February 3, 2003

A special session on mayors and their role in preventing chronic diseases and providing local leadership in promoting healthy living and healthy lifestyles was held January 24 during the 71st Winter Meeting. In the United States, five chronic diseases—heart disease, cancers, stroke, chronic obstructive pulmonary diseases, and diabetes—account for more than two-thirds of all deaths and three-fourths of the $1 trillion spent on health care annually.

Sponsored by the Federal Centers for Disease Control and Prevention and AstraZeneca Pharmaceuticals, the session was chaired by Richmond (CA) Mayor Irma Anderson and moderated by Dr. Timothy Johnson of ABC-NEWS' Good Morning America. In brief remarks, Conference President Boston Mayor Thomas M. Menino strongly emphasized the theme that local efforts can have a major effect on chronic diseases. Menino cited Boston's smoking ban, cancer crusade, and over-the-counter needle program as instances in which his initiatives have created a better health climate for citizens. After two expert panelists provided background information on the national level, Dr. Johnson moderated a discussion in which a number of mayors shared stories of how their local efforts have affected public health in their cities.

Dr. James Marks, Director, National Center for Chronic Diseases Prevention and Health Promotion Centers for Disease Control and Prevention, presented an overview of chronic diseases and their impact, particularly on minorities. These diseases, he said, represented "epidemics more powerful than those we think of from infectious diseases." With an aging population, a decline in fitness and a dramatic increase in obesity, America faces a major health-care crisis in the decades ahead.

Dr. Marks's stressed the growing concern that unless the nation starts to seriously address and fund prevention efforts, health care costs will continue to overwhelm the system. He stated that by 2030, there will be two people working for every one retiree on Medicare. In his words, "This is not going to work." Again, reducing obesity and the use of tobacco as well as increasing physical activity are major steps toward heading off the health crisis that we could be facing in 2030.

Dr. Elizabeth Duke, Administrator of the Health Resources and Services Administration, noted that her department and the Administration have placed significant focus on such initiatives as an increase in funding for the National Institutes of Health, with a special emphasis on minority health and health disparities.

The session concluded with the mayors sharing their local best practices on prevention and awareness efforts in their cities. Fort Worth Mayor Kenneth Barr, discussed how after the church shooting three years ago in Fort Worth, he formed a mental health committee that has resulted in a person being able to get mental health referrals at any point of entry into the health care system; and a wrap-around mental health care program that treats the patient and the whole family.