The health picture in the United States is "a rather drab and bleak one," Dr. John Seffrin told nearly 200 health workers Friday in his keynote address of the annual Utah Public Health Association meeting.

Seffrin, an Indiana University professor and chairman of the department of applied health science, said the greatest dilemma facing this nation on any level is the rising cost of providing health care. In 1987, "a shade under $500 billion was spent on health care in the U.S. These costs are more than we can afford," Seffrin said.At least part of the problem stems from missing opportunities for educating the public on health risks, he said.

"The top 13 percent of health-care users use as much health care as the other 87 percent," he said. "And what do we know about that 13 percent? They are smokers, drink alcohol or are obese." If physicians took five minutes to advise all their smoking patients how bad the habit is for their health, they could get 20 percent to quit. Yet only one-quarter of doctors he had contacted said they spent that time with clients.

Citing findings in an American Cancer Society study, Seffrin said, "Health is the number one concern of American adults," in 70 percent of the population. Noting a majority of those surveyed had changed their diet within the past few years to prevent heart attacks, cancer or cardiovascular disease, he told the audience, "the public is receptive to education."

He also pointed to a scientific study of the effectiveness of warning smokers, conducted during from 1964 to 1978. "In estimates we've saved 200,000 lives through education," he said.

There are several reasons that health education is not more widespread, Seffrin said.

Health-care organizations are fragmented, and they need to be unified to be heard by the politicians who are in control of funding them.

Most health-care workers "have woefully little experience in the political arena," he said. And although health professionals shared information among themselves it is a well-kept secret from most of the rest of the world. "We are a triple threat," he said.

He urged the audience to form coalitions to let the public and politicians know that providing health care is becoming a crisis, which desperately needs attention and to "be exemplars, to be willing to stand up and be counted," he said. "Health education works."