Surgeon General Applauds Faith + Community Leaders Helping People From Crisis to Career

Surgeon General Applauds Faith + Community Leaders Helping People From Crisis to Career


Health and economic prosperity — a lot of
times, we don’t think of the social determinants of health and how it impacts our lives, but
we have a Surgeon General who does understand that connection. Before he became a doctor, he was a health
commissioner in the State of Indiana, and an anesthesiologist as well in Indiana. I’m also especially excited that Dr. Adams
has a motto. It’s better health through partnership. And it couldn’t fit any better than to have
our Surgeon General to be here to really model what I’ve been talking about that need to
connect, not just to the faith-based community, not just to local governments, but I’m going
to throw in private sector as well to address any addiction challenges that we have. So I’m excited. Welcome to your city hall away from home. You’re here to bring this issue to us, and
we’re going to take it our members. So, thank you all very much, and Dr. Adams,
come on up. Welcome Dr. Adams, our Surgeon General. Well good afternoon everyone. Thank you Clarence Anthony for the kind introduction
and for your incredible leadership at the National League of Cities. I don’t need to say anything, he said it all. Clarence took all of my lines. He took my Hamilton reference. He even took my haircut. There’s nothing more to say. I really am glad to be here I want to give
a special thanks to Shannon. Shannon where are you? Shannon Royce and her team from the HHS Office
of Faith and Opportunity Initiatives, for making sure that people in congregations and
communities are getting the resources and help they need in making sure
we lift up the great things that you all are already doing. I understand this room is filled with folks
from national and local faith communities. Raise your hand if you represent a faith community
in the room. Alright, fantastic. We have addiction recovery support providers,
any of those in the room, social enterprise employers, corporate chaplains, public leaders
and private investors. Fantastic. Fantastic. We need everyone to support people in recovery
and get them back to work and to school, back to their families – to rebuild their lives
and walk the bridges from treatment and recovery to again being a part of our communities once
again. And every single one of you is critical to
make that happen. I want you to hear me say this and if you
are Tweeting this out, and I encourage you to Tweet and put this on Facebook to share
this so that people beyond the folks in this room can benefit from our conversation we
are going to have today and over the next few days. I want you to hear the Surgeon General of
the United States say that the power of faith-based groups to turn around tragedy is real. It is very real and I saw this first hand
in Scott County, Indiana. Where faith leaders were critical to turning
the county around after what was a historic HIV outbreak. And I don’t know if you are familiar or not
but it’s a small rural community, about 4,000 people that had never had more than 3 HIV
cases in a single year in the recorded history of the town. And in a little over a year we had over 200
cases of HIV related to injection drug use and it was really partnering with folks who
we don’t traditionally from a health sphere think of. The faith community. The law enforcement community. The Chamber of Commerce. It was working in concert with those individuals
again with the faith community at the center of it that allowed us to turn around this
HIV outbreak and Scott County is no longer known as the community that suffered from
the largest HIV outbreak in the history of the United States related to injection drug
use. They are now known as the community that overcame
the largest HIV outbreak related to injection drug use in the history of the U.S.
I want you all to know that I am sincere when I say thank you all for making the effort
to be here because whatever the problem, you know about it long before we do. You are seeing it experiencing it and we need
you to be a part of the solution. I want you to know a little bit about what
I am working on. During my tenure, I’m focused on three main
areas: Number one, addressing substance misuse, and
in particular the opioid epidemic. But we don’t want to be fooled in thinking
that is the only substance that people are misusing and focusing solely on putting out
the fire and ignoring the fact that upstream from opioid misuse is substance misuse including
alcohol that includes e cigarettes among our young people. That includes marijuana. Particularly in this country we are getting
a lot more liberal in our ideas about who should and shouldn’t have access to marijuana. We can talk about that if you want to. I have some strong feelings about that. I think we need to look at substance misuse
across the board so I am focusing on opioid misuse with a particular target of opioid
misuse. Number two, I am working to improve the health
of our communities by making the connection between investments in communities and associated
economic prosperity. I am going to talk about that in a little
bit but I’m a big believer. We have some mayors and city officials in
the room so I’m going to tell you all a quick story that I told Mayor Anthony. I was at the conference of US Mayors last
Fall and I had Mayor Deblasio from New York on one side of me and Mayor Benjamin from
Columbia, South Carolina on the other side of me. Had a group of mayors all around the table
and I asked the question, and I was half joking, but I wanted to know what made these mayors
tick and I said how many of you all ran for office on a pledge to lower the hemoglobin
A1C rates in your community by 15%. And for the folks not medically inclined the
hemoglobin A1C is how we measure whether or not you are diabetic and how diabetic you
are. I was shocked, not a single mayor raised their
