Thank you, Mr. McDonough, for that gracious introduction and, of course, for the opportunity to come home to New York. People often remark that New York City is something of a microcosm of our nation as a whole. For that reason, I cannot think of a better place to have this conference. But even more, I cannot think of a better time to have it than now. What today's presentations tell us is something that Secretary Shalala, myself-and our entire Administration-are aware of back in Washington. We are living through a remarkable-perhaps unprecedented-economic expansion: a time in which millions of jobs have been created, productivity is up, and the U.S. economy has firmly reestablished its vitality. I think Chairman Greenspan the other day used the phrase "truly phenomenal." But while our economy has brought hope and opportunity to millions, we recognize how much more still needs to be done for many Americans. That is a particular issue for us at the Department of Health and Human Services. Because while many measure low incomes in dollars and cents, we also see them reflected in illnesses and injuries that go untreated-and in diseases, even deaths, that could have been prevented. We have seen these occurrences not only in our cities, but in Appalachia, the Mississippi Delta, and the reservations of Native Americans. I would like to speak with you for a moment about the challenges that we face today-and about the demands they will place on us tomorrow. In the time that I have been at Health and Human Services, one of the things I have learned is that the public health profession has quite a lot to teach policymakers. That is something many New Yorkers learned earlier this decade when Dr. Margaret Hamburg was New York City's health commissioner. Faced with a serious outbreak of tuberculosis, she organized a multipronged effort aimed at prevention, treatment, and long-term care. It was an effort that involved not only mobilizing health care providers in the field, but also policymakers in New York City, Albany, and Washington. And it was a success. Dr. Hamburg's accomplishment was all about making the right diagnoses, and carrying out the right plan of action. Well, when public health professionals examine America's health, they see many, many strengths, but they also recognize some very serious symptoms. The good news, of course, is that Americans are living longer, healthier lives. Thanks in large measure to advances in public health, over the course of this century the average American's life span has increased by twentyfive years. Today, infant mortality is at an all-time low and child immunization is at an all-time high. We have even seen a decline in teen pregnancy. And, over the last several years, we have made dramatic inroads in our fight against AIDS, cancer, and other diseases. But there is also some disturbing news: too many are being left behind. Let me share a few statistics with you: Today, infant mortality rates for African-Americans are twice as high as they are for white Americans. Chinese-Americans are four to five times more likely to have liver cancer than other citizens. Latinos suffer diabetes at a rate twice the national average. The diabetes rate among Native Americans is three times as high as the national average. In fact, one-half of all the adults in the Pima Indian Tribe in Arizona are diabetic. That is the highest known rate in the world. These are the symptoms. What is the diagnosis? We have known for a long time that an individual's risk of an early death rises as his or her standing in the social hierarchy falls. In fact, income is actually one of the strongest single predictors of mortality. This is what it really means when, despite the incredible economic gains we have made over the last six years, we say how much more we still need to achieve. Today, 10.5 percent of Americans over the age of sixty-five are still living in poverty. …