Decline in Public Health Physicians May Harm Health, Report Says: Workers Sought

Kim Krisberg

Nations Health. 2007;37(6) 

In This Article

Food Safety Programs Often Underfunded

According to the Centers for Disease Control and Prevention, 76 million people contract a food-borne illness every year, 325,000 are hospitalized and 5,000 die, with a price tag of billions in health care costs and lost productivity. The most common types of food-borne illnesses are the bacterias E. coli, Campylobacter and salmonella and a group of viruses known as Norwalk-like viruses, which are rarely diagnosed and usually resolve themselves within a few days. Ensuring food safety has been a longtime duty of public health workers and departments, but state and local public health professionals only have so much authority and thinly stretched resources. A bigger problem, many advocates contend, is the woeful lack of authority and funding at federal food safety agencies, which oversee the manufacturing of food before it arrives at the local grocery store or café.

"What's happening is that government agencies continue to receive inadequate funding at a time when we're seeing more and more outbreaks and recalls in this country and we're going completely in the wrong direction," said Nancy Donley, president of Safe Tables Our Priority, commonly known as STOP. "We have such a fragmented food safety system as it is and there's really nobody looking at the whole picture and deciding what's the best way to take this issue on and make our resources the most effective."

Donley, who became a food safety advocate more than a decade ago after her 6-year-old son died due to E. coli-contaminated beef, is among many calling for a single federal food safety agency with public health as its sole mission. Currently, the nation's food safety responsibilities are scattered among 15 agencies, the two primary agencies being the U.S. Department of Agriculture, which is responsible for meat, poultry and processed egg products, and Food and Drug Administration, responsible for virtually everything else. This system is so fragmented that in April a U.S Government Accountability Office report designated federal food safety oversight a "high-risk" area. But while FDA oversees about 80 percent of the food supply, it receives only about 25 percent of federal food safety inspection funding, with much of the rest going toward USDA, GAO reported. In addition, the only product either agency can force a company to recall is infant formula -- other food safety-related recalls are voluntary.

"The problem is that the (funding) pie itself isn't big enough," Donley said. "It's not a matter of one agency receiving too much and the other too little, there's just not enough to go around. Period."

Still, FDA is seriously underfunded, according to Sally Greenberg, senior counsel at Consumers Union, which backs legislation that would create a single national food agency. Because of funding deficiencies, FDA food inspections have declined 81 percent since the early 1970s, and the number of FDA food safety staff has dropped by 12 percent since 2003, Greenberg told The Nation's Health. And though the amount of food imported into the United States continues to increase, FDA only inspects about 1 percent.

"They've lost staff, they've significantly lost resources, they are losing the capacity to ensure the safety of our food supply," said Chris Waldrop, director of the Food Policy Institute at Consumer Federation of America. "Things are starting to slip through the cracks."

According to Waldrop, proposed fiscal year 2008 federal funding for USDA's Food Service and Inspection Service is about $930 million, while proposed funding for FDA's entire food safety program is only $467 million. Of the proposed FSIS funding, about $840 million will go toward meat, egg and poultry inspection, in contrast to about $312 million of FDA's funding going toward inspections of produce and seafood. Waldrop also noted that although the number of FDA field staff bumped up after the terrorist attacks of Sept. 11, 2001 -- due to fears that terrorists would target the U.S. food supply -- FDA food safety field staff are now below pre-Sept. 11 numbers.

"What we're doing now is the bare minimum and sometimes not even that," Waldrop said.

And unfortunately, increasing rates in food-borne illnesses rates seem to be coinciding with declines in federal attention to food safety. According to an April report from CDC's FoodNet, a national food-borne illness surveillance program, while incidences of E. coli, salmonella and listeria have declined since FoodNet began a little more than 10 years ago, such rates have been rising during the past few years. For example, from 1996-1998, 2.3 people per 100,000 contracted E. coli. By 2004, the number was down to 0.9 per 100,000 people -- the National Healthy People 2010 objective for E. coli infection. Now, E. coli numbers are back up to 1.31 per 100,000.

Waldrop and fellow advocates are hoping national policy-makers will take steps to remedy food safety problems by supporting the Safe Food Act of 2007, introduced into Congress in February. The legislation, known in the Senate as S. 654 and House as H.R. 1148, would establish a single food agency, implement consistent performance standards for food processors and food establishments and would give the single food agency recall authority. However, until the Safe Foods Act or similar legislation is acted on, consumers need to be food safety savvy, educating themselves on safe food handling practices. Waldrop noted that with the recent food contaminations and recalls, he wouldn't be surprised if buying from local food markets and farmers becomes even more popular and that "can only be a good thing."

"(Weak federal authority) does put more onus on the consumer than is fair, but consumers do have a role to play," he said. "Still, we need to ensure that the food that comes into their kitchens is as safe as possible and right now that's not happening."

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