1. Boris D. Lushniak, MD, MPH RADM, USPHS Deputy Surgeon General
Department of Health and Human Services
Office of the Surgeon General
of the
United States of America
Boris D. Lushniak, MD, MPH
RADM, USPHS
Deputy Surgeon General
For more information, call us at 1–800–279–1605 or visit our Web site at
We look forward to hearing from you. Thank you. 1

2. DISCLOSURE OF CONFLICTS OF INTEREST
Boris D. Lushniak, MD, MPH
I do not have any relevant financial relationships with any commercial interests
No off-label discussion of drugs or devices
Work supported by US Government (DHHS, PHS, FDA, CDC/NIOSH)

3. The United States Public Health Service
Who we are
What we do
I’m the special assistant to the assistant secretary for health for the U.S. Public Health Service Commissioned Corps Transformation.
I play a highly critical role in the efforts to significantly grow the 6,000 officer active-duty force and provide increased opportunities for the Corps to help advance public health service, policy, and support through expanded assignments in Federal agencies and other organizations across the Nation.
In my 20-year Federal career, I have had the opportunity to serve in policy and managerial assignments of progressively increasing responsibility and scope, including executive and leadership roles at the National Institutes of Health, the Health Resources and Services Administration, and the Centers for Medicare and Medicaid Services.
I have also represented HHS in regional/State assignments and activities, serving as the Regional Health Administrator for Region 1 (New England) and assisting the hurricane response efforts in Louisiana and Florida in the fall of 2005.
I directed the HHS field response to Hurricane Wilma in November of that year, working closely with the Florida State Department of Health.
I joined the Commissioned Corps as an Epidemic Intelligence Service (EIS) officer and preventive medicine resident with the Centers for Disease Control and Prevention.
I am a board-certified fellow of the American College of Preventive Medicine and received my medical, public health, and bachelor’s degrees from the University of Michigan in Ann Arbor.

4. Seven Uniformed Services of the United States
DOD
Armed
Military
Non-DOD
Armed
Military
(DHS)
Non-DOD
Non-Armed
Can Be Militarized
(HHS)
(DOC)

5. The USPHS Commissioned Corps
The Surgeon General is the Commander of the USPHS Commissioned Corps
Regina M. Benjamin, MD, MBA
VADM, USPHS
18th Surgeon General

6. The Mission of the Commissioned Corps
Protecting, promoting, and advancing
the health and safety of the nation

7. US Public Health Service Mission
As America’s uniformed service of public health professionals, the Commissioned Corps achieves this mission through:
Leadership and excellence in public health practice
The advancement of public health science
Rapid and effective response to public health needs

8. The United States Public Health Service
1798 Act provided care for sick and injured
merchant seamen (loose hospital network)
1870 Marine Hospital Service (national system)
1871 Supervising Surgeon (later Surgeon General)
Dr. John Maynard Woodworth
1878 Quarantine functions (smallpox, yellow fever,
cholera)
1889 Legislation creating Commissioned Corps
1891 Immigrant services
1902 Public Health and Marine Hospital Service
1912 Public Health Service (with broadened powers)
I’m the special assistant to the assistant secretary for health for the U.S. Public Health Service Commissioned Corps Transformation.
I play a highly critical role in the efforts to significantly grow the 6,000 officer active-duty force and provide increased opportunities for the Corps to help advance public health service, policy, and support through expanded assignments in Federal agencies and other organizations across the Nation.
In my 20-year Federal career, I have had the opportunity to serve in policy and managerial assignments of progressively increasing responsibility and scope, including executive and leadership roles at the National Institutes of Health, the Health Resources and Services Administration, and the Centers for Medicare and Medicaid Services.
I have also represented HHS in regional/State assignments and activities, serving as the Regional Health Administrator for Region 1 (New England) and assisting the hurricane response efforts in Louisiana and Florida in the fall of 2005.
I directed the HHS field response to Hurricane Wilma in November of that year, working closely with the Florida State Department of Health.
I joined the Commissioned Corps as an Epidemic Intelligence Service (EIS) officer and preventive medicine resident with the Centers for Disease Control and Prevention.
I am a board-certified fellow of the American College of Preventive Medicine and received my medical, public health, and bachelor’s degrees from the University of Michigan in Ann Arbor. 8

