“Promoting and Protecting Brain Health Across Race & Age” Hilton Head, SC November 15, 2017 4th Annual Healthy Churches 2020 National Conference I am pleased to be part of our 45th reunion. We have survived longer than some, so we should not take for granted that we are all still alive and well enough to gather here today. I am excited to address this topic of the Surgeon General’s prescription since it brings together much of my work as Director of the CDC, Surgeon General, and Assistant Secretary for Health. David Satcher, MD, PhD Founding Director & Senior Advisor Satcher Health Leadership Institute and Morehouse School of Medicine 16th U.S. Surgeon General

Conflict of Interest Disclosures for David Satcher, M.D, PhD Grant/Research Support NIH-TCC, 2010-2016 Consultant Nothing to disclose Speakers Bureau American Program Bureau; Satcher Group Stock Shareholder Johnson & Johnson/ MetLife Insurance Company Other (identify)

Satcher Health Leadership Institute Mission The mission of the Satcher Health Leadership Institute (SHLI) is to develop a diverse group of exceptional health leaders, advance and support comprehensive health system strategies, and actively promote policies and practices that will reduce and ultimately eliminate disparities in health. Leadership lessons from the Satcher Health Leadership Institute: Leadership responds to opportunities, challenges and crises Leadership is a team sport Leadership is not position-dependent Effective leadership transforms communities Leadership requires a global perspective Leadership is like a relay race 2

Morehouse School of Medicine Vision Statement “Leading the creation and advancement of health equity”

Satcher Health Leadership Institute Leadership Development Health Policy Fellows Community Health Leadership Health professions student rotations Quality Parenting

Healthy People 2010 Overarching Goals Increase Years and Quality of Healthy Life Eliminate Racial and Ethnic Health Disparities

Healthy People 2020: Overarching Goals • Attain high quality, longer lives free of preventable disease, disability, injury, and premature death • Achieve health equity, eliminate disparities, and improve the health of all groups • Create social and physical environments that promote good health for all • Promote quality of life, healthy development, and healthy behaviors across all life stages

Equality vs. Equity Policy change is essential to achieving health equity. Every person deserves the opportunity to reach his or her maximum health potential.

What if we had Eliminated Disparities in the Last Century? 83,500 fewer Black deaths in 2000 24,000 from heart disease 7,000 from HIV / AIDS 4,700 infant deaths 22,000 from diabetes 2,000 fewer Black women from breast cancer More health insurance coverage 2.5 million Blacks, including 620,000 children Satcher et al., 2005

What if we were equal? Source: D. Satcher et al, Health Affairs, March/April 2005

What Are the Social Determinants of Health? The conditions in which people are born, grow, live, work and age. They are shaped by the distribution of money, power and resources at global, national and local levels. Changes in the Social determinants of Health often require policy changes. Source: WHO

Viewing the Human Brain Source: Google Play

The Learning Connection

Physical Activity & Mental Health Health Impact Studies show that physical activity reduces depression & elevates mood. Studies show that physical activity improves sleeping. Studies show that physical activity improves mental acuity. Studies show that physical activity reduces stress and anxiety.

Mental Health The successful performance of mental function, resulting in productive activities, fulfilling relationships with others, and the ability to adapt to change and to successfully cope with adversity. The last 25 years has resulted in a scientific revolution around mental health. 1

Key Messages Mental health is fundamental to overall health and well-being. Mental disorders are real.

Key Messages Mental disorders are disabling. Mental disorders are as disabling as cancer or heart disease in terms of premature death and lost productivity. Life expectancy- 25 years less than population.

Key Messages  44 million adults Mental disorders are common (U.S.). 1 in 5 Americans has a diagnosable mental disorder each year.  44 million adults  13.7 million children

The Good News Research has improved our ability to recognize, diagnose, and treat conditions effectively. 80-90% of mental disorders are treatable using medication and other therapies

The Bad News Of those with diagnosable mental disorder… Fewer than half of adults get help  Only one-third of children get help

McKinlay’s Population Model of Health Promotion: Healthy Diet for Children Nutrition training Requirements for professional certification (childcare Healthcare) Parent training re; feeding Practices/healthy diets Agriculture policy Food subsidies And expanded funding/ Eligibility for NSLP/NSBP State/Federal Food and menu Label regulations Community-wide Education campaigns BMI screening And treatment Restaurant/grocery store/school point of purchase prompts School soda bans/ Competitive food restrictions Zoning/business Inventive for grocery stores Farmers markets Federal /State Lobbying/discharge regulation (upstream) (midstream) (downstream) Source: Based on McKinlay (1995), Glanz (1999)

Lifestyle Indicators and the 16th Surgeon General’s Rx We implemented the 10 Leading Health Indicators as a way for individuals and groups across the nation to connect with, understand, and implement changes in these critical areas of health. These indicators are comprised of five health systems indicators and five lifestyle indicators. Society has to provide the opportunity for these things to be achievable

In order to eliminate disparities in health and achieve health equity, we need leaders who first care enough, leaders who know enough, leaders who have the courage to do enough and leaders who will persevere until the job is done. Take-home recommendations: We need for healthcare providers to partner with the communities in which they practice Community members, leaders, healthcare providers, and policy-makers all need to work together to improve community health SHLI’s leadership development programs work to improve community health SHLI-MSM

“Promoting and Protecting Brain Health Across Race & Age” Hilton Head, SC November 15, 2017 4th Annual Healthy Churches 2020 National Conference I am pleased to be part of our 45th reunion. We have survived longer than some, so we should not take for granted that we are all still alive and well enough to gather here today. I am excited to address this topic of the Surgeon General’s prescription since it brings together much of my work as Director of the CDC, Surgeon General, and Assistant Secretary for Health. David Satcher, MD, PhD Founding Director & Senior Advisor Satcher Health Leadership Institute and Morehouse School of Medicine 16th U.S. Surgeon General