Health and Human Services Policy (from Pew Prospectus 2009)

Source Organization: The Pew Charitable Trusts

Author: Shelley A. Hearne

03/20/2009 - The Pure Food and Drug Act and the Meat Inspection Act were rightly considered landmark legislation when they were passed by Congress more than a century ago.

Until that point, protections against the sale of poor-quality food were mostly state-based, and federal action was fragmentary—on imported adulterated medicines, for example. By comparison, the two laws enacted in 1906 were broad. They provided federal inspection of meat products, required food labels and banned "the manufacture, sale or transportation of adulterated or misbranded or poisonous or deleterious foods, drugs, medicines and liquors."

Change was overdue. New technologies—canning, refrigeration and chemical preservatives, for instance—had increased the kinds of foods available; and consumers, increasingly urban and shopping in the emerging self-service markets, knew less and less about what they were buying. Historians credit another factor in gaining congressional support for food-safety legislation after years of delay: The public wanted information to make good purchasing decisions. They were outraged about abuses, such as those in the meatpacking industry described in The Jungle, Upton Sinclair’s 1906 novel; and they were increasingly interested in applying science—that is, hygienic codes—to food safety and other aspects of home economics, a term coined in 1899.

Today, we can look back on a century punctuated with advances in food safety, including stronger legislation and the evolution of regulatory agencies such as the U.S. Food and Drug Administration (FDA). Yet we are not in the clear. Currently, nearly 20,000 new food products are launched each year; globalization challenges our ability to trust our food sources, which are literally worldwide; and specific outbreaks—for instance, E. coli O157:H7 and hepatitis—have worried the public.

The figures are staggering. Food-borne illnesses caused by microbial pathogens annually account for some 5,000 deaths in the United States and more than 76 million illnesses and 325,000 hospitalizations, plus serious, life-long health problems in many. Further, we are seeing more and more of these dangerous bacteria becoming resistant to life-saving pharmaceuticals. In fact, agricultural overuse of antibiotics has been directly connected to resistant Campylobacter, E. coli and Salmonella, which are among the leading causes of food poisoning in humans. Every outbreak costs the economy dearly, with thousands to millions of dollars in lost productivity and medical costs.

Our nation’s capacity to protect consumers cannot be met by the structures we have in place. A decade ago, the National Academies of Science called for reform of the nation’s food safety system, and in a series of reports since then, the Government Accountability Office, the investigative arm of Congress, has endorsed that goal and made specific recommendations for improvement.

The Produce Safety Project of Pew’s Health and Human Services Policy program is approaching this problem by focusing on improving the FDA’s oversight of domestic and imported produce through the adoption of mandatory, enforceable safety standards from farm to fork. The project is advocating for regulations based on prevention, scientifically sound risk assessment and management, and integrated data collection. Last September, the project released the results of a survey of likely voters: By a 3-to-1 margin, respondents wanted the federal government to establish new safety standards for the growing, harvesting, processing and distribution of fresh fruits and vegetables—even if the measures would increase costs.

The project’s report on the handling of the Salmonella Saintpaul outbreak in the summer of 2008 exposed weaknesses in the government’s response to food-borne illness. The project recommended organizational reforms throughout the public health system for a more coordinated outbreak response; timely and effective data-sharing among public health agencies; and establishment of unified risk-communication plans prior to an outbreak.

In a related effort, our Campaign on Human Health and Industrial Farming is working to reform U.S. policies to protect human health by eliminating antibiotic abuse on large industrial farms, where most of the meat consumed in the United States is raised. Health experts agree that the misuse of these life-saving drugs by humans and on factory farms is contributing to the rise of antibiotic-resistant infections among Americans and jeopardizing the public’s health. The campaign achieved an important goal in July 2008 when Congress passed legislation requiring standardized annual reporting to the FDA on non-human pharmaceutical use. This will help the FDA determine which antibiotics important to humans also are being marketed for farm animals. The campaign is championing further reforms, including legislation that will require the FDA to phase out the use of antibiotics in livestock when disease is not present.

By offering research and common-sense, achievable remedies, Pew’s Health and Human Services Policy program is working to safeguard our food supply—and, in our other projects, the pharmaceuticals we take and the financial instruments we use to ensure our overall well-being. It is our hope that through these efforts, we can contribute to making Americans healthier, safer and more financially secure.

Shelley A. Hearne
Managing Director, Health and Human Services Policy

Read more about Pew's work in Pew Prospectus 2009 (PDF).

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