9. A Proud History From Ellis Island… …To tribal lands Across America…
1918
From Ellis Island… …To tribal lands
Across America…
…Around the World
The earliest predecessor of the Commissioned Corps was the Marine Hospital Service. At the time—the early 1800s—our country relied on a healthy merchant marine for trade and security. Our seamen traveled widely. Often, those who became ill brought their sicknesses back home, which made their health care a Federal concern.
The Marine Hospital Service eventually grew into the Public Health and Marine Hospital Service. In 1912, Congress shortened this name to the U.S. Public Health Service, with the Commissioned Corps as its uniformed service.
The responsibilities of the U.S. Public Health Service also changed, as new threats to our country’s public health emerged.
Congress charged the U.S. Public Health Service with preventing the introduction and spread of major epidemic diseases such as smallpox, yellow fever, and cholera. To meet this responsibility, the service and its Corps took over many national quarantine, disinfection, and immunization functions.
Congress also charged the U.S. Public Health Service to carry out the medical inspection of arriving immigrants, such as those landing at Ellis Island in New York.
The workplace environment and its effect on the health of workers became a major concern for the service in the early 1900s.
By 1912, the U.S. Public Health Service was authorized to investigate human diseases (such as tuberculosis, hookworm, malaria, and leprosy), sanitation, water supplies, and sewage disposal.
The Office of International Health Relations was established in Today’s Commissioned Corps officers work abroad as well as in the United States to help prevent the spread of infectious and communicable diseases. New threats to our public health, such as SARS, avian flu, drug-resistant TB, and MRSA—continue to develop.
That’s a very brief history of the Corps. 9 9

10. Categories of Commissioned Corps Officers
Over 6,500 officers in 800 locations, worldwide
11 Professional Categories
Medical
Dental
Nursing
Pharmacy
Scientist
Health Services
Engineer
Therapist
Veterinarian
Dietitian
Environmental Health

11. US Duty Stations

12. Federal Agencies Utilizing Commissioned Corps Officers
(Not all agencies and programs are represented)

13. Public Health & Prevention Missions of the Surgeon General: Overweight & Obesity
Combat overweight epidemic
Target Obesity

14. Public Health & Prevention Missions of the
Surgeon General
Smoking
Underage Drinking

15. Public Health & Prevention Missions of the Surgeon General: Deep Vein Thrombosis & Healthy Homes
Best DVT Prevention Practices
Promoting Healthy Homes

16. Public Health & Prevention Missions:
Healthy Youth for a Healthy Future
National Outreach Campaign
- Encourage healthy eating habits
- Help kids stay active
- Promote healthy choices
- Local roundtables with non-traditional partners
Faith-based organizations
Businesses
Chambers of Commerce
- Recognition of “Community Champions”

17. The Surgeon General’s Vision for a Healthy and Fit Nation

18. Major Actions of OSG A Report of the Surgeon General
How Tobacco Smoke Causes Disease
The Biology and Behavioral Basis for Smoking-Attributable Disease
December 9, 2010

19. Major Actions of OSG
The Surgeon General’s Call to Action to Support Breastfeeding 2011
January 20, 2011

20. Upcoming Actions
March 8, 2012 – release of “Preventing Tobacco Use Among Youth and Young Adults” (Washington DC)
Other OSG initiatives – prescription drug misuse in teens, youth violence
Let’s Move campaign
Million Hearts Hearts campaign
Prevent 1 million heart attacks and strokes in 5 years
Aspirin, Blood Pressure, Cholesterol, Smoking

21. Medical Reserve Corps

22. Public Health
The science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals.
CEA Winslow, 1920

23. 10 Great Public Health Achievements-US 1900-1999
Vaccination
Motor-vehicle safety
Safer workplaces
Control of infectious diseases
Decline in deaths from heart disease and stroke
Safer and healthier foods
Healthier mothers and babies
Family planning
Fluoridation of water
Recognition of tobacco as a health hazard
MMWR 1999 Apr 2;48(12):241-3.

