Ex-surgeon general speaks in Cape

Saturday, June 21, 2003

According to Jocelyn Elders, America does not have a health-care system, it has a very expensive "sick-care system," one that can't seem to grasp the deadly problem of babies born with low birth weight.

"There is enough money in the system -- $1.6 trillion," Elders said Friday during a stop in Cape Girardeau. "But if we don't take ownership of the problem, we're never going to solve it."

Elders, a pediatric endocrinologist and the first African-American woman to hold the position of U.S. surgeon general, was the keynote speaker at the fourth annual Low Birth Weight Partnership Conference at Drury Lodge.

About 130 health-care professionals, consumers and state agency workers attended the conference that was sponsored by Missouri Bootheel Healthy Start.

Cynthia Dean, the director of Bootheel Healthy Start, which is based in Sikeston, Mo., said Elders attending the conference will raise awareness of the problem.

"Just her being here will increase the visibility of the problem," she said. "She's right: This is real and it's happening. We have to stop it."

Baby danger

Nationwide, low birth weight -- defined as a baby weighing between 3 pounds, 5 ounces to 5 1/2 pounds -- is the leading contributor to infant death, Elders said. About one in 13 babies are born with low birth weight in Missouri, and that increases to one in 10 in Missouri's Bootheel.

But Elders said doctors don't practice in inner cities where uneducated, poor pregnant women tend not to take care of themselves as well.

When doctors do see such women, Elders suggested they don't know how to deal with them.

"This is an increasingly diverse culture," she said. "But doctors are still handing out brochures. Some of these uneducated, poor women need more than a folder."

Elders is perhaps best known for getting the attention of parents while she was surgeon general starting in 1993 under President Clinton. She was asked to resign in 1994 after she suggested that all children should have free access to condoms and be encouraged in sexual stimulation.

There were flashes of that idea during her luncheon speech Friday, and she drew largely supportive responses from the crowd in her sermon-style speech, with responses like "Amen" and "Say it."

"We've got to stop teenagers from having babies," she said. "I was preaching this more than anybody. The babies of teenagers do have more low birth weights. But the culture, society and government refuse to admit our children are having sex."

Teaching abstinence as the only option is only setting children up to fail and does not give them the knowledge to make wise choices, Elders said.

"The biological urge is greater than the president knows, greater than their mammas know and greater than the preacher knows," she said. "It's all right for the TV to teach them. It's all right for the girlie magazines to teach them. It's all right for the street to teach them. Why isn't it all right for us to teach them?"

These remarks are similar to ones Elders made when she was surgeon general. Those who endorse abstaining from sex until marriage -- including President Bush -- take the opposite view that there is no such thing as "safe sex." The only way to completely avoid sexually transmitted diseases and pregnancy, abstinence proponents say, is to wait until marriage to become sexually active.

Elders said that babies born with low birth weights stay in the hospital longer, have more health and learning problems and sometimes die.

A good deal of the speech focused on African-American women and their relationship to low birth weights.

Regardless of age, education, income or marital status, a black infant is more than two times as likely to die in the first year of life than a white baby, Elders said. She said this is true both nationally and in Missouri.

"When we stop smoking, it reduces the problem by 20 percent," she said. "We have to make sure all women have adequate nutrition and access to health care. We have to make sure pregnant women have transportation. African-American women have 17 percent of all the babies, but we have 30 percent of the very low birth weight babies. Something's not right."

She said that the women themselves must shoulder some of the blame too.

"Black women know what I'm talking about," she said. "We say, 'If it don't hurt, we don't need to go to the doctor.' We're not pregnant until the doctor says so. That means we're even later getting prenatal care."


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