UCLA School of Public Health Commencement

By:  Kathleen Sebelius
Date: June 15, 2012
Location: Los Angeles, CA

Thank you, Linda, not only for that very kind introduction, but also for all the work you've done over the years on behalf of Americans' health. Among her many other accomplishments, Linda chaired the IOM committee last year that recommended new preventive services for women to be covered under the health care law. So Linda can add to her legacy that millions of American women will now no longer have to go without cervical cancer screenings or well woman visits or birth control because they can't afford them. So thank you, Linda.

Faculty, family, friends, Class of 2012: I'm honored to be with you today. And I want to begin with some well-earned congratulations for the graduates. As a proud mother who attended my son's graduation in May when he received a Masters, I know how much hard work it took to get here today.

I also know that none of you got here on your own. As a good friend of mine often says, "we all drink from wells we didn't dig, and are warmed by fires we didn't build." So before we go any further, let's give a round of applause to all the parents, siblings, relatives, teachers, and friends here who helped you along the way.

You've all taken different paths to get here today. You and your classmates arrived to UCLA from 35 different countries and from every part of the United States. Some came directly from college. Others were already well into established careers. You've pursued interests ranging from how to get people to eat more fruits and vegetables to how nations can better respond to natural disasters. But you also all have something in common: a commitment to working for the common good.

I feel confident saying this, because if you didn't have that commitment, you wouldn't be here. Let's be honest: public health is not the most glamorous field. The words "Did you see the latest CDC Morbidity and Mortality Weekly Report?" are not overheard very often at cocktail parties.

Nor is there a lot of a credit to be had. You've chosen a field where you can save someone's life and they will never know your name; a field where your greatest successes will be invisible: the injuries, deaths, and disease outbreaks thatdidn't happen.

I could tell you that at least the money's great, but that's not true.

The truth is you've chosen a career that promises little fame or fortune. But it does have one big thing going for it: the opportunity to make a significant -- often life-saving -- difference in people's lives. And today, I believe that opportunity is bigger than ever.

No matter where you look today, health is at the top of the agenda.

Here in the US, the new health care law has offered up a new vision for health care in this country -- one with a greater focus on prevention, better coordination, and more access to care -- but we need new leaders like you to help make that vision a reality.

Around the world, some of our biggest health goals are within reach for the first time -- from eradicating polio to ushering in the first AIDS-free generation -- but we need new leaders like you to help to finish the job.

The world has never been more in need of your talents and skills than it is right now. And as you set out into that world, there are two trends you should keep in mind.

The first is that all health is global. When I began my career, there was a clear distinction between health workers whose focus was here in the US, and the more exotic experts who focused the rest of the world. You either did one or the other.

But today, those distinctions are blurring. Within hours of being sworn in as Secretary, I was in the Situation Room talking to the Mexican Health Minister about the emerging H1N1 flu epidemic. When I got to my office, the first call I got wasn't from a member of Congress or a Governor -- it was from WHO Director, Margaret Chan, wanting to discuss how we could coordinate our global response.

In our department, a global perspective now informs almost everything we do.

For example, nearly half of our fruit and over three quarters of our seafood are imported from outside the US. So are many of the ingredients in our medicines. In a world where no disease stops at our borders and no market is contained within our shores, no country can separate its own health from global health.

Now some of you may think that this doesn't apply to you. Your interests may be more local -- in helping older people in LA manage their chronic conditions, for example. But even if your focus is local, the problem isn't. Health challenges like chronic diseases are increasingly ones that all countries struggle with. And that means that somewhere around the world right now, there's another public health student sitting at a graduation, thinking of ideas for how to help seniors manage their diabetes in her city. And by sharing research and best practices, you can learn from and help each other.

The only way America, or any country today, can keep its people healthy and safe is by working with its global neighbors.

So whether you end up working for an NGO in Khartoum or running a community health center in Compton, I hope you'll do your part to contribute to greater global collaboration on health. That's trend one.

The second key trend is that health policies are finally beginning to take into account the full range of factors that affect health, what you all know as the social determinants of health.

Now, this idea is not new. It goes all the way back to Hippocrates who once said: "If you want to learn about the health of a population, look at the air they breathe, the water they drink, and the places where they live." And it's definitely not new to you as public health students.

But what is new is that for the first time, we're putting this principle to work at the national level. For years, we've underinvested in prevention, spending as little as four cents of each health care dollar trying to keep people healthy in the first place.

But that's started to change. Thanks to the health care law, we have a new National Prevention Strategy that provides a roadmap for agencies across government and partners across the country on how they can help build healthier communities.

Along with it, we've adopted a "health in all policies" approach. That means that when we build new roads, we're going to try to build them in ways that allows people to safely walk and bike. When we build new housing, we're looking at everything from safe play areas to smoke-free environments. When we put in place new environmental regulations, we want to make sure the health benefits are taken into account.

Efforts like these are long overdue. But that doesn't necessarily mean they're here to stay. In tough times, prevention programs are too often the first to hit the chopping block, in part because the benefits can be hard to see. When a dramatic surgery saves the life of a heart attack victim, the payoff is obvious. When a healthy diet helps prevent a deadly heart attack, it may only show up years later as a data point in a journal article.

So, in addition to being practitioners of prevention, you will also have to be advocates for prevention. Until a community shows the same outrage when their healthy school lunch program is cut, as when their school nurse is eliminated, it will be hard to continue investments in prevention.

I want to leave you with some famous lines from a speech delivered when I was still a student. In 1966, Robert Kennedy traveled to South Africa and, speaking about the greatest challenges of his time, he said: "This world demands the qualities of youth. Not a time of life, but a state of mind, a temper of the will, a quality of the imagination, a predominance of courage over timidity, of the appetite for adventure over the life of ease."

That's what the world needs today. You chose this path because you wanted to make a difference. And you are graduating at the perfect time to do just that. So forget the praise, the glory, and the big bucks. Go out and make a big difference -- a lifesaving difference -- each and every day.

Congratulations, and good luck!

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