24. Public Health US 2009 6.22 infant deaths per 1000 live births (45)
78.11 life expectancy in years (49)
Health care expenditure
17.6 % GDP (1)
$2.5 trillion
$8160 per person

25. Core Public Health Functions
Assessment and monitoring of the health of communities and populations at risk
identify health problems and priorities - surveillance
The formulation of public policies
designed to solve identified local and national health problems and priorities
Assure that all populations have access to appropriate and cost-effective care
including health promotion and disease prevention services
evaluation of the effectiveness of that care

26. to attain public health
Use policies,
research agendas
recommendations,
to attain public health
goals
The Vision

27. Healthy People www.healthypeople.gov
Developed in 1979 by the Department of Health and Human Services
Science-based, 10 year national objectives
For promoting health and preventing disease
Includes a vision, mission, goals, focus areas, criteria, objectives and action plans for achieving the targets

28. Healthy People 2020 Launched Dec 2010 600 objectives, 1300 measures
Each objective has a reliable data source, a baseline measure, and a target for specific improvements

29. Healthy People 2020 Implementation Framework
MAP-IT
Mobilize -- partnerships
Assess – needs and assets
Plan – clear objectives and concrete steps
Implement – workplan, POC, communication plan
Track – evaluate and track progress
Using Healthy People to make the case for funding

30. The Affordable Care Act
Unique Opportunities for Prevention

31. National Prevention Council
Bureau of Indian Affairs
Department of Labor
Corporation for National and Community Service
Department of Transportation
Department of Agriculture
Department of Veterans Affairs
Department of Defense
Environmental Protection Agency
Department of Education
Federal Trade Commission
Department of Health and Human Services
Office of Management and Budget
Department of Homeland Security
Office of National Drug Control Policy
Department of Housing and Urban Development
White House Domestic Policy Council
Department of Justice

32. Advisory Group 17 non-federal members Statutory Role:
Develop policy and program recommendations
Advise National Prevention Council on prevention and health promotion practices

33. National Prevention Strategy
Extensive stakeholder and public input
Aligns and focuses prevention and health promotion efforts with existing evidence base
Supports national plans

34. Vision
Working together to improve the health and quality of life for individuals, families, and communities by moving the nation from a focus on sickness and disease to one based on prevention and wellness.

35. National Prevention Strategy

36. Healthy and Safe Community Environments
Clean air and water
Affordable and secure housing
Sustainable and economically vital neighborhoods
Make healthy choices easy and affordable

37. Clinical and Community Preventive Services
Evidence-based preventive services are effective
Preventive services can be delivered in communities
Preventive services can be reinforced by community-based prevention, policies, and programs
Community programs can promote the use of clinical preventive service (e.g., transportation, child care, patient navigation issues)

38. Empowered People
People are empowered when they have the knowledge, resources ability, and motivation to identify and make healthy choices
When people are empowered, they are able to take an active role in improving their health, supporting their families and friends in making healthy choices, and leading community change

39. Elimination of Health Disparities
Health outcomes vary widely based on race, ethnicity, socio- economic status, and other social factors
Disparities are often linked to social, economic or environmental disadvantage
Health disparities are not intractable and can be reduced or eliminated with focused commitment and effort

40. Priorities Tobacco Free Living
Preventing Drug Abuse and Excessive Alcohol Use
Healthy Eating
Active Living
Mental and Emotional Well- being
Reproductive and Sexual Health
Injury and Violence Free Living
Source: National Vital Statistics Report, CDC, 2008

41. Federal Implementation
Provide coordination and ongoing leadership at the Federal level, and among all Federal departments
Establish processes for continual public input
Establish specific and measureable agency- specific actions to address recommendations
Monitor and track federal actions
Annual Status Report

42. Optimal Implementation

43. What’s Next Regional meetings
Execute and coordinate NPS actions across Council agencies
Encourage partners to create and execute their own NPS action plans
Monitor and track progress
Share successes!
Keeping accountability of the Strategy progress; begin tracking reporting for the Annual Status Report
Sharing success, specifically cross-cutting and innovative examples

44. nationalpreventioncouncil
For more information go to:
nationalpreventioncouncil
Contact the National Prevention Council at:

45. Deputy Surgeon General boris.lushniak@hhs.gov
Boris Lushniak, M.D., M.P.H.
RADM, USPHS
Deputy Surgeon General