THE BLOG
02/28/2013 11:06 am ET Updated Apr 30, 2013

The Grandfather of Preventative Health: A Farewell to Dr. C. Everett Koop

Dr. C. Everett Koop passed away on Feb. 25, and I already really miss him. When I think about this revolutionary man, there are two words that come to mind: integrity and prevention. Although Dr. Koop was deeply conservative and religious, he was opposed by many on the left and the right because he had the integrity to go where the data took him, regardless of politics or his own personal opinions.

To the almost incoherent rage of the Republican Party, Dr. Koop had the courage and persistence to argue for contraception and sexual education in schools as a necessary part of the war on AIDS. He was a man who stood his ground and followed the facts -- and the facts then, as they do now, frequently led to prevention because back then, finding a cure was hard to impossible. The iconic Dr. C. Everett Koop quote that will always stick with me is: "You can't talk of the dangers of snake poisoning and not mention snakes."

Again to the anger of the vested right-wing interests, Dr. Koop was never a stranger to making bold statements, and this applied to his stance on cigarettes as well. He once said clearly and honestly that nicotine has an addictiveness similar to that of heroin or cocaine and as Surgeon General waged a war against smoking with an aim to make the U.S. a smoke-free society by the year 2000. He was steadfast, because the facts were clear -- cigarettes were causing innumerable diseases, including lung cancer and emphysema, both painful ways to live and die. The only possible cure was prevention and, to everyone's surprise, once the U.S. embarked on changing smoking behavior, it worked.

The number of active smokers in the U.S. has dropped from about 40 percent of the population in 1984 to 19.3 percent of U.S. adults in 2012. We all know that's still 45 million too many people, but if you do the math, it's 75 million fewer smokers than we would have if Dr. Koop hadn't spoken up and mandated the warning messages on every package of cigarettes. Contrast this success with the onset of obesity, which has tripled in adolescents in the the U.S., even as the rate of smoking has dropped to less than half of what it was.

Now that anti-retroviral drugs have made AIDS a survivable or chronic disease, we seem to have forgotten the terror and fear that AIDS created in the mid-1980s. I lived in San Francisco from 1981 to 1989, and all around me people were dying, and it seemed that there was nothing we could do. It was awful, and at the time, all we could really do was prevent more people from getting AIDS. Dr. Koop showed us that preventing the spread of AIDS was eminently doable, and he did this despite his religious beliefs, because he was a man of integrity and a man of science.

Thirteen years ago, Dr. Koop said, "Except for smoking, obesity is now the No. 1 preventable cause of death in this country. Three hundred thousand people die of obesity and obesity-related illnesses (diabetes, heart disease, high blood pressure) every year." It seems likely that if he had been the Surgeon General then, we may already have seen a war on harmful eating similar to the one he waged on smoking -- and we may have similar results to show. Dr. Koop not only preached prevention, he took action to make it happen, but without him at the helm, obesity has almost doubled in the last 13 years and is now the No. 1 health crisis in the U.S. today.

Where are the men like him now?

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