Once again access and reimbursement are key issues and I will address
them in appropriate circles with special attention to reimbursement for
immunization against influenza, appropriate screening services, and atten-
tion to readiIy diagnosed and easily treatable conditions.
Policy matters will be delineated and referred to appropriate authorities
where responsive action seems most likely.

Smoking

I will continue my personal efforts to convince elderly Americans of the
benefits of kicking the habit as well as my constant pressure on physi-
cians to acknowledge that it is never too late to quit, that preventive medi-
cine does have an important role in the health care of elderly people, and
that no means to quitting is as effective as a physicians personal advice
to .his patient to stop smoking.
These recommendations will be turned over to the revitalized Office of
Smoking and Health and I will see that each recommendation gets the
attention it deserves.

The Federal government buildings have a restricted smoking policy. All
Health and Human Services buildings have had a total ban on smoking
for the past month. We will get smoking off airlines, out of public build-
ings, including restaurants, and before the year 2000 smokers will ask for
permission to smoke in the presence of nonsmokers-and that will fit my
definition of a smoke-free society by the year 2000.
It is in the area of smoking and health that I probably have my greatest
clout, and I promise my personal attention to each recommendation made.
I hope to be around long enough to convene the Interagency Commit-
tee on Smoking and Health to address smoking and the elderly.
And finally, I have already begun to work with the churches which have
awakened to realize that smoking is the number one cause of disease, dis-
ability, and death.

There is one other area that I will address, if possible and when feasi-
ble, that can only enhance the outcome of many of the recommendations
made here.

That area is cross generational relationships. Not only are the relation-
ships of the elderly with children socially and emotionally beneficial to the
elderly, but they can be a source of education, indeed, wisdom, and com-
panionship, but they can also prepare the youngster for much that is to
come in life.

Kids don't know enough about old people and about people of all ages
with handicaps. This is one place and one way to began.
Only 9 percent of children in the United States live within walking dis-
tance of a grandparent. How tragic that seems as I recall my childhood!
I reaped great benefits as a child from a relationship with my grandpar-
ents. But I truly believe my interest in and concern for the elderly is not
because I am old, but because of the bond that existed with my grandpar-
ents. Every child lives within walking distance of an elderly person who
might weIl serve i&co grand parentis if there is such a word.


What a great project for our next first lady-whoever she might be. We'll
see!

When I addressed you on Monday, I told you that the recommenda-
tions would be given the widest possible circulation. Because the docu-
ment I have before me is in such good form, I think it may be possible
to have a printed copy off the press within 6 weeks. You will recall that
I said we may be asking some of you for help in reference to distribution
suggestions. But let me say now that if there are any of you here who
just know that there are several obscure individuals or groups that you
just knav we will not think of, we would be happy to have your sugges-
tions even before we ask for them. Just use your judgment.
One of the greatest satisfactions .for me that comes from a Surgeon
General's Workshop is to look back a year hence and see how much has
been accomplished. With that in mind I would suggest that, as the year
goes by, when you are able to do something that implements suggestions
made at this workshop that you notify us. It is our intent to collate these
and to report to you at 6 months and again at a year.
Walt Whitman was also a Brooklyn boy, like myself, and maybe that's
why I like him. It was Walt Whitman who wrote these lines:
Youth, `large, lusty, luuing-youth full of grace, force, fascination,
Do you kmw that old age my come after you with equal force, grace,
jZS&UltiO?l?
Our answer to Walt Whitman ought to be . . . Yes, we know. And we
should really mean it.
I hope to see some you at the hearing for the Objectives of the Nation
this afternoon.

Have a safe trip home.
Thank you.

102


LIST OF PARTICIPANTS

Faye G. Abdellah, EdD, ScD. Deputy Surgeon General, United States Pub
  lit Health Service, Washington, DC..
Frederick J.Abramek. Food and Drug Administration, Rockville, MD.
William B. Abrams, MD. Executive Director, Scientific Development, Merck
Sharp & Dohme Research Laboratories, West Point, PA.
Ingrid Azvedo. Chairperson, Federal Council on Aging, Elk Grove, CA.
Shirley Bagley. National Institute on Aging, National Institutes of Health,
  Bethesda, MD.                             \
Joseph C. Barbaccia, MD. President, Association of Teachers of Preventive
  Medicine, Professor and Vice Chairman, Division of Family and Com-
munity Medicine, University of California, San Francisco, CA.
James D. Beck, PhD. Professor and Chairman, Department of Dental
Ecology, University of North Carolina School of Dentistry, Chapel Hill,
  NC.

