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Remarks as prepared; not a transcript

Vice Admiral Richard H. Carmona, M.D., M.P.H., F.A.C.S.
United States Surgeon General
Department of Health and Human Services

American Society for Law Enforcement Training (ASLET)
17th Annual International Conference

Tuesday, January 20, 2004
St. Louis, Missouri

"Education and Training: The First Steps in Achieving National Preparedness"

Thank you for that introduction, Captain Meyer. It is a real pleasure to be here among friends and colleagues.

In nominating me to be the 17th U.S. Surgeon General, President Bush and Health and Human Services Secretary Thompson recognized that the nation’s health and the nation’s defense are more closely intertwined than ever. Never before has there been this intersection of public health and public preparedness.

That’s why I always say that serving as a Sheriff’s deputy and SWAT team leader, and previously in Vietnam as an Army Special Forces medic and weapons specialist, helped prepare me for this job.

Before President Bush and Secretary Thompson nominated me to this position, I was an anonymous guy working in my community. And as a high-school drop-out, I didn’t exactly have a straight career trajectory to the Office of the Surgeon General.

But the President was looking for someone who could understand the new threats we face—weapons of mass destruction causing immediate large numbers of civilian casualties. These threats mean that we now need to combine the disciplines of medicine and law enforcement and the military to protect and defend our homeland.

And just as important, all of us in these critical homeland defense positions need to take care of ourselves.

We need to be physically and mentally ready to meet whatever challenges come our way.

The reality is that what you do is not strictly law enforcement. You may be called on to play the part of the priest, the marriage counselor, the mentor, or the surrogate parent. It’s a multi-dimensional job.

As trainers and educators, you are teaching officers not only how to use their weapons, but when. And you are teaching officers how to handle the worst that life has to offer: the trauma of an officer-involved shooting; the trauma of being the first on the scene of a suicide, or domestic abuse, or a fatal auto accident.

As officers, we want to be tough, macho, to not ever show pain. But that’s unrealistic in a job where the stress is equal to living and working in a war zone.

And for officers who experience a trauma, it’s not unusual for depression to hit—and to hit hard; for divorce rates to spike; for outstanding men and women to start looking for answers at the bottom of a bottle of pills or booze.

We all know, we all have friends who have been hurt. The lucky ones had support from fellow officers and their agencies. There are more than 17,000 law enforcement agencies in the United States. Many have been working on these issues for decades.

I got very interested in this issue after I was the officer in an officer-involved shooting—a shooting that I know saved innocent lives, but that I think about every day, and I know will be with me until the day I die.

I want to ask all of you to continue working with ASLET and with each other to promote partnerships, training, and sharing of best practices to help officers survive the physical and mental aspect of traumas ….. with their careers and their families still intact.

I want to thank you for your dedication to training the men and women who have been invested with one of the most important jobs in America — protecting society.

Through education, you are preventing death and disability, you are promoting safer communities by teaching conflict resolution through alternative means.

You are teaching the importance of physical fitness, mental preparation, and academic preparation. Along the way, you help build character, and you strengthen communities.

You are so often working anonymously, but I want you to know that you are not unrecognized. In meetings with President Bush, I have often heard him say that that the law enforcement officers in the states and communities throughout our nation must receive more of the recognition and resources that have previously been in too short supply.

Law is one of the foundations of a civil society, and with law comes law enforcement. We need honorable people to enforce the law, to promote and preserve order. We’ve seen the devastation that can occur in a society in the absence of law enforcement.

Right now, one of the most important steps in the rebuilding of Iraq is training Iraqi locals to serve as law enforcement officers. These are some of the most sought-after jobs in the new Iraq.

President Bush recognizes your commitment and the importance of the partnerships you have built in your communities and between law enforcement agencies throughout the nation and the world.

Priorities

When President Bush and Health and Human Services Secretary Tommy Thompson nominated me to be Surgeon General, they asked me to focus on three priorities to maintain and improve the health of the American people.

All three of my priorities are very strongly evidence-based. They are:

First, Prevention. — What each of us can do in our own lives and communities to make ourselves and our families healthier.

Second, and new to the Office of the Surgeon General: Public Health Preparedness. We are investing resources to prevent, mitigate, and respond to all-hazards emergencies.

You and the officers you train and educate are securing our homeland, preparing us for the next fight.

and

Third, Eliminating Health Care Disparities. I am so happy and proud that the President and Secretary have charged me with working with them and all of you to eliminate health disparities.

