**AAP Remarks**

Thank you, Dr. Rosenberg. And thanks to Dr. Mary Anne McCaffree and the
rest of the American Academy of Pediatrics for inviting me to be a part
of your Legislative Conference this year. I understand that this is the
18^th^ year that pediatricians have come to this event to gain the
skills necessary to become effective advocates of children's health
concerns, and this could not be a better moment in time for your
advocacy! I can think of no better voice to represent these issues than
you- the pediatricians treating our children. For all of your
extraordinary work, I would like to thank you, not just as an FCC
commissioner, but as a proud mother of three. My work with pediatricians
spans several decades---of course beginning with our own
pediatrician-Dr. David Thombs one of the most respected pediatricians in
Tennessee, but also in larger, public policy issues such as expanding
ESPDT in our Medicaid program you all have undoubtedly heard
about-Tenncare; helping write a separate chapter in our mental health
code for children and youth, representing abused and neglected children
in Juvenile court for many years, and one of my most prized honors:
being selected by the TN Chapter as its "Friend of the Child" recipient
for work trying to get the SCHIP program for Tennessee; which 10 years
later may finally become a reality!

As you can imagine, I give a lot of speeches about important issues
facing the FCC and indeed our country: from our new Homeland Security
Bureau, to the digital transition (which, by the way, please go to our
website and get the consumer guide before you purchase one of those big
expensive TVs that may not work after Feb. 09!!), to some of the largest
corporate mergers in US history, to requiring all telecom providers to
coordinate E911 calls, to those you probably read about the most:
indecency and content related issues on TV.

However, when I went to the FCC, I vowed that I would continue to be a
voice for parents and children on issues that we have some authority
over. While I am an attorney by training and certainly respect the 1^st^
Amendment, I truly believe that our children are this country's most
valuable assets, and the government should treat them as such. You all
are the first to know that in order to ensure they reach their greatest
potential, we must make certain to create a healthy environment for both
their minds *and* their bodies. Obviously, this is a task that every
parent faces---and one you assist with almost daily\-\-- but parents
cannot do it alone. This is a task that will take our entire society.

With the arrival of digital and satellite television, not to mention
cell phones and facebook, we have available to us a seemingly infinite
number of platforms of information and entertainment with a click. Along
with that, though, our children have gained an exposure to certain
imageries and influences that can have a very negative impact on their
development. The violence children witness on television can act as a
direct counterweight against the attitudes and social lessons that we
try to instill in them as parents.

As you may have read recently in the press, Congress asked the FCC to
study and report back to them, the effects of television violence on
children. The results were, to a mother of 2 boys, not surprising. I
especially appreciated the pediatricians and other specialists and
researchers who provided strong evidence into the record about the
negative effects on children including that the exposure to violent
television programs can cause desensitization---losing the ability to be
empathetic. Some research confirms that exposure to excessive violence
can lead to more aggressive or even violent behavior later in life.
While many media companies dispute the research and our report, over 80%
of parents agree with us and believe that violent television programs
alter their children's behavior. Such exposure, as you all know, can
also lead to sleep abnormalities, inconsolable nightmares, and even an
increased fear of becoming victims themselves. So whether you believe
there is a direct corollary to violent behavior, there are numerous
negative effects on children ...and ***No child deserves that***.

**[CORE Programming]{.underline}**

I don't want to give you the wrong impression, though. This is not about
casting blame; this is about harnessing the power and potential of the
media to be an exceedingly *[positive]{.underline}* influence on our
children. A prime example -- in the 1990s, thanks in large part to the
collaborative efforts of the FCC, the American Academy of Pediatrics,
and others, television stations began airing at least 3 hours of
CORE-educational programming for children under age 16 every week, with
very limited amounts of commercial time. We have enhanced that recently
and even now are working on limitations on the media websites where
children are directed. And in 1996, upon the urging of Congress and a
number of advocacy groups such as yours, the television industry
voluntarily implemented a ratings system for viewers to quickly
ascertain the nature of its programming and the age range for which it
is appropriate, enabling parents to more easily and more accurately
monitor the television viewing of their children.

**[Ratings Systems]{.underline}**

Despite these great strides, though, we still have much more work to do.
For example, the ratings system for television programs is significantly
inconsistent between networks. Often, one network will perceive a
certain level of violence as at least "moderate" and apply a "V" label
to the show's rating. Another network might air the same level of
violence and feel that it is less than moderate, applying no warning
about violent content whatsoever. Also, of exceptional risk to younger
children, much violent content in children's shows is labeled simply
"FV" for fantasy violence. Even fantasy violence, though, can seriously
impact a child less than 7 years old. And, sometimes the network will
stop with one rating label even if the show actually has sexual content,
indecent language AND violence. I think it is time to address these
inconsistencies.

To adequately address this problem, the television industry must adopt
more consistent, accurate guidelines for rating the content of their
programming. These new guidelines should take into account the
discrepancies between the networks' subjective perception of its shows'
content and parents' assessment -- almost 40% of parents feel that TV
ratings are inaccurate. At least one study agrees with those parents,
citing that 2/3 of high-risk shows with violence were inaccurately
rated.

