Department of Health and Human Services
Office of the Surgeon General
of the
United States of America
Boris D. Lushniak, MD, MPH
RADM, USPHS
Deputy Surgeon General
DISCLOSURE OF CONFLICTS OF INTEREST
Boris D. Lushniak, MD, MPH
I do not have any relevant financial
relationships with any commercial interests
No off-label discussion of drugs or devices
Work supported by US Government
(DHHS, PHS, FDA, CDC/NIOSH)
The United States Public Health Service
• Who we are
• What we do
Seven Uniformed Services of the United States
DOD
Armed
Military
Non-DOD
Armed
(DHS)
Military
Non-DOD
Non-Armed
Can Be Militarized
(HHS)
(DOC)
The USPHS Commissioned Corps
The Surgeon General
is the Commander of
the USPHS
Commissioned Corps
Regina M. Benjamin, MD, MBA
VADM, USPHS
18th Surgeon General
The Mission of the Commissioned Corps
Protecting, promoting, and advancing
the health and safety of the nation
US Public Health Service Mission
As America’s uniformed service of public
health professionals, the Commissioned
Corps achieves this mission through:
• Leadership and excellence in public health
practice
• The advancement of public health science
• Rapid and effective response to public
health needs
The United States Public Health Service
1798 Act provided care for sick and injured
merchant seamen (loose hospital network)
1870 Marine Hospital Service (national system)
1871 Supervising Surgeon (later Surgeon General)
Dr. John Maynard Woodworth
1878 Quarantine functions (smallpox, yellow fever,
cholera)
1889 Legislation creating Commissioned Corps
1891 Immigrant services
1902 Public Health and Marine Hospital Service
1912 Public Health Service (with broadened powers)
A Proud History
1918
From Ellis Island…
…To tribal lands
Across America…
…Around the World
Categories of Commissioned Corps Officers
• Over 6,500 officers in 800 locations, worldwide
• 11 Professional Categories
• Medical
• Dental
• Nursing
• Pharmacy
• Scientist
• Health Services
• Engineer
• Therapist
• Veterinarian
• Dietitian
• Environmental Health
US Duty Stations
Federal Agencies Utilizing Commissioned Corps
Officers
(Not all agencies
and programs are
represented)
Public Health & Prevention Missions of the
Surgeon General: Overweight & Obesity
• Combat overweight epidemic
• Target Obesity
Public Health & Prevention Missions of the
Surgeon General
• Smoking
• Underage Drinking
Public Health & Prevention Missions of the Surgeon
General: Deep Vein Thrombosis & Healthy Homes
Best DVT Prevention Practices
Promoting Healthy Homes
Public Health & Prevention Missions:
Healthy Youth for a Healthy Future
• National Outreach Campaign
- Encourage healthy eating habits
- Help kids stay active
- Promote healthy choices
- Local roundtables with non-traditional
partners
Faith-based organizations
Businesses
Chambers of Commerce
- Recognition of “Community Champions”
The Surgeon General’s Vision for a Healthy and Fit
Nation
Major Actions of OSG
 A Report of the Surgeon General
 How Tobacco Smoke Causes Disease
 The Biology and Behavioral Basis for SmokingAttributable Disease
 December 9, 2010
Major Actions of OSG
 The Surgeon General’s Call to Action to
Support Breastfeeding 2011
 January 20, 2011
Upcoming Actions
• March 8, 2012 – release of “Preventing
Tobacco Use Among Youth and Young
Adults” (Washington DC)
• Other OSG initiatives – prescription drug
misuse in teens, youth violence
• Let’s Move campaign
• Million Hearts Hearts campaign
– Prevent 1 million heart attacks and strokes in 5
years
– Aspirin, Blood Pressure, Cholesterol, Smoking
– www.millionhearts.hhs.gov
Medical Reserve Corps
Public Health
The science and art of preventing disease,
prolonging life and promoting health
through the organized efforts and informed
choices of society, organizations, public and
private, communities and individuals.
– CEA Winslow, 1920
10 Great Public Health
Achievements-US 1900-1999
 Vaccination
 Motor-vehicle safety
 Safer workplaces
 Control of infectious
diseases
 Decline in deaths from
heart disease and
stroke
 Safer and healthier
foods
 Healthier mothers and
babies
 Family planning
 Fluoridation of water
 Recognition of
tobacco as a health
hazard
MMWR 1999 Apr 2;48(12):241-3.
