Surgeon General calls for psychologists to increase efforts in health promotion

By Sara Martin
Monitor staff

Last year, 5.8 million prescriptions were written for Viagra-- the most ever for a new drug, said U.S. Surgeon General David Satcher, PhD, MD. But what most people don't realize, he said, is that "physical activity probably has, in the long run, as great if not a greater benefit over sexual potency as Viagra."

As yet though, most Americans don't see the value of health promotion and disease prevention, preferring instead to pop pills for their ailments. Motivating people to change their behaviors--from exercising more and eating better to restricting drugs and alcohol and avoiding unsafe sex--is where psychologists come in, he said. Satcher spoke at the APA miniconvention, "Critical Issues for Women in the New Millennia" during APA's 1999 Annual Convention in Boston.

"We know that 50 percent of deaths are directly related to human behaviors, and yet we spend too little time researching and implementing programs related to them," said Satcher.

Ninety percent of the nation's health-care budget is spent on treating the late stages of disease, he reported. Less than 2 percent is spent on disease prevention and health promotion.

"I hope all of you get interested in how we can move people in these areas," he urged. "If we did, we could cut down on half of cardiovascular deaths and reduce the onset of type-II diabetes by one-third."

Satcher's message--that behavioral and social sciences play a critical role in people's health-has been a refrain throughout his career. Promoting healthy behaviors is part of his primary goal of achieving a balanced community health system--one that "balances health promotion, disease prevention, early detection and universal access to care."

In Satcher's view, health care is not just about seeing a health-care professional when an illness takes hold. Instead, health care should also take place in the home, in schools, churches and community centers where people can learn to promote health and prevent disease.

"Many of the things that we invest in treating today--or that we fail to invest in treating today, especially in the area of mental health--could be prevented if we had a balanced community approach," said Satcher. "It calls for a research agenda that balances basic research, biomedical research, behavioral research and public health research."

A balanced approach to care could, for example, dramatically reduce violence by increasing awareness of the precursors of aggressive behaviors, and encouraging communities to find solutions that work for them, said Satcher. Along those lines, Satcher has backed the launch of the "Safe Schools, Healthy Children" initiative, which encourages communities to submit proposals for programs that help youth avoid violence, drugs and destructive behaviors. The $300 million program is supported by three U.S. departments: Education, Justice and Health and Human Services.

"The beauty of this program is that it requires communities to come together [to solve their own problems]," said Satcher. "It shows how far we've come since we saw violence as law enforcement--it is now a public health issue."

A balanced community health system could also help achieve several other important goals, said Satcher: