FDA Commissioner Identifies Misinformation, Implementation of Scientific Knowledge As Biggest Concerns in Health Care

In the opening session at the American Heart Association 2022 Scientific Sessions, FDA Commissioner Robert Califf, MD, said that tackling misinformation and effectively implementing changes are 2 areas in which the United States is currently falling short.

Biomedical science and technology are in the midst of an amazing period of discovery and development, Califf said, but those advantages are not resulting in improved health outcomes for the US population. Importantly, Califf said the implementation phase is where the medical system is truly falling short.

“We are, and it’s just my opinion of course, failing right now at implementation,” Califf said. “We’re not in first place and we’re losing ground, and we’d better do better for our people.”

The United States spends significantly more money on health care but has worse results than other developed countries, Califf said. For example, life expectancy at birth is now nearly 5 years shorter in the United States than in other high-income countries, and Califf added that China surpassed the United States in life expectancy this year.

These disparities in life expectancy also vary significantly within the United States, with rural regions having significantly shorter life expectancy rates than coastal, urban areas. Importantly, these disparities are expanding rather than improving.

“I believe that this is the biggest trend in America that we need to pay attention to, for a whole variety of reasons,” Califf said.

Drug use is also growing, and Califf emphasized the need to distribute naloxone throughout the country in order to save lives. He compared its distribution to the use of defibrillators, saying that prior to their distribution, many more people died of heart attacks.

Finally, Califf identified tobacco usage as another challenge. More than 480,000 individuals die each year from tobacco use, and 5.6 million children alive today are expected to die prematurely from smoking, Califf said.

To address all of these concerns, Califf said experts must change their approach.

“This word ‘reckoning’ is used a lot right now, and it has a lot of meanings,” Califf said. “I think as American heart people, we’ve got a moment of reckoning right now. We need to do something more than we’re currently doing and something different, because what we’re doing right now is not working.”

To that aim, Califf gave three suggestions. Firstly, he said it is essential to reinvigorate the evidence generation system so that experts know what works and what doesn’t work, with fewer arguments. Secondly, he said the entire health care system must relentlessly focus on interventions that work to tackle the major sources of death and premature loss of function. Finally, he urged all clinicians to spend some time every day tackling misinformation, which he said is directly contributing to the destruction of health and well-being.

“I’ve been going around saying that misinformation is the most common cause of death in the United States,” Califf said. “There is no way to prove that, but I do believe that it is.”

REFERENCE

Adams J, Albert M, Benjamin R, Califf R, Patel M. Moving Science into Public Health: Lessons Learned. Presented at American Heart Association 2022 Scientific Sessions. November 5, 2022.