Public Health US 2009
6.22 infant deaths per 1000 live births (45)
78.11 life expectancy in years (49)
Health care expenditure
– 17.6 % GDP (1)
– $2.5 trillion
– $8160 per person
Core Public Health Functions
 Assessment and monitoring of the health of
communities and populations at risk
– identify health problems and priorities - surveillance
 The formulation of public policies
– designed to solve identified local and national health
problems and priorities
 Assure that all populations have access to
appropriate and cost-effective care
– including health promotion and disease prevention
services
– evaluation of the effectiveness of that care
Healthy People
www.healthypeople.gov
Developed in 1979 by the Department of Health
and Human Services
Science-based, 10 year national objectives
For promoting health and preventing disease
Includes a vision, mission, goals, focus areas,
criteria, objectives and action plans for
achieving the targets
Healthy People 2020
 Launched Dec 2010
 600 objectives, 1300 measures
 Each objective has a reliable data source, a
baseline measure, and a target for specific
improvements
www.healthypeople.gov/HP2020
Healthy People 2020
Implementation Framework
 MAP-IT
–
–
–
–
–
Mobilize -- partnerships
Assess – needs and assets
Plan – clear objectives and concrete steps
Implement – workplan, POC, communication plan
Track – evaluate and track progress
Using Healthy People to make the case for
funding
www.healthypeople.gov/HP2020
The Affordable Care Act
Unique Opportunities for Prevention
National Prevention Council
Bureau of Indian Affairs
Department of Labor
Corporation for National and
Community Service
Department of Transportation
Department of Agriculture
Department of Veterans Affairs
Department of Defense
Environmental Protection Agency
Department of Education
Federal Trade Commission
Department of Health and Human
Services
Office of Management and Budget
Department of Homeland Security
Office of National Drug Control
Policy
Department of Housing and Urban
Development
White House Domestic Policy
Council
Department of Justice
Advisory Group
17 non-federal members
Statutory Role:
– Develop policy and program recommendations
– Advise National Prevention Council on prevention
and health promotion practices
National Prevention Strategy
 Extensive stakeholder
and public input
 Aligns and focuses
prevention and health
promotion efforts with
existing evidence base
 Supports national
plans
Vision
Working together to improve the health and
quality of life for individuals, families, and
communities by moving the nation from a focus
on sickness and disease to one based on
prevention and wellness.
National Prevention Strategy
Healthy and Safe Community
Environments
• Clean air and water
• Affordable and secure
housing
• Sustainable and
economically vital
neighborhoods
• Make healthy choices
easy and affordable
Clinical and Community Preventive
Services
• Evidence-based preventive services
are effective
• Preventive services can be
delivered in communities
• Preventive services can be
reinforced by community-based
prevention, policies, and programs
• Community programs can promote
the use of clinical preventive
service (e.g., transportation, child
care, patient navigation issues)
Empowered People
• People are empowered when they
have the knowledge, resources
ability, and motivation to identify
and make healthy choices
• When people are empowered, they
are able to take an active role in
improving their health, supporting
their families and friends in making
healthy choices, and leading
community change
Elimination of Health Disparities
• Health outcomes vary widely
based on race, ethnicity, socioeconomic status, and other
social factors
• Disparities are often linked to
social, economic or
environmental disadvantage
• Health disparities are not
intractable and can be reduced
or eliminated with focused
commitment and effort
Priorities
 Tobacco Free Living
 Preventing Drug Abuse and
Excessive Alcohol Use
 Healthy Eating
 Active Living
 Mental and Emotional Wellbeing
 Reproductive and Sexual
Health
 Injury and Violence Free
Living
Source: National Vital Statistics
Report, CDC, 2008
Federal Implementation
 Provide coordination and ongoing leadership
at the Federal level, and among all Federal
departments
 Establish processes for continual public input
 Establish specific and measureable agencyspecific actions to address recommendations
 Monitor and track federal actions
 Annual Status Report
Optimal Implementation
What’s Next
 Regional meetings
 Execute and coordinate NPS actions
across Council agencies
 Encourage partners to create and
execute their own NPS action plans
 Monitor and track progress
 Share successes!
For more information go to:
www.healthcare.gov/
nationalpreventioncouncil
Contact the National Prevention Council at:
prevention.council@hhs.gov
Boris Lushniak, M.D., M.P.H.
RADM, USPHS
Deputy Surgeon General
boris.lushniak@hhs.gov
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