December 31, 2013

Top-10 Public Health Issues of 2013

Top TenBy Gordon Schnell

As we usher in the New Year with hopeful anticipation of all the positive public health developments that await us in 2014, here is a look-back at 2013 and our Top-10 listing of public health issues in the spotlight.

10.  Herbal Supplements.  The herbal supplement trade has grown into a multi-billion dollar business because these alternative remedies offer the promise of treating the old fashioned way some of our most nagging conditions.  But recent studies have found a strong likelihood that these wholesome medicinal treats are not what they claim to be.  Instead, a significant portion are “contaminated” or “filled” with ingredients not on the product label, posing significant health risks, particularly to those with serious allergies.

9.  Caffeine.  High caffeine energy drinks like Monster and Red Bull have catapulted themselves into a $20 billion a year powerhouse industry, largely fueled by their increasing popularity with children.  But research shows that for kids, using these drinks can lead to serious health complications including obesity, heart and neurological complications, seizures, and even death.  So far, despite urging by the medical community, the FDA has done very little to regulate this industry, and in particular, how these drinks are marketed to children.

8.  Junk Science.  There are more than eight thousand so-called “open access” scientific journals that have sprung up in recent years.  Unlike the more traditional print journals which rely on subscription fees, these online-only journals make their money from publication fees charged to the authors.  Thus volume, which is boundless on the Internet, is the key to profitability.  Peer review or other screening devices to ensure some measure of quality control, just get in the way, leading to a proliferation of publications on medical or scientific developments based on faulty science, or even downright fraud.

7.  Generic Drugmaker Liability.  The Supreme Court ruled this year that generic drug manufacturers cannot be held liable for defects in the design of their products.  The decision follows from the Court’s 2011 ruling that similarly shielded the generics from liability for inadequate safety warnings on their drug labels.  Taken together, these decisions essentially shut the door on any lawsuits that potentially might be brought by individuals injured by generic drugs.  The FDA has recently proposed rules that, if passed, would change this dynamic and hold generic makers more accountable for the safety and labeling of their products.

6.  Hospital PricingNumerous studies this year, even one conducted by the Centers for Medicare and Medicaid Services, have shown that our system of hospital pricing is subject to a complete lack of transparency and a total disconnect from the regular forces of supply and demand.  It also is a major cause of the skyrocketing cost of healthcare in this country.

5.  SugarOutgoing NYC Mayor Michael Bloomberg lost his battle to limit the size of sodas served throughout the Big Apple, but his anti-sugar crusade raised some much needed attention on the issue.  The average American consumes roughly three times the 8 teaspoon daily limit of sugar the American Heart Association recommends.  There also seems to be little dispute that our sugar binge is a leading cause for the significant rise in diabetes, some calling the link as direct and undisputed as cigarettes and lung cancer.

4.  Obesity.  According to this year’s Human Capital Report released by the World Economic Forum, the U.S. ranked 112 out of the 116 major countries it surveyed when it comes to obesity and the major diseases to which obesity has been linked — heart disease, cancer, diabetes and respiratory failure.  What is most disquieting about the statistic is how far we have plunged in the global health landscape despite the amount of resources we have and the ever-increasing amounts of money we are spending on healthcare.

3.  Hospital Error.  Hospital errors now constitute the third leading cause of death in this country (behind heart disease and cancer).  And it is a problem that seems to be growing despite all of the money being pumped into the system.

2.  Fracking.  The debate rages on over whether hydraulic fracturing of oil and gas is a safe and cost-effective energy source or a recipe for environmental disaster.  Several studies are emerging showing a direct link between fracking and water contamination.  Some states are taking these studies very seriously.  Others seem to be embracing this controversial energy source without the serious consideration and debate it deserves.

1.  Antibiotics.  The CDC recently reported that every year more than two million people in the U.S. get infections that are resistant to antibiotics and at least 23,000 of them die as a result.  Virtually everyone now recognizes that it is our overuse of antibiotics, particularly with farm animals, that is the principal cause of this escalating health crisis.   The FDA recently passed rules to restrict antibiotics use with livestock, but many question whether they are too little too late.

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