It is a challenging agenda, and I am committed to seeing measurable progress in these areas during my tenure as Surgeon General. But I can’t do it alone. I need you — your expertise, your experience, and your passion. The experiences I had as a law enforcement officer were the best background for my current position for many reasons.

I got to see from the street level, as a paramedic and later as a police officer, all of the things that are preventable in our society: drunk driving, domestic violence, knife and gun violence, all of the trauma. I was on the receiving end, like you, of all those things that were preventable.

Prevention

My top priority as Surgeon General can be summed up in one word: prevention. Everything I do has prevention first. Like many of you, I’ve lived through the era of mandatory law enforcement PT and testing a couple of decades ago to the current "honor" system.

Over the years I’ve been an FTO, an instructor at FLETC, and a SWAT team leader. I know the value of fitness firsthand. I’ve had to run or go on extended ops at the end of a long shift, I’ve had to respond to back-up and primary calls on days that I would rather have been in bed. What ultimately got me through those days was my level of fitness, my mental preparedness, and the training I had received.

As an academy instructor for the Officer Survival courses, the question I always asked officers as they prepared to leave the academy was: "Where will you be five years from now? Will you still be physically fit? …Can you still draw your weapon in time? Are you still in shape?"

The reality is the risk you entertain is not only to yourself if you’re not prepared to respond to the worst-case scenario call, but also the potential harm that you put your fellow officers in because you’re not able to physically respond.

Those of you who have taught for years know that the young officers need to hear this, and it needs to be reinforced.

For me, it would be a fate worse than death to not be able to back up a fellow officer because I wasn’t physically able, because I was out of shape and got winded before I could reach the side of a brother or sister in uniform.

Those of us who wear a uniform must keep ourselves in what I call "fighting shape."

Obesity

In law enforcement, we are in the business of preparing for the worst. We act positively and plan negatively. So let’s take a look at a threat that is very real, and already here: obesity.

Nearly 2 out of 3 of all Americans are overweight and obese; that’s a 50% increase from just a decade ago. Over 15% of our children and teenagers are overweight. That’s 9 million American kids who are at serious risk for Type 2 diabetes, a disease that was unheard of in young people just 20 years ago.

Why are we facing this health catastrophe? It’s almost entirely preventable through healthy diet and exercise. But over 25% of children in America spend four or more hours a day every day watching television, playing video games, and surfing the web.

Less than a quarter of all students get the recommended hour of physical activity each day. We are seeing a generation of kids who grew up OFF the playground and ON the PlayStation.

We need to focus on getting children and their parents excited about increasing the amount of physical activity in their lives.

Better health will ultimately make for better citizens and, for those who choose this career path, better public safety officers.

As officers and educators, you are leaders and role models in your communities. Work with schools and youth groups to get kids moving, and continue to be role models, showing kids the importance of being physically fit, eating healthy, not smoking, and not drinking or doing drugs.

And as we are getting our kids to be healthy, we need to do it ourselves. Being overweight or obese, smoking, and drinking too much directly impact job performance in law enforcement and public safety.

But it is possible that officers are also more susceptible to being overweight in the first place because of working irregular, long hours under high stress. There is a concept known as "abdominal obesity," or fat around the middle. Medical research shows that stress actually changes your nervous system and hormones in ways that encourage fat accumulation around the waist. This type of fat has been linked to increased rates of hypertension, heart disease, and diabetes.

But we can’t use stress as an excuse. We have to work out every day, eat healthy foods, and stay away from tobacco.

I want to commend ASLET for working with the National League of Cities to develop a voluntary fitness program for law enforcement officers. ASLET recognizes that fitness is a key component to officer safety and survival.

Physical fitness doesn’t start and end at the academies. It has to continue throughout the officer’s career and life.

Charge and Closing

The law enforcement community can lead by example. Put into practice the behavioral guidelines that we know work. Encourage your fellow police, fire, and EMT officers to eat right, exercise, and stop smoking and drinking.

Members of law enforcement are leaders in homeland defense. You can also lead by example in your own lives by making healthy choices.  I work out every day. So do President Bush and Secretary Thompson.

Those of us in government, law enforcement, and the military have a higher standard to adhere to. It is our patriotic duty to be in the best shape possible, both mentally and physically. You and the officers you train are the final line between bad and good. That means that you have the toughest jobs in America. You protect and serve, using innovative tools and techniques to keep our communities safe.

Our country is in your debt, every single day.

Thank you for your hard work. Take care of yourselves!

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Last revised: July 2, 2004

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