Of course, the debate regarding the impact of violence in the media is
not a new one. It actually first drew congressional attention in 1952,
when the House convened a hearing on the subject. A year later, the
Senate took up the matter. Unfortunately, during the 54 years since
then, the entertainment industry has consistently recycled the same
rhetoric and spin it used during those hearings, and the problem
persists. Though I prefer self-regulation first, the industry has passed
on far too many opportunities to do so. The well-being of our children
is too important to wait any longer.

Just as in the push for more educational programming, the Academy has
great potential to take a leading role in the advancement of more
appropriate ratings guidelines. From your unique perspective of both the
physical and mental health of children, you can provide state and
federal government officials, industry executives, and even parents with
a wealth of insights into the proper balance of media exposure for
healthy development and methods by which that may be achieved, and I
hope you will join in a discussion of improving the entire rating
system.

**[Parental awareness of Violence in the Media]{.underline}**

As *you* well know, dealing with children and parents every day, changes
on the industry side are only half of the equation, though. Parents must
also become more informed about the resources already available to them
to protect their children from violence on television. The ratings
system will only be effective if parents understand the descriptor
codes. Only about half of all parents are able to identify the "V" as an
indicator of violence, and only 12% of parents can define the "FV" as
fantasy violence. Almost as many parents, 8%, interpreted "FV" to mean
"Family Viewing."

Additionally, parents are largely unaware of the potential for or even
the existence of the V-chip, which parents can use to block out selected
programming from their television sets that they do not want reaching
their children. Unfortunately, though, 2 in 5 parents are unaware that
their televisions are even equipped with the V-chip. Of those who are
aware, less than half have actually used it. But of those who have used
the V-chip, almost 90% said that it was useful to them in protecting
their children from unwanted content.

As parents, we have the responsibility to be aware of what our children
watch and to talk to them about what they see in the media. As
pediatricians, you have an invaluable role in advocating not only to
your elected officials about violence in the media and the tools
available to families, but also acting as advocates to parents --
informing them about the affects of violent programming on their
children, encouraging them to sit down with their children to talk about
what they see on television, explaining the ratings guidelines, or even
advising them to just turn off the television sometimes. Nickelodeon,
for instance has a "Day of Play" where the screen goes black and it says
"GO OUT AND PLAY". I wish more networks and more parents would do the
same; but not just for 1 out of 365 afternoons; but what about limiting
TV and computer to the rest of those 364 days a year!

**[Healthy Lifestyles]{.underline}**

In addition to nurturing their mental well-being, though, we must also
work to encourage healthy lifestyles and physical well-being. In the
past, I focused my energy on advocating for better schools, working
toward increasing the rate of childhood immunizations, and representing
neglected and abused children. Today, and through our authority to
regulate children's TV, I have turned my attention to a new epidemic
that is charging to the forefront of children's health concerns:
*obesity*.

**[Childhood Obesity]{.underline}**

You know the statistics better than anyone in the country. Over 10
million children are obese or at risk of obesity and by some counts 1 in
4 youth and teens are overweight. To parents, the most apparent problem
is likely the low self-esteem and even depression that being overweight
creates in young people, but the health consequences are even more
staggering. In addition to heart problems, overweight and obese children
must contend with significantly higher risks of health defects, such as
Type 2 diabetes---which was basically unknown when I grew up---but
doubled in prevalence with the rise of childhood obesity.

**[Costs]{.underline}**

While our most pressing concern is that of the well-being of our
children, of course, the rising costs associated with this issue must be
addressed as well. In a time of concerns over meeting the funding needs
of the U.S. health care programs, obesity should be a major focus. While
we don't yet know the indirect costs such as child care costs or lost
school-time, childhood obesity alone creates over \$150 million in
medical expenses. Not to mention that obese children are twice as likely
to become obese adults. Obesity-related medical expenses are a growing
percentage of our national health care costs, accounting for almost 10%
of medical expenses and over \$100 billion dollars, about half of which
were covered by Medicare and Medicaid. The pressure on my home state of
Tennessee alone is well over a billion dollars a year to be paid for by
state health care programs. This national epidemic is putting an
unbearable strain on our health care system.

**[Task Force]{.underline}**

So how do we even begin to combat such a colossal crisis? To start, we
have to change the eating and fitness habits of our children. Our kids
are constantly being bombarded with advertisements for junk foods and
soft drinks; not just by the media, but the internet and even inside
their own school cafeterias. That's why the FCC and Senators Tom Harkin
and Sam Brownback teamed up with your own Marjorie Tharp and
representatives from many other organizations, including non-profit
groups *and* representatives of the food and beverage and advertising
industries, to form the Task Force on Media and Childhood Obesity. Our
mission, as you probably know, is to chart out recommendations for
advertisers and food manufacturers to approach children through the
media with a healthier agenda in mind.

