address all of these areas to make certain that all people and communities are healthy and happy. I want you to look at the social determinants of health framework. The groundwork has been laid for this, and we've not, do not know how all the things we need to do. This slide demonstrates the social determinants framework. It can be the cornerstone for your work as you build a more equitable society. OFFICIAL TRANSCRIPT NATIONAL ACADEMY OF FUTURE PHYSICIANS AND MEDICAL SCIENTISTS © 2020 ALL RIGHTS RESERVED 2 JUNE 2020 The slide you're looking at is looking at some of the light has been worked out by a group of scientists that spent about 10 years coming up with what they call with a social determinants of health. And they found that influence the health of individuals over from the birth through their where they live, the kind of health care they got, through the death in their lifetime, and how it influenced how social and economic policies were influenced. How it influenced the local community and influenced individual, and how it had a major influence on their health. The social determinants address disparities that are faced today, and we’ve faced for generations. Our goal for 30 years has been to eliminate disparities in healthcare. I think you will be the ones to accomplish this in your lifetime. One of the goals for Healthy People, that started in 1990, and one of the goals for health care 2030 or 2020, is eliminate and reduce disparities, social and economic disparities, address health care, education, housing, physical environment, work environment. We all know where we work very much influence our health. Think of what's going on in our poultry environment at this time. These are all interactive for the individual as well as for the community. And the outcomes. Each one is essential. You have to address all of them. And of course, we've been very concerned about what's going on with racism, social justice system, all of our issues. Racism, sexism, priceism, so each one being essential for the whole, let's work together. And we have these multiple strategies to address these issues. Singular issues, singular strategies won't work. We have to have educational strategies, success strategies, preventive strategies, intervention strategies, political strategies, research strategies, leadership strategies. And of course, we all know most important is leadership. You will be our future leaders, you have great responsibility. Leadership is not an easy task. You may think of yourself as a natural leader, or you may think you have no leadership ability at all. However, leadership can be studied and learned. We when we think of the 10 talents, next slide please, of transformational leadership, which you will be. You will be expected to be successful in transforming the behavior people and systems. You must learn to lead with high moral and ethical values, inspirational vision, trust, and be motivated to do the right thing. Remember, when things get tough, you have to press on in life. Keep your eye on the prize. The prize is that you want healthy, educated, motivated people in communities with hope. There'll be times that you want to give up, but do not. We need to go on.
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