hand. What we need to do is help frame health, not
in hemoglobin A1C, but in ways that resonate with voters and with policy makers and so
when you look a Gallup polls, the number one issue people vote on, democrat or republican,
black or white, rural or urban is jobs and the economy. And so it’s the reason why I’m not ignoring
health I’m trying to translate health into the metrics that people care about so that
they understand investing in a healthy community is going to be healthy for a good bottom line. The third issue I am raising awareness of
the link between our Nation’s health, and its safety and national security because when
i was looking at those polls the number two issue people vote on is safety and security
and that may play out in different ways in different elections. People consistently vote on safety and security. Here is a shocking statistic 70% of our 18-24
year olds are ineligible for military service because they can’t pass the physical, can’t
meet the educational requirements or have a criminal history. So poor health in your communities
isn’t just a matter of hemoglobin A1Cs or cancer 20 or 30 years down the road or heart
attacks or strokes. We are literally a less safe country now because
we are an unhealthy country. We need to help people make that connection. My guiding principle across all of my priorities
is Better Health through Better Partnerships, because we cannot change our future alone. We’ve been all chugging along in our silos,
health silo, faith based silo or industry silo. Einstein said the definition of insanity is
doing the same thing and expecting a different result. We have to break down these silos and partner
if we want to achieve better health however you define it. Community Health as a means of achieving Economic
Prosperity, or CHEP as I like to call it, is a prime example of this. Last spring, I participated in a Webinar hosted
by HHS Office of Faith and Opportunity Initiatives, where I first introduced this concept. Community health and economic prosperity are
inextricably linked. When community health is poor so is community
prosperity. We have seen it play out. New information coming in from the last recession,
there’s a lot of fear that we are entering another recession. Some data from the last recession showed that
communities that invest in complete streets, clean air laws, invest in things that lift
up a community had better economic resilience during the recession. Less job growth, less wage loss and they bounced
back more quickly after the recessions. So again, health and prosperity are inextricably
linked. Today, I’d like to focus on how each and every
one of you can not only address, but leverage the crisis that is the opioid epidemic as
a way to improve health and also improve the economic prosperity of your communities because
if we’re going to be honest that a reason a lot of community
leaders are so concerned about this. I work with the Department of Labor and from
a health point of view what I view as a health crisis they are viewing as a work force crisis. We have 7 million unfilled jobs in this country,
more unfilled jobs than there are actually people looking for work. So even though we have record economic growth
going on it is at risk of stalling because we don’t have enough healthy workers so many
people have checked out due to the opioid epidemic. Opioid addiction and overdose cost $20.4 billion
in lost productivity. Everyone in the room knows that $20 billion
is more than just a number. We’ve seen firsthand how this crisis has impacted
generations of families, and now we know how much it has impacted our businesses and our
economy. And we also know that there are many ways
we can intervene and help individuals suffering from addiction outside of just healthcare,
and that businesses have some self-interest in intervening. The truth is 80 to 85 percent of health is
driven by factors that have nothing to do with health care, we focus a lot on healthcare. Healthcare is 10-15% of our overall health
and factors largely in our communities the places where you all work is what drives health
as much if not more so than the doctor standing up here on the stage
when you have fallen into the stream versus trying to prevent it. About 40% of our health is driven by social
and economic factors. These factors range from employment to income
to education to community safety and social support. Our health affects our businesses, as that
lost productivity number indicates. Our businesses need a healthy workforce in
order to thrive and our economy needs a health population. You’re here in DC. Anyone hear about this company Amazon? They just put their second headquarters a
few miles from here in Crystal City, Virginia. What folks don’t know is that 4 of the top
20 healthiest cities in the country as rated by US News and World Reports, surround Crystal
City, Virginia. That is not an accident folks. Healthy communities lead to healthy workforces
which in turn lead to job growth and wage growth and we’ve seen it right here. And I cannot think of a group of individuals
better situated to intervene at this nexus than our faith leaders who are across the
country and in the room. Our faith partners all of you, and many more
have an extraordinary ability to bring communities together, to serve the most needy and the
most vulnerable, and I am often heard saying, and anytime anyone, anywhere, suffers from
poor health, it’s not just their problem, we all pay the price. You all serve those most needy and most vulnerable
and bring out the best in our residents and call out the humanity of each of us. That is critical at a time like this. I understand there are faith communities,
I like to do my homework before I come, that are doing some really innovative work:
Providing space for social enterprise entrepreneurs to hire persons in early recovery; Critical. We’ve got a generation of folks who have been
incarcerated or have succumbed to substance misuse. What are they going to do when they get out
