Surgeon General nominee, Dr. Regina Benjamin, has her work cut out for her

July 13, 3:00 PMBaltimore Disease Prevention ExaminerRene Najera

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Obesity will get you nowhere, fast. (Image Credit)

As President Obama is looking for ways to improve the quality and financial aspects of medicine in the United States, he has now nominated Dr. Regina Benjamin for the job of Surgeon General of the United States. Dr. Benjamin is a rural physician from Alabama. She first came onto the national scene when her clinic in Bayou la Batre, Alabama, was first destroyed by Hurricane Katrina and then burned down after being rebuilt. She is a recipient of the 2008 acArthur Foundation's so-called "genious grant", a half-million dollar grant given to people who make a difference in the world. There is no doubt that Dr. Benjamin has the know-how and will have the resources to take action on all sorts of health issues in the country. The question is how much cooperation we, the public, and we, the public health professionals, can give her.

Here are some of the challenges both she and all of us face...

DIABETES

The Centers for Disease Control and Prevention put the number of people in the United States with diabetes at around 23 million, with about 25% of them now knowing they have the disease. Per capita, most of the cases can be found in Southern States (Alabama, Florida, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, Texas, and West Virginia). In 2007, it was estimated that diabetes cost the U.S. economy somewhere around $174 billion in treatment of the disease, its complications, and the loss of productivity from it. In terms of deaths, diabetes was the sixth cause of death in the U.S. with over 69,000 deaths being mentioned as the underlying cause of death and contributing to a total of over 213,000 deaths. And that's just the deaths reported.

HEART DISEASE

Heart disease goes hand-in-hand with diabetes because many of the factors that lead to type II diabetes, like obesity, or are a result of it, like hypertension, lead to heart disease. Over 630,000 deaths from heart disease occur each year, based on the latest data. That is 137 times the number of fatalities in the Iraq War. In terms of money, over $475 billion is expected to be lost in diagnosing, treating, and living with heart disease. Yet there are no protests on Capitol Hill to stop these trends, and there is no real concerted effort to get us to change our habits. Dr. Benjamin, hopefully, will lead the charge.

HIV/AIDS

Probably the most preventable condition that is in epidemic proportions not just in the United States but in the world is HIV infection, which leads to AIDS. HIV is a virus that is transmitted by blood, unprotected sexual contact, and from mother to child at birth or through breast milk. There are many drugs on the market that can reduce the virus in patients' blood, thus extending their lives and improving their symptoms. But these drugs are costly, $10 per day or more. Also, HIV can be prevented by the use of condoms, many of which are free.

OUR MANHATTAN PROJECT

Of course, there are other diseases and conditions that require a lot of time, attention, and money to get under control or eliminate. Yet these goals cannot, and should not, be the job of just one person in the office of Surgeon General. Losing weight as a nation should be our Manhattan Project, something we can all rally behind and contribute to. Drop the rate of obesity and we drop the rates of heart disease, diabetes, and maybe even cancer. Get smokers to quit and the rates of lung disease (and the loss of productivity) drop dramatically. Help drug users get clean, and we get rid of crime. Teach effective sexual health, and there will be less unwanted pregnancies (in turn, less abortions, less sexually transmitted diseases). The list goes on and on...

Dr. Benjamin and others in leadership positions in Public Health will need all the help they can get from the American public and those of us in Public Health. After all, you can take the horse to the water, but you can't make it drink... Unless you trick it into losing weight.