In keeping with the Library's African American History Month theme of "Heritage and Horizons: The African American Legacy and Challenges of the 21st Century," U.S. Surgeon General David Satcher's Feb. 11 keynote address celebrated past achievements of African Americans in medicine while outlining the nation's preventive health goals for the first decade of the new century.
"The present is the egg laid by the past that has the future in its shell," said Mr. Satcher, quoting Harlem Renaissance writer Zora Neale Hurston. "Each year during this month, we are reminded of the power, the courage and the steadfastness of great American champions of color, and we are encouraged and reinvigorated to build on that great legacy. The fact that we remember them is due, in no small part, to the resources you provide to the millions of researchers, scholars and tourists who visit the Library of Congress and the millions more who use its [electronic] services each year."
According to Mr. Satcher, the origin of medicine can be traced to 5000 B.C., with its close relationship to religion and astronomy in Babylonia and Mesopotamia. "Ancient practitioners trusted the gods and looked to the stars to treat disease," said Mr. Satcher. He cited the achievements of Imhotep, "the first bona fide physician," who lived in Egypt in 3000 B.C.
More recent achievements of African Americans in medicine include those of Daniel Hale Williams, who pioneered open heart surgery; Percy Julian, who developed synthetic steroids to treat arthritis and other inflammatory diseases; and Charles Drew, whose work with blood plasma led to the best method for collecting and storing blood.
Mr. Satcher has also played a role in African American and medical history. Sworn in on Feb. 13, 1998, as the 16th U.S. Surgeon General, he is the first black male to hold the post, and the second person in history to simultaneously serve as Surgeon General and Assistant Secretary for Health. (The first person to hold the dual position of Surgeon General and Assistant Secretary for Health was Julius B. Richmond, the 12th U.S. Surgeon General, who served in 1977-1981). In these roles, Mr. Satcher serves as the secretary's senior adviser on public health matters and as the director of the Office of Public Health and Science.
Eliminating the disparity in health care on the basis of race or ethnicity is one of Mr. Satcher's top priorities as outlined in "Healthy People 2010," the nation's health agenda, which was launched last month.
"A baby born to an African American mother has more than twice the risk of dying in the first year as a white baby," he said. "African American women have the highest mortality from breast cancer, although the incidence of breast cancer is higher among white women." The reason, according to Mr. Satcher, is access to health care. "Too many people are uninsured or underinsured."
The AIDS epidemic is another public health risk that is increasingly affecting the minority population. "In 1986, 25 percent of new AIDS cases were among African Americans, 14 percent were Hispanics, and 8 percent were women. Last year the Centers for Disease Control reported that 45 percent of new cases were among African Americans, 25 percent Hispanic, and 25 percent women." On a positive note, Mr. Satcher reported that progress has been made in decreasing the number of deaths from AIDS, as a result of new and improved drugs for treatment.
Deaths from influenza, particularly in the young and elderly, is another area in which disparate access to health care is a factor. "Immunizations have done a lot to close the gap, but there are still major disparities. Only 50 percent of African Americans over the age of 65 receive the flu shot, as compared with nearly 70 percent of seniors in the majority population."
Immunization is one of 10 Leading Health Indicators highlighted in the "Healthy People 2010" plan.
"The plan has 467 objectives," said Mr. Satcher. "While the objectives may vary from community to community, we hope that everyone will adopt the 10 Leading Health Indicators." Five of the indicators are related to the health care system, while the other five are related to environment and life-style, such as violence and injury, environmental quality, access to care and mental health.
"Unfortunately, there is still a stigma that stands in the way of treatment for mental illness," said Mr. Satcher. "The message of the Surgeon General's report is that mental illness is just like any other disease, only it happens to involve the brain."
In the area of life-style indicators, the plan addresses tobacco and other substance abuses, physical inactivity, obesity and responsible sexual behavior.
"It is not just a matter of taking individual responsibility," said Mr. Satcher. "It is also the responsibility of the community. If we don't teach our children about sex at home, at school and in our churches, then we are failing in our community responsibility."