even if they do recover? We are pushing them towards recovery
they know that when they get out of jail, get out of recovery they have that scarlet
letter on them and they are never going to be able to be employed again. It’s critical that we think about what kind
of future we are painting for them. I was actually at Aberdeen Proving Ground
talking to a gentleman who was in recovery he said to me the biggest challenge that folks
aren’t talking about is that you’ve got to make it more attractive for me to go into
recovery than it is for me to get high. As bad as it got for me, being in the throes
of addiction and getting high and supporting my habit, there was nothing on the recovery
horizon that seemed attractive to me. I couldn’t get a job, my family had written
me off, the community didn’t want me back in the community and we have to make it more
attractive for people to recover than it is to continue to get high. Some of you are mentoring men and women on
writing resumes, interviewing jobs and developing other soft skills needed to get that job and
get back in the work place. Training retired folks in their communities
to drive their church vans and getting people to their new place of employment. One of the biggest challenges I’ve heard is
transportation. Whether getting to recovery or getting to
their jobs. It’s a huge barrier we don’t think about when
thinking about health that we don’t think about when we think about employment. When we are in our silos we don’t think about
the fact that in order for us to help them or in order for them to help us, they have
to get from home to where we are or we need to figure out how to meet them where they
are. Offering their facilities as incubator space
for entrepreneurs: Lifting up peer coaches to walk with folks and help them navigate
early recovery and new employment. Critically important. Peer recovery coaches, critically important. As with many Americans, the opioid crisis
is not just pressing, but personal for me. My baby brother, Philip, is currently serving
a ten-year prison sentence for crimes committed to support his addiction. Stole $200 from a vacated property, got a
ten-year prison sentence. I don’t tell that story to evoke the sympathy
I often get, I tell it to get, gosh the $150-$200 a day to incarcerate someone times five years,
if he gets out on parole in five years, means all of you as tax payers are going to pay
a quarter of a million to half a million dollars to incarcerate him. Versus five thousand dollars for a diversion
program, versus $500 to get his anxiety and depression treated, versus $50 for a community
resilience program and I know I’m going a little bit off script but that is exactly
what the Centers for Faith Based and partnerships at HHS is all about. Trying to say how can you use some of that
money upstream and create programs and opportunities that prevent us from paying half a million
dollars to incarcerate someone on the back end. And then do it over and over and over again
because we still haven’t strengthened communities to the point that he has any hope when he
gets out other than run back into the arms of the same people that led him into that
situation in the first place. My brother suffered from untreated mental
illness, and unfortunately turned to drugs to self-medicate. I share my family’s struggle to illustrate
that addiction can happen to anyone. We used to think, we were all taught when
we were younger that addiction happens to bad people and bad families, well my parents
managed to raise a Surgeon General so I think they did something right. If it can happen to our family, it can happen
to any family and I hope by sharing my story, I hope to give others the courage to share
theirs, so that together we can fight stigma. I truly believe, stigma is one of our biggest
killers. It killers more people than fentanyl because
it prevents us from recognizing a problem and finding solutions, from coming forward,
from sharing our family’s problems. How many communities that we know of, that
we are in, where people hide the fact that a loved one has addiction. You know I talked to a mother who lost her
son to an overdose, and she said to me, when someone has cancer they have a potluck, they
bring casseroles. When someone dies from an overdose no one
talks about it. If they do talk about it, they lie about it. They actually fudge the obituary. They don’t own it. We have to get to a place where we see addiction
as a disease and not a. We’re providing casseroles, we’re providing
tangible support for people in communities when they are suffering from addiction, when
they are suffering from a loss and not driving them into the shadows. I’ll close by stating that every one of you
is a leader in your community. So it is imperative that we use our platform
to maximum effect and that starts with humility and I know I am preaching to the choir here
but it starts with servant leadership. I am a big believer in servant leadership. I know I am preaching to the choir because
you all are here. But I also know in the faith community we
have some concerns with people who talk the talk but don’t walk the walk when it comes
to servant leadership. Servant leadership is about meeting the needs
of others so that their success in turn becomes your success. And until we all start to embrace that we
are not going to get where we want to be. Give your imagination free rein as to what
is possible because again doing the same thing and expecting a different result is insanity. We have to throw this completely on its head. We have to rethink addiction. We have to rethink recovery. We have to rethink what community supports
look like. You know, here in DC folks are often saying
we need more money for this, we need more money for that. We do but we aren’t going to spend our way
out of this problem, not in the paradigm that we’ve currently got. So have some imagination, have the courage
to think outside the box. Many people think one of the contributors
