Americans today may be living an average of 30 years longer than a century ago, but now the quality of their lives and those of their children is more at risk, according to U.S. Surgeon General David Satcher.

America's "top doctor" recently offered his prescription for improving health in the 21st century to faculty, staff, students and community members in the first of a series of special lectures celebrating the 50th anniversary of the School of Medicine.

A near-triumph over many infectious diseases, due to factors ranging from improved sanitation to vaccines and antiobiotics, has enabled Americans, who lived, on average, to age 47 a century ago, to reach 77 today - or even older, as evidenced by the 50,000 centenarians in the U.S. today. Heart disease and cancer are on the decline - due in no small part to the groundbreaking 1964 Surgeon General's Report on the harmful effects of smoking, Satcher said.

Today, however, disorders linked to lifestyle choices - obesity-related diseases, for example - threaten to diminish the quality of life. "Over half of the diseases in this country are related to human behavior," Satcher said. The consequences take effect early in life.

"Quality of life begins with conception," he said. A fetus's exposure to alcohol and other drugs may impact that child's health permanently.

Obesity is skyrocketing among children, as is Type 2 diabetes. Also of concern are teen smoking and drinking as well as sexual activity, carrying the risks of HIV/AIDS and other sexually transmitted diseases. One in 10 children suffers from a debilitating mental disorder, he noted, with only 20% receiving treatment.

"Children need help, but too often, they don't get that help," Satcher said. "To the extent that we respond to the needs of the most vulnerable among us, we do the most to promote health of the nation."