Neal Bellos. President, Association for Gerontology in Higher Education,
The Geronotology Center, Syracuse University, Syracuse, NY.
Donald R. Bennett, MD, PhD. Director, Division of Drugs and Toxicology,
American Medical Association, Chicago, IL.
Thomas Beresford, MD. Department of Psychiatry, University of Michigan,
School of Medicine, Ann Arbor, MI.
Michael Bernstein. Executive Director, Gulf Coast Jewish Family Services,
Largo, FL:

Nathan Bill&, MD. Associate Professor, Department of Psychiatry,
Georgetown University, School of Medicine, Washington, DC.
Gerald Bloedow. Executive Director, Minnesota Board of Aging, St. Paul,
  MN.

Jeffrey B. Blumberg, PhD. Associate Director, USDA Human Nutrition,
Tufts University, Boston, MA.
Enriqueta Bond, PhD. Institute of Medicine, Washington, DC.
Dianne Bracco. Acting Executive Director, New York City Self-Help
Qearinghouse, Brooklyn, NY.
Jacob L. Brody, MD.. Dean, School of Public Health, University of Illinois
at Chicago, Chicago, IL.

Steven W. Brummel. President, Elvirita Lewis Foundation, Palm Springs,
  CA.

Richard Burnett. Regional Program Director, Administration on Aging
Region VII, m City, KS.

103


Carl J. Caspersen, PhD. Behavioral Epidemiology and Evaluation Bran&,
Division ,uf Health Education, Centers for Disease Contml, Atlanta, GA.
Nancy Chapman. President, Chapman Associates, Washington, DC.
Vii Chen, Healm Resoumes and Servkes Adm@stration, RockviUe, MD.
Ronni Chemoff, PhD. Associate Director, Geriatric Research Education and
Evaluation, John L. McClellan Memorial Hospital, Little Rock, AR.
Jan&t Clinton, MD. Director, Bureau of Health Professions, Health Resources
and Services Administration, Rockville, MD.
Gene D. Cohen, MD, PhD. Associate Director on Aging, National Insti-
tute of Mental Health, Rockville,. MD.
Jean Coyle. National Center for Health Promotion and Aging, National
Council on the Aging, Washington, DC.
Barry J. Cusack, MD. Chief of Geriatrics, Veterans Administration Medical
  center, Boise, ID.

Mary Ann Danello, PhD. Special Assistant to the Commissioner for
Science, Food and Drug Administration, Rockville, MD.
John Diaz. Regional Pmgram Dire&r- Region IV, Administration on
Aging, Dallas, TX.

Gayle Dolecek. Health Resources and Services Administration, RockviIle,
  MD.

Teri Dowling. .Director, Office of Senior Information, Referral, and Health
Pmmotion, San Francisco Department of Health, San Francisco, CA.
Michael Dreis. Food and Drug Administration, Rockville, MD.
Johanna Dwyer, ScD. Director, Frances Stem Nutrition Center, New
England Medical Center Hospital, Boston, MA.
Janice Eldred. Henry J. Raiser Family Foundation, Menlo Park, CA.
Bernard Engel, PhD. Gerontology Research Center, National Institute on
Aging Baltimore, MD.

Ronald Ettinger, DDS. Professor of Dentistry, University of Iowa, Iowa
city, IA.

George Everyingham. Director, Egyptian Area Agency on Aging, Carter-
  die, IL.

Diana Fabacher. University of Mississippi Medical Center, Jackson, MS.
Anne Fainsinger. Alliance for Aging Research, Washington, DC.
Timothy Fagan. Director, Baltimore County Department of Aging, Towson,
  MD.

Carol Fraser Fisk. Commissioner, Administration on Aging, Washington,
  DC.

Wilda Ferguson. Commissioner, Department for the Aging Richmond, VA.
Jerome Fleg MD. Gemntology Research Center, National Institute on Aging,
  Baltimore, MD.

Jean Cutler Fox, PhD. Director, Graduate Mental Health/Psychiatric Nurs-
ing, School of Nursing, University of Vii, Charlottesville, VA.
J P. Jean Frazier, PhD. Professor, Department of Health Ecology, University
of Minnesota School of Dentistry, Minneapolis, MN.
Robert Fried, MD. Office of Disease Prevention and Health Promotion,
Washington, DC.

