January 13, 2011
Vice Admiral Regina M. Benjamin, M.D., M.B.A
Surgeon General
Chair, National Prevention, Health Promotion and Public Health Council
Office of the Surgeon General
5600 Fishers Lane, Room 18-66
Rockville, Maryland 20857
RE: Draft National Prevention Strategy
The National Partnership for Women & Families applauds the Administration’s efforts to develop
a comprehensive National Prevention and Health Promotion Strategy (National Prevention
Strategy) focused on prevention and wellness. We believe that a comprehensive and
coordinated National Prevention Strategy will play a vital role in moving the country toward a
health model based on wellness.
The National Partnership for Women & Families is a non-profit organization with 40 years of
experience working to promote access to quality health care, fairness in the workplace and
policies that help women and men meet the dual demands of work and family. We have long
advocated for policies to ensure access to comprehensive, affordable health care for all women
and families that includes access to reproductive health care and a focus on addressing the
specific challenges faced by low-income women and women of color in accessing and using
preventive care.
We greatly appreciate the open and inclusive process adopted by the National Prevention,
Health Promotion and Public Health Council (Council). Specifically, we appreciate the Council’s
responsiveness to the comments on the earlier draft of the “Draft Framework for the National
Prevention Strategy.” In conjunction with our colleague organizations, we are submitting
separate comments outlining additional suggestions and comments focused on addressing
workplace policies that have a clear and direct effect on improving American’s health. Our
comments here will focus specifically on the need to recognize the importance of sexual health
as an essential, integral component of overall health.
Include reproductive and sexual health as a targeted strategic direction.
Surgeon General David Satcher’s Call to Action to Promote Sexual Health and Responsible
Sexual Behavior (2001) was an important, formal government acknowledgment of the
importance of a sexual health framework in addressing the adverse outcomes of unhealthy
sexual behavior and circumstances. In 2010, the Centers for Disease Control and Prevention
began a process to revitalize Dr. Satcher’s call by examining a public health approach to
advancing sexual health. We applaud this effort, which seeks to re-frame sexual health in the
context of wellness and health promotion.
Recognizing sexual health as an important part of the health and quality of life of individuals,
families and communities, is globally recognized as a key priority. The World Health
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Organization, the Pan American Health Organization, and numerous countries have sought to
enhance sexual health policy, education and research to improve overall health outcomes. We
believe that the strategic directions provide a broad prevention framework but in the spirit of the
stated goals, we believe the framework should address not only the leading causes of death,
but should also focus on the general health and well being of society. We recommend that
reproductive and sexual health be included as a targeted strategic direction which includes
comprehensive reproductive health care, such as family planning services and accurate, nonjudgmental sex education.
Our nation’s current sexual health challenges are daunting but this specific area of focus has
widespread preventive benefits. Rates of unintended pregnancy and sexually transmitted
infections (STIs) are high. There are about 19 million new STIs in the United States each year.
Half of all pregnancies are unintended, including over 80% of unplanned pregnancies among
teens. Dating violence rates are high even among high school girls—about one in five is abused
by a dating partner. And, fueled by poverty, lack of access to care, and myriad social factors,
poor sexual health outcomes are greatest in communities of color. Disparities in STI rates are
abysmal. Unintended pregnancy is increasingly concentrated among lower income women and
in communities of color. Our national discomfort with both sex and race combine to support a
disastrous result. Addressing sexual health with a focus on reducing these disparities would
greatly support the overall goals of the national health promotion strategy.
Adverse sexual health outcomes reach beyond sexuality and affect quality of life and economic
security. The economic and social burden of sexual health problems and the barriers they pose
to individuals achieving optimal health and quality of life, provide a strong argument for inclusion
in a national prevention and health promotion strategy.
The importance of improving access to family planning services and comprehensive sex
education is well-documented. The National Prevention Strategy should recognize that healthy
sexuality throughout the lifespan is an integral part of an individual’s health and well-being and
an area of focus that compliments other aspects outlined in the draft framework for the National
Prevention Strategy. Promoting healthy sexuality includes not just preventing unwanted
pregnancy and keeping men and women free of disease, but also empowering and educating
men and women to engage in healthy relationships, including support for LGBT youth who have
disproportionate rates of depression and suicide, and ensuring that all individuals have access
to the care and services that enable them to achieve optimum health.
As a nation we are not comfortable talking about sex. Having the federal government take a
leadership role in normalizing our conversations about sex and addressing sexual health in a
comprehensive, health promotion strategy is critically important and we urge you to include a
targeted strategic direction addressing reproductive and sexual health. We look forward to
future opportunities to work with the Council as it continues to develop strong prevention, health
promotion and public health strategies.
Sincerely,
Debra L. Ness
President