A few weeks ago, as a post-Thanksgiving treat, we began a series on food and the public’s health by discussing the summer recall of 36 million pounds of ground turkey meat linked to a potentially deadly strain of Salmonella. As we told you then, The Public’s Health will be exploring the sometimes-dangerous relationship between animal safety and treatment, general food safety, and our health.

Some readers weren’t happy with this, and wondered if our attention to the issue was overblown, claiming that the United States has the “safest food supply in the history of the world.” To figure out whether or not this is true, let’s consider what we are measuring and have a look at the data. Certainly, part of food safety can be evaluated by examining the burden of illness caused by pathogens in our food. According to the most recent statistics from the Centers for Disease Control and Prevention (CDC), there are about 48 million cases of “domestically acquired, foodborne illnesses” in the United States each year, 127,000 hospitalizations, and 3,037 deaths.

Although international rankings comparing food safety outcomes are imprecise, in a recent report published by scientists at the University of Saskatchewan Graduate School of Public Policy, the United States does rank towards the very top, just behind Denmark, Australia, the United Kingdom and Canada in overall food safety. So while we may not have the safest food supply in the history of the world, our food supply is pretty darn safe. But with approximately 3,000 deaths and well over 100,000 hospitalizations, is it safe enough? Can we do better?

The Institute of Medicine (IOM) of the National Academy of Sciences, our nation’s “independent adviser of scientific matters,” sure seems to think so. In 2010, an IOM Committee Report entitled “Enhancing Food Safety: The Role of the Food and Drug Administration,” called attention to an FDA that “lacks a comprehensive vision for food safety” and recommended that the agency “change its approach in order to properly protect the nation’s food.” Among the IOM’s recommendations:

  1. the FDA "should use a risk-based approach to evaluate food safety problems rather than its current reactive approach to food safety—which only addresses problems on a case-by-case basis and may fail to account for all the factors involved in making a decision";
  2. "In an effort to normalize and integrate food safety practices across the nation, the FDA should provide standards to states and localities and oversee their implementation";
  3. the FDA must "enhance the efficiency" of food safety inspections"; and
  4. the U.S. government should modernize and reorganize the food safety system through the creation "of a single food safety agency to unify the efforts of all agencies and departments with major responsibility for safety of the U.S. food supply."

But the statistics cited above and the recommendations in the IOM's report account for only a piece of the food safety puzzle. A related, but distinct topic that over the last decade has received an increasing amount of attention is that of the nature of our food system itself: that almost all of the food consumed by Americans is produced by an industrial agriculture system, also known as factory farming. The factory farm can produce anything from livestock to poultry to fish, as well as fruits and vegetables, and does so on a massive scale.

Measuring the health effects of factory farm produced food is difficult, if not impossible. We have no direct way to measure, for example, how many people get sick each year from run-off from the pesticides sprayed on our food, or whether people are getting sick because of the way the animal they just ate was raised. A recent report by the Pew Charitible Trusts and The Johns Hopkins School of Public Health, “Putting Meat on the Table: Industrial Farm Animal Production in America,” tries to tackle this issue in the context of meat production.

The report calls attention to the potential public health threats from factory farming, including the threat of human antimicrobial resistance from the use of antibiotics in livestock and poultry feed (animals are fed between 17 and 25 million pounds of antibiotics each year to stimulate growth and keep them healthy) and the threat of air and water pollution from farm run-off. To address this problem it recommends the phasing out and eventual ban of nontherapeutic antibiotics in animals. The report also calls attention to "the contamination of rivers, streams, and coastal waters with concentrated animal waste; animal welfare problems, mainly as a result of the extremely close quarters in which the animals are housed; and significant shifts in the social structure and economy of many farming regions throughout the country."

Next week we will take a look at animal welfare as a public health concern. Until then, do you still think the U.S. is doing a good job? Can we do better?

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