of the opioid misuse epidemic is economic hard times and lack of job opportunities and
you heard the mayor say that when he talked about hope. Certainly once someone becomes caught in the
web of addiction, a healthy future can seem like an impossible dream and it’s just easier
to get high. This convening will offer you tools and resources
and I will get you started with a little advice. Build relationships throughout the community. Everybody has something to offer and can be
part of the solution. And I’ll tell you in my time as state health
commissioner of Indiana and my time as Surgeon General people expect me to come into a meeting
like this and ride in on a white horse and give you all the solutions to save the day. The fact is, I’m sorry that isn’t going to
happen, but what I am able to do is bring people together, convene people, get people
talking. It is much more important for every single
one of you meets five, ten, twenty new people over the time that you are here and learn
from their best practices and their failures than one of you meets the Surgeon General
of the United States and that is the truth. So build relationships throughout the community,
starting here, starting now, starting today. Think creatively about preventing opioid misuse
from happening in the first place, prevention is an important part of this and helping those
who need support right now and recovery. It’s not one or the other, it’s got to be
both. We’ve got to mop up the water as it spills
out of the sink onto the floor but we’ve also got to turn off the spigot otherwise we are
going to keep on mopping and fall further behind. For those that are parents you know that I
have been through this before with my kiddos. Oh my gosh, they flooded the tub one time
and there was water pouring out of the chandelier as I walked into the house and the first thing
we thought was we through a towel underneath the dining room table before it collected
and went down into the basement and we were in freak out mode and suddenly decided we
need to go upstairs and figure out where this water is coming from. But we do that all the time. We tend to focus on the downstream and not
the upstream. You help with this by creating mentorship
programs and internship programs. By creating and strengthening pathways to
high school graduation, college, the military and employment. All of these are options if we catch them
early enough and get them back on the right pathway and then they open doors for other
people. Those little wins then add up to bigger wins
because then they start to see a future. Whether you are a workforce development office,
a city official, recovery support provider, a local business or a congregation- consider
what you can do together to create recovery-supportive work and school environments, recovery friendly
environments. Like Belden in Indiana. Anyone heard about them? The second lady and I went out there. They were having so many vacancies that production
and expansion were suffering and when people were coming to apply, they were failing the
initial drug screen, so what Beldon did is what I challenge you to do, I challenge you
to think outside the box. They partnered with the community and offered
potential employees treatment and recovery and then shepherded them into jobs at the
factory. They found that some of those employees are
now some of the most loyal and best employees. Their innovation strengthens the community. It lowers incarceration and it meets a pressing
business need. That’s that nexus we are talking about. Help ensure that prevention strategies are
culturally, linguistically, and age appropriate, and that they match people’s health literacy
skills. That’s critical. A lot of times we have great programs that
aren’t accessible to the people that most need them because they are not in the right
language or they are not at the right level or they are not in the right place. In Scott County Indiana we had to setup a
syringe service program and we set it up a mile away from the community and we didn’t
think that that would be a big deal. Remember that whole transportation issue,
that stigma issue, they didn’t even want to walk, because they didn’t want to be seen
walking that mile to syringe service program. And so we had to move it into the community. We had to make sure we understood our audience
and tailor our solution to meet their needs instead of expecting them to adapt to what
we were offering. Meet with community members to ensure that
community needs are identified and addressed. I never would have known that as the big city
official who rode in from Indianapolis, setup the program and said we did our job. If we never talked to the community to find
out what the needs are. If you are a member of the faith community-
how can you work more closely with the business community to be a support for someone newly
entering the workforce, or trying to enter the workforce? And again our Center for Faith Based and Neighborhood
Partnerships, I’m so proud of them, I’m so happy we have this program because in many
cases we think it’s bad for government and the faith based community to mix. The faith based community shouldn’t be talking
to the for profits out there because their motives are completely not aligned with ours. But the reality there is common ground for
all of us to partner and so I challenge you to work with the business community and show
them that by supporting your programs you can support a healthy workforce and help their
bottom line. If you are in the public sector how are you
engaging the diverse community assets to bridge services to employers and employees? Think big and think inclusively with imagination
and hope. My motto is better health through better partnerships. Because no matter what you are passionate
about, if you commit to forging better partnerships and being a better partner, better health,
stronger community and greater prosperity are sure to follow.


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