Cody Carlson, a former investigator for the Humane Society of the United States, writes in The Atlantic that last month, politicians in Iowa bowed to corporate pressure when they passed a law designed to stifle public debate and keep consumers in the dark. Instead of confronting animal cruelty on factory farms, the top egg- and pork-producing state is now in the business of covering it up. HF 589 (PDF), better known as the “Ag Gag” law, criminalizes investigative journalists and animal protection advocates who take entry-level jobs at factory farms in order to document the rampant food safety and animal welfare abuses within. In recent years, these undercover videos have spurred changes in our food system by showing consumers the disturbing truth about where most of today’s meat, eggs, and dairy is produced.
FDA to Require Tobacco Companies to Report Chemicals in Products
The FDA has announced that it will require the tobacco industry to disclose whether any of 20 potentially harmful chemicals are found in their products, reports USA Today. This information must be available in a consumer-friendly format a year from now. Tobacco companies are also going to have to back up claims of “modified risk” products with scientific studies. Both FDA requirements are part of the Family Prevention and Tobacco Control Act, passed in 2009.
Chevron and Merck Secretly Funded Attack-Ads in 2010
Bloomberg reveals that during the 2010 midterm elections, big oil and big pharma spent millions of dollars to help elect Republicans to Congress through attack-ads. The Supreme Court’s 2010 Citizen’s United decision paved the way for virtually unrestricted corporate campaign spending, in this case to fund politically active groups like Americans for Prosperity. According to Think Progress, a blog of the Center for American Progress Action Fund, Chevron’s profits have jumped 23.3 percent since its 2010 controbutions.
Finding a Cure for “Pharmacosis”
“What is the difference between a doctor and a pilot?” Dr. David Healy asked during a recent talk at the CUNY Graduate Center. The answer? A doctor isn’t going to go down with you.
Healy, a psychiatrist, psychopharmacologist and scientist, is the author, most recently, of Pharmageddon, a book about the “hijacking” of American healthcare by the pharmaceutical industry and what can be done about it. During his talk, Healy observed that doctors, not patients, are the consumers of medicine. And because doctors, unlike pilots, are not going to be personally affected by every professional decision they make, they may be less critical of “evidence” put forth by pharmaceutical companies, and more willing to overlook potential risks associated with the drugs they prescribe.
Healy argues that we have become too comfortable with the randomized control trial as our only source of drug evaluation. Evidence from clinical trials now trumps the values of patients and the expertise of doctors, despite the fact that, in Healy’s opinion, these trials have become mechanical and thoughtless. Because of dependence on control trials, prescription drugs are seen as innocent until proven guilty, and the pharmaceutical industry, rather than doctors, is playing an increasingly large part in curing disease.
In Pharmageddon, Healy cites examples of clinical trials that showed significantly different evidence of a drug’s effects than were actually published. “The unpublished trials primarily are negative,” he said in his talk, but pharmaceutical companies have strategies for turning negative trials into positive reports. Healy pointed to Eli Lilly’s Prozac trials from 1986. Data on suicides and suicidal acts while on Prozac were compared to the same events on placebo, no drug, or older drugs. For U.S. trials, Eli Lilly listed four suicides on Prozac and one on placebo, as well as 26 suicide attempts on Prozac and nine on other treatments. The corporation took this data and discounted seven of the nine suicide attempts on Prozac as non-genuine, while none of the placebo attempts were discounted. Four of the nine suicide attempts on placebo were in patients who had recently discontinued fluoxetine treatment (fluoxetine is the generic name for Prozac). Ultimately, the data that ended up in a 1991 BMJ article that reported on these trials looked quite different from the original 1986 data. Healy goes into further detail on this and other examples in Pharmageddon and on his blog.
“When the range of ways the suicide data were handled by Eli Lilly in this case or other companies in other cases do come up,” he writes, “companies tend to portray themselves as not statistically sophisticated. The implication is that if things went wrong, they did so by accident.” Accident or not, there is a lack of consistency between what the literature says and the trial results. Healy calls this the greatest divide in all of medicine.
Because of our dependence on randomized control trials and resulting uncritical acceptance of new drugs, we are suffering, according to Healy, from a new disease he calls “Pharmacosis.” One thing we can do to prevent the spread of this disease is to shift from evidence-based medicine to data-based medicine. We can do this by providing access to the data from randomized control trials, not just to the published reports.
We also need to give greater weight to anecdotal evidence. Currently, doctor and patient observations of drug effects are disregarded, despite the fact that most of these observations turn out to be correct. Though reports of adverse events from taking a drug may be anecdotal, Healy believes that it is still important for the system to pay heed and change as a result. This is why Healy has started www.RxISK.org, a patient adverse event reporting system. Through this website, patients can enter side effects they are experiencing from a particular drug, learn more about that drug, and view how many other people in their area are experiencing similar effects. People experiencing adverse events from a particular drug may believe that they are isolated, but this system will allow them to see whether others are having similar problems, and ideally mobilize them to do something about it.
In a video clip on Rxisk.org, Maria Bradshaw, whose son died by suicide 15 days after taking Prozac and experiencing a range of adverse reactions, discusses how sharing these reactions is important. She says that the trial populations pharmaceutical companies use to test their drugs are not representative of people who actually take them. “The only way that we’re actually going to learn about how these drugs work on people in the general population is for people like me and everyone else out there who’s using these drugs to file adverse reaction reports,” she urges. Healy’s hope is that people will use Rxisk.org to do just that, giving us a mechanism besides control trial reports through which to judge drugs, ideally reversing the effects of Pharmacosis.
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The Supplemental Nutrition Assistance Program and Recent Exceptions for Prepared Foods
In August 2011, the Rhode Island Department of Human Services launched a pilot program in the Providence area that allows some elderly, homeless, and disabled households to buy “hot prepared meals” using Supplemental Nutrition Assistance Program (SNAP) benefits – but only at Subway sandwich shops.[1]
SNAP (formerly known as food stamps) is the largest government nutrition assistance program in the United States, helping one in seven Americans pay for their food.[2] Each month, approximately 47 million people receive SNAP benefits, and the limits on