104


Mary Alice Gaston. Department of Dental Hygiene, University of Tennessee,
Memphis,, TN.
Pearl S. German, ScD. Professor, Division of Health Policy and Manage-
ment, School of Hygiene and Public Health, Johns Hopkins Univer-
sity, Baltimore, MD.
Helen C. Gift, PhD. Epidemiology and Oral Disease Prevention Program,
National Institute of Dental Research, National Institutes of Health,
  Bethesda, MD.
Neville Derek Gilmore, DMD, DrPH. Professor and Chair, Department of
Community Dentistry and Human Behavior, Southern Illinois Univer-
sity, Alton, IL.
Barbara G&h. Manager, Patient Education, Division of Ambulatory Care,
Health Promotion, and Women and QQren's Health, American Hospi-
tal Association, Chicago, IL.
Andrew Goldberg MD. Division of Geriatric Medicine, Francis Scott Key
Medical Center, Baltimore, MD.
Edith s. LisansQ Gomberg PhD. Professor, university,of Michigan, School
~ofSocialWork,Ann&bor,MI.
Patricia Goode, MD. University of Alabama School of Medicine, Birming-
  ham, AL.
Marie Gooderham. Member, Board of Directors, American Association of
Retired Persons, Washington, DC.
Enoch Gordis, MD. Director, National Institute on Alcohol Abuse and
Almholism, RockdIe, MD.
Stephen Gordon, PhD. National Institute of Arthritis, Musculoskeletal and
Skin Disorders, National Institutes of Health, Bethesda, MD.
Milkent Gorham. Associate Director for Federal Relations, American Opto-
metric Association, Alexandria, VA.
Estelle Greenberg, PhD. Brookdale Foundation, New York, NY.
Saadia Gmenberg PhD. Division of Program Development, Administra-
tion on Aging Washington, DC.
Stephen C. Graft, PharmD. Executive Director, Commission on Orphan
Diseases, Office of the Assistant Seaetaq for Health, Rockville, MD.
Jessie Gnunan, PhD. Manager, Public Education, American Cancer Society,
  N& York, NY.
Judith Hall&s&, PhD. Gerontology Research Center, National Institute of
Aging, Baltimore, MD.
Mary Harper, PhD. National Institute on Mental Health, Rockville, MD.
Raymond Harris, MD. Center for the Study of Aging Albany, NY.
Wilson C. Hayes, PhD. Professor and Director, Orthopedic Biomdanics
Laboratory, Beth Ismel Hospital, Harvard Medical School, Boston, MA.
Marc W. Heft, DMD, PhD. Associate Professor, Oral and Maxillofacial
Surgery, University of Florida, College of Dentistry, Gainesville, FL.
RogerHerdman,~.AssistantDirectarfarHealthandLifesciences,qffice
of Technokrgy Assessment, United States Congress, Washington, DC.
CIinton Hess. Regional Program Dimctor, Administration on Aging-Region
VIII office, Denver, co.


Carol Hogue, PhD. Associate Professor, !3chool of Nursing, University of
North Camlina, Chapel Hill, NC.
John Holloszy, MD. Professor of Medicine, Washington University, St.
  Louis, MO.

John HOm, PhD. Adult Development and Aging Division, Department of
  P$hology, University of Southern California, Los Angeles, CA.

Mary C. Howell, MD, PhD. Assistant Clinical Pmfessor, Director, Kennedy
Aging Project, Harvard Medical S&001, Watertown, MA.
Daniel A. Hussar, PhD. Rerninjjon Pmfessor of Pharmacy, Philadelphia
College of Pharmacy & Science, Philadelphia, PA.
Dennis W. Jahnigen, MD. Head, section of Geriatric Medicine, Department
of Intemal Medicine, The Cleveland Clinic Foundation, Cleveland, OH.
Sharon Jaycox. Program Associate, Smoking or Health, American Lung
Association, New York, NY.

Norge W. Jerome, PliD. Professor, Department of Preventive Medicine,
school of Medicine, University of Kansas M+ical Center, Kansas City,
  KS.

Judith K. Jones, MD, PhD. Associate Clinical Director for Researh George
town University Center on Aging, Great Falls, VA.
William Kachadorian, PhD. Gerontology Research Center, National Insti-
tute on Aging, Baltimore, MD.
Edna Kane-Williams. Health Advocacy Services, American Association of
Retired Persons, Washington, DC.
Robert L. Kane, MD. Dean, !?chool of Public Health, University of Mhne-
sota, Minneapolis, MN.

Katherine Keaveney. University of Alabama school of Optometry, Birming-
  ham, AL.

H. Asuman Kiyak, PhD. Associate Professor, Depa$rnent of Oral and
Maxillofacial Surgery, University of Washington, !3chool of Dentistry,
  Seattle, WA.

C. Eve&t Koop, MD. Surgeon General, United States Public Health Sewice,
Washhigton, DC.

Lorraine Kmetch, PhD. Chief, Services to Older Adults, Department of
' Mental Health, Sacramento, CA.
Shhiki Kumanyika, PhD. Department of Epidemiology, Johns Hopkins
university, Baltimore, MD.