**[Ad Statistics]{.underline}**

The Kaiser Family Foundation recently reported that children between the
ages of 2 and 7 watch an average of 12 commercials for food each day.
Teenagers see about 17 a day, and 8 to 12 year olds watch 21 food
commercials each day. In a time when children are very impressionable
and are just becoming independent consumers, that's 7600 food
commercials each year! Though parents must take the initiative to
monitor their children's television viewing and to just say "no" when
their children ask for foods that are high in fat, salt, and sugar, we
can't ask them to stand alone against more than **[\$10
billion]{.underline}** of advertising that these industries target at
our children every year.

As with the entertainment industry, though, the media and the food and
beverage industry are not our enemies. On the contrary, they have the
opportunity to become very powerful allies in this fight. For example,
the National Advertising Review Council brought together 10 of the
largest food and beverage companies, including Kraft, McDonald's,
Coca-Cola, and PepsiCo, to establish the Children's Food and Beverage
Advertising Initiative, pledging to devote **[half their advertising
dollars]{.underline}** spent on marketing to children, including
Internet and other media forms, to promote **[healthier diets and
healthier lifestyles]{.underline}**. Nickelodeon has partnered with the
Alliance for a Healthier Generation in an attempt to reach out to 2
million kids and encourage them to adopt healthier eating habits and to
get more exercise. The Discovery Channel helps families lose weight and
has a health challenge annually. Disney has totally changed their
properties to serve healthier choices. And there are many more such
leaders in the media.

In this fight, there are no enemies. However, there are allies *[who
have not yet reached their full potential.]{.underline}*

Children under 8 years old still view 26 junk food ads for every 1 ad
about fitness or nutrition. The ratio for preteens is 48 to 1, **[and
for teenagers, 130 to 1!]{.underline}** Obviously, our children are
still receiving an unhealthy, *disproportionate* amount of advertising
favoring foods that are high in fat, sodium, and sugar over healthy
diets and healthy fitness habits. But how do we know that changes in
advertising to children will be effective in curbing their
over-consumption of these foods? In the words of Dr. McGinnis, chairman
of the Institute of Medicine, "We know it'll work because advertising
works."

Again, though, while more responsible food advertising practices will
help, childhood obesity will not be eliminated simply by changing what
they see on television. The responsibility is on all of us -- including
the government, teachers, parents, doctors, and even the children
themselves -- to find the solution.

**[Educational system and Arkansas]{.underline}**

Our education systems can, and have, played a major role in this
struggle. In Florida, Governor Crist just signed a bill into law
mandating at least half an hour of physical education each day in all
elementary schools. Those of you from Arkansas have given the rest of us
reason to be optimistic. That state, which Gov. Huckabee called the
"fatest state in the union" launched a statewide initiative and began
monitoring students' weight, changing school diets, encouraging active
lifestyles, and advising parents of health concerns as a part of the
wildly successful Healthy Arkansas initiative, and the rate of childhood
obesity was actually halted in its footsteps-in 3 years.

But we still have so much more work to do.

**[Statistics on TV]{.underline}**

Obviously, parents must take personal responsibility as well. In a
typical childhood full television and video games, surfing the Web and
instant messenger, parents must also learn to turn off the TV and shut
down the computer. On average, children spend ***25 hours a week***
watching TV! Compare that to the 30 hours spent in school or the
***meager 17 hours spent with their parents***! But parents are on the
right path. From 1994 to 2003, the number of parents of 3-5 year olds
who limited television time rose from 54% to 67%. Parents are beginning
to get the message. Luckily, parents aren't alone. We have pediatricians
such as you to advise us on a healthy lifestyle for our children, a
responsibility which you must approach not only seriously, but
*[aggressively]{.underline}*.

> **[Advocacy and Policy]{.underline}**

As pediatricians and members of the American Academy of Pediatrics, you
are in a unique position to speak with convincing authority on these
pressing issues. You deal first-hand with the problems that officials at
the state and federal level typically are only able to talk about. You
have the ability to act as a direct link between parents & children and
policy-makers, helping formulate these policies and then have put them
into action yourselves. You've seen the negative effects of violence in
the media on young children. You've seen the positive impacts of
increased educational programming. And you've even been pained as you've
witnessed childhood obesity rates rise among your own patients. I don't
think there could be a more convincing source of advocacy than you in
America.

The solutions to these problems facing our children will not only be
found in the entertainment, advertising, or food manufacturing
industries; it won't be found only in our schools or in the government;
and it won't be found only with parents either. The answer lies in the
cooperation of ***all*** of those facets of a child's life. This is not
any one individual person, government agency, or company's problem. This
is all our problem, and we must come together as a *community* to find
the solution. Otherwise, we will have failed our children together \...
**[and *they deserve better than that*]{.underline}**.

I thank you for your efforts here in Washington and at home and join you
in your passion for the betterment of our children's lives. Thank you so
very much.

**(Brief question and answer session)**

> **(Time: between 17.5 and 18 minutes)**