Elders Calls Education the Best Rx : Medicine: The likely choice for U.S. surgeon general plans to focus on instruction, especially for young people, as the surest route to good health.

Dr. Joycelyn Elders, President-elect Bill Clinton’s likely choice as the nation’s next surgeon general, intends to use the potentially influential job to promote widespread school-based health education and services for teen-agers, including the availability of contraceptives--an agenda that almost certainly would inflame passions in some quarters.

“The things I stand for are the kinds of things that are not talked about much in this country and are controversial,” she said in an interview. “But I believe it’s time we began to deal with problems that are there--rather than go back to what we wish the situation was. We can’t afford not to do it.”

Elders, a 59-year-old African-American, is a pediatric endocrinologist who has run the Arkansas health department since 1987. Her appointment is expected to be announced today in Little Rock. A formal announcement has been on hold because the term of the current surgeon general, Dr. Antonia Coello Novello, does not expire until March, 1994, and she has expressed reluctance to leave the post.

Novello has been urged by the Clinton camp to take another job within the Public Health Service.

As surgeon general, Elders would assume a largely bully pulpit post--one without any real authority to make public health policy but with ample opportunity to influence public opinion.

From all signs, it appears she intends to make the most of the opportunity, seeing a model in former U.S. Surgeon General C. Everett Koop, who served in the Ronald Reagan Administration and is regarded as one of the most influential surgeons general in history.

“I had a long telephone conversation Monday with Dr. Koop,” she said. “He gave me a lot of wonderful information. His bottom line was: You can make this job whatever you want. He said to make sure I had my facts correct--that all my data were correct--and to stand for what I believe in.”

She said she was aware that her positions are likely to create enemies--”I probably would not have been a good surgeon general under Mr. Bush. He was not about the things I feel I am about”--but that she expects Clinton to support her fully as he has done in Arkansas.

“He said when I was appointed director of health in Arkansas that he didn’t know what he was getting,” she said, laughing. “After five years, he knows what he is getting.”

As chief of the state health department, Elders was an advocate for maternal and child health, in particular programs aimed at curbing the state’s epidemic of teen-age pregnancy. She became a voice for programs aimed at aiding children--much as new First Lady Hillary Clinton has--and would be expected to carry out that theme in a national role.

She has pushed for school-based health clinics and health curricula and for the availability of contraceptives for teen-agers through school health clinics. She also has been a strong proponent of a woman’s right to choose an abortion.

“One very important issue that I feel very strongly about is that every child born in America be a planned, wanted child,” she said. “I will very much push for health education and the availability of contraceptives for young people.”

Not surprisingly, such positions angered conservative forces when she espoused them in Arkansas, including legislators and church and anti-abortion groups. Already, she has begun to raise the ire of national anti-abortion organizations.

“The surgeon general is supposed to be a kind of propaganda minister, and I think Dr. Elders will be a propaganda minister for the most extreme pro-abortion agenda,” said Douglas Johnson, legislative director for the National Right to Life Committee.

She said she was prepared for such disagreements.

The decision to have an abortion “is between a woman, her God and her doctor--and should not be a decision made by a politician,” she said.

Elders said she believes programs that provide health services and contraception information to young people could have a major impact in reducing poverty, substance abuse, violence, AIDS, sexually transmitted diseases and other serious social ills.

“All of those things are a direct result of our failure to provide comprehensive health education in our schools and to make services available where our children are,” she said, adding that she hopes to develop a partnership between health and education.

“You can’t educate children if they aren’t healthy, and you can’t keep them healthy if they aren’t educated,” she said.

As surgeon general, she said she also would focus on women’s and minority health issues, childhood immunization and vaccine injury, smoking, AIDS and disease prevention.

“Prevention is primary,” she said. “We’ve got to teach our people prevention and how to use the health care system. Insurance does not equal care. We can do more to improve our own health than any medical discoveries can. There won’t be any miracles by Bill Clinton or anyone else that will be nearly as effective as what we can do for ourselves.”

In that vein, she said, “I will be out talking and educating and trying to move the public and use everybody I can--schools, ministers, businesses.”

She acknowledged she initially wanted to be named secretary of health and human services. But she said she looks forward to working with secretary-designate Donna Shalala and is excited about what she can do as surgeon general.

“I’m going to have fun as surgeon general,” Elders said. “As secretary, I wouldn’t have enjoyed more than half the work--running a large department, fighting over budgets--I wouldn’t have time to do the thing I do best: being an advocate for people, fighting for children, and fighting for the things I think this country should be about.”