F. Marc LaFa, MD. Professor of Medicine, Univehty of Rochester School
of Medicine and Dent&y, Rochester, NY Gretchen Lagodna, PhD.
Associate Professor, College of Nursing, University of Kentucky, Lex-
ington, KY.

David Lamb, PhD. Department of Exercise Physiology, Ohio State Uni-
versity, Coluhbus, OH.

Richard Lindsay, MD. Professor of Medicine, University of Virginia !.%hool
of Medicine, Charlottesville, MD.
Susan Lo&hart. Office of the Surgeon General, Rockville, MD.
Adelaide Luber. Dhztor, Rhode Island Department of Elderly Affairs, Pmvi-
dence, RI.

106


Steve Luchter. Chief, Planning and Policy Development Division, National
Highway `I'raffic Safety Administration, Washington, DC.
David Macfayden, MD. Former Manager, WHO Global Programme for
Health of the Elderly, Jefferson `Medical School, Philadelphia, PA.
Susan Maloney. office of Disease Prevention and Health Promotion, Wash-
ington, DC.

Marylen Mann. Executive Director, OASIS, St. Louis, MO.
James Y. Marshall. American Dental Association, Chicago, IL.
Frank Martin, DDS. Bureau of Health Professions/Health Resources and
  Services Administration, Rockville, MD.
Kathleen MKormick, PhD. Geriatric Research Center, National Institute on
Aging, Baltimore, MD.

J. Michael McGinnis, MD. Director, Office of Disease Prevention and Health
Promotion, Washington, DC.

L. Joseph Melton, III, MD. Head, Section of Clinical Epidemiology, Mayo
Clinic, Rochester; MN.

Walter Merk, MD. Director, Human Nutrition Research Center, USDA,
  BeltsvilIe, MD.

Angela Mickalide, PhD. Office of Disease Prevention and Health Promotion,
Washington, DC.

Steven R. Moore. Food and Drug Administration, Rokville, MD.
Jana Mossey, PhD. Associate Professor, Community and Preventive
Medicine and Psychiatry, Medical College of Pennsylvania, Philadel-
phia,' PA.

Henry Monks. Of&e of Minority Health, Department of Health and Human
!3ervices, Washington, DC.

Gregory Morosco, PhD. Chief, Health Education Branch, National Heart,
Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
Roseann MuIligan, DDS. Chaknan Section of Geriatric and SpeciaI Patient
Dent&y, University of Southern California, School of Dentistry, Los
Angeles, CA.

Badma E. Naegele. Chief, Health Promotion Directorate, Minis&y of Health,
Ottawa, Ontario, Canada.

Michael Nevitt, PhD. Assistant Professor, Department of Medicine and
Epidemiology, University of California, San Francisco General Hospi-
tal, San Francisco, CA.

Frank Nice. National Institute of Neurological and Communkative Disorders
and Stroke, National Institutes of Health, Bethesda, MD.
Herbert Nickens, MD. Dim&r, Office of Minority Health, US Public Health
Semice, Washington, DC.

Linda C. Niessen, DMD. Director, Geriatric Dental Program, VA Medical
center, Perry Point, MD.

Thomas Novotny, MD. Office of Smoking and Health, Centers for Disease
Contml, Rockvine, MD.

Paul Nutting, MD. Mercy Medical Center, Denver, CO.
Nancy J. Olins, MA. Director of Program Development, American Associa-
tion of Retired Persons Pharmacy Service, Alexandria, VA.

