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.

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?

Read more about The Public's Health.