The top administrator at the Kansas Department of Health and Environment said Thursday abstinence-only education programs were inadequate to sufficiently reduce unwanted pregnancies and moderate the spread of sexually transmitted diseases.

Secretary Lee Norman, who has experience as a family physician, hospital system executive and military medical officer, said KDHE could help reduce unwanted pregnancy in Kansas and diminish demand for abortions by broadening standard educational offerings to emphasize contraception. It should be a collaboration among KDHE, county health departments and school districts, he said.  

He emphasized Finney County's rising rate of teen pregnancy and escalation in the number of people testing positive for HIV, gonorrhea, syphilis and chlamydia.

"Abstinence education is not going to do it," Norman said. "That's what the educational process is in Finney County. The school system says, 'We teach one kind of sexual education, and that's abstinence. And that's all we teach,' which is failing. It doesn't prevent pregnancy and it doesn't prevent sexually transmitted illness."

Norman spoke to The Topeka Capital-Journal's editorial advisory board about his top priorities in terms of public health reform during the next two to four years.

Officials with the Garden City public school district, the ninth largest in Kansas, didn't respond to a request for comment about Norman's analysis.

Norman also prioritized reduction in drug overdose fatalities, enhancement of rural hospital trauma systems, development of a needle exchange program for drug users and the training of health professionals to improve early detection of autism in children.

In addition, he spoke of obesity as a national security threat because so many 18- to 22-year-olds would fail the military's physical fitness standard. He characterized the incidence of gun violence in the United States as a public health crisis.

"I put it in the context of if we had 38,000 to 40,000 people dying of anything in this country, let's say an infectious disease, people would be marching in the streets to do something about it," said Norman, who is U.S. Army qualified with an M4 rifle and Beretta pistol.

Norman said he would direct KDHE to make a stronger stand against substance abuse, with an emphasis on opioid addiction. Expansion of Medicaid under the Affordable Care Act would bring resources to individuals struggling with addiction, he said.

Gov. Laura Kelly proposed expanding eligibility for Medicaid to about 130,000 Kansans, and the Kansas House approved a bill in the 2019 session that stalled in the Kansas Senate. Republican lawmakers and Govs. Jeff Colyer and Sam Brownback thwarted adoption of an enlarged footprint for Medicaid in Kansas. Currently, more than 400,000 Kansans take part in the health program.

Norman said he would support formation of a state program to provide individuals consuming illegal drugs an opportunity to exchange used syringes for clean syringes. The response from skeptics will be that he enables people in their destructive habits, he said. The counter argument for an exchange program, previously demonstrated effective in Indiana when Vice President Mike Pence was governor, is the reduction in spread of disease, he said.

Norman said rural Kansans, especially people living in regions classified as frontier due to sparse population, need heightened access to trauma services. That includes immediate aid at local hospitals and rethinking of the transportation network to bring injured people to such facilities as the University of Kansas Medical Center, he said.

"I taught trauma and combat medicine for 35 years. You have a golden hour to handle that trauma," he said. "I've seen it. As chief medical officer at KU, I'd just hold my head and say, 'If we had seen that patient yesterday, we would have saved him.' "

He said one in 59 live births would be diagnosed as residing on the autism spectrum and supplemental training of primary-care medical professionals could lead to intervention with children during their preschool years. Kansas should bolster training of physicians, physician assistants and nurse practitioners to improve identification of the disorder, he said.