107


   Franklin P. Ollivierre. Region I%- Director-Region I, Administration
     on Agiiq, Boston, MA.
   York Qnnen. iXector of Prog~~- Development, President's Council on
    Physical Fitness and Sports, i$:ashington, DC.
   Marria Ory, PhD. Chief, Social !?cexe Research ofi Aging, Behavioral and
     SociaLResearch Progmn, Ntiti Institute on Aging, National Ins&
      tutes of Health, Bethesda, M3.
   Terry Pechacek, PhD. Division of Cancer Prevention and Control, National
      Cancer Institute, National In&lutes of Health, Bethesda, MD.
   Jo ANI Peps. Nutrition Coon&mm, Health and Human Services-Region
      VIII Office, Denver, CO.
   Scott pressOn, DDS. Indian Heath Ser$ce, Rockville, MD.
   Barbara Quaintawe. Health Advocacy %-vices, American Association of
     Retired Persons, Washington, DC.
   Daniel Quirk. Executive Director! *National Association of State Units on
     Aging Washington, DC.
   Peter Rabins, MD. Chief, Department of Psychogexiatrics, Johns Hopkins
      .School of Medicine, Baltimore, MD.           . .
   William Rakowski, PhD. Center for kntology and Health Care Reseaxh,
     Brown University Pmgram in Medicine, Providence, RI.
   Wayne A. Ray; PhD. Director, Division of Pharmacoepiderniology, Van-
     derbilt University School of Medicine, Nashville, TN.
   Paul S. Rhodes, MD. Director, Geriatric Care of Greater Washington,
     Washington, DC.
   Barbara Rimer, DrPH. Director, Health Communications Research, Fox
     Chase Cancer Center, Philadelphia, PA.
   Dorothy Rice, ScD. Professor, Department of Social and Behavioral Sciences,
     School of Nursing, University of California, San Francisco, CA.
   Vicent C. Rogers, DDS. Chairman, Department of Community Dentistry,
     Georgetown University School of Dentistry, Washington, DC.
   Robin Room, PhD. Director, Alcohol Research Group, Medical Research
     Institute of San Fran&co at Pacific Presbyterian Medical Center, Ber-
     keley, CA.
   I.,inda.Saltzman, PI-0 Division of Injury Epidemiology and Control, Centers
      for Disease Control, Atlanta, GA.
   Richard Sattin, MD. Division of Injury Epidemiology and Control, Centers
      for Disease Control, Atlanta, GA.
   Michelle J. Saupders, DMD. Director, South Texas Geriatric Education Center
     University of Texas, San ArItOdo, TX.
   David G. Schulke. Special Commit@ on Aging, United States Senate,
     Washington, DC.
   Ruth %igler. Executive Director, South Carolina Commission on Aging,
      Columbia, SC.
   Richard H. Seiden, PhD. Suicid&gist Consultant, Oakland, CA.
   Marymae Seward. Department d Psychology, University of Southern
     CaIifornia, Los Angeles, CA.
   Kathleen Shay. Department of F+hOlOgy, University of Alabama at
     Birmingham, Birmingham, .M-


Domthy L. Smith, PharmD. President, Consumer Health Information Cor-
poration, McLean, VA.

Gwen Solon, MD. Office of Technology Assessment, Congress of the United
States, Washington, DC.

Ann Sorenson, PhD. National Institute on Aging, National Institutes of
Health, Bethesda, MD.

Suzanne K. Steinmetz, PhD. Professor, Individual and Family Studies,
University of Delaware. Newark, DE.
Thomas E. Stevens. University of Mississippi School of Medicine, Jackson,
MS.

Michael Stoto, PhD. Institute of Medicine, Washington, DC.
Rebekah Street. University of Southern California School of Nursing,
Paramount, CA.

David Sundwall, MD. Administrator, Health Resources and Services Ad-
ministration, RockvIle, MD.

Fred Tavill. Dire&or, Milwaukee International Health Training Center,
Milwaukee, WI.

Hugh H. Tilson, MD, DrPH. Head, Product Surveillance and Epidemiology,
Burroughs Wellcome Company, Research Triangle Park, NC.
William N. Tindall, PhD. Director of Professional Affairs, National As=
ciation of .Retail Druggists, Alexandria, VA.
Wayne Turner, PharmD. Food and Drug Administration, Rockville, MD.
Anthony Vutum, MD. Professor and Head, Department of Family and Com-
munity Medicine, University of Arizona Medical School, Tucson,
AZ.

Judith Wagner, PhD. Office of Technology Assessment, United States
Congress, Washington, DC.

Susan Nobel Walker, PhD. Health Promotion Research Program, !3ocial
Science Research Institute, Northern Illinois University, Dekalb, IL.
Patricia F. Waller, PhD. Director, Injury Prevention Research Center, Uni-
versity of North Carolina, Chapel Hill, NC.
Hongying Wang DDS. School of Stomatologyj Beijing Medical University,
Minneapolis, MN.

Gregg War&w, MD. Department of Family Medicine, University of Cin-
tinnati Cdege of Medicine, Cincmnati, OH.
Nancy Wartow, Pmgram Analyst, Office of Program Development, Admin-
istration on Aging, Washington, DC.
Richard Weindruch, PhD. Biomedical Research and Clinical Medicine,
National Institute on Aging, National Institutes of Health, Bethesda,
MD.

Charles Wells, Deputy Commissioner, Administration on Aging, Wash-
ington, DC.

Sara White. Office of Disease Prevention and Health Promotion, Washing-
ton, DC.

Emla Polly Williams. Cherry Hill, NJ.
T. Franklin Williams, MD. Director, National Institute on Aging, National
Institutes of Health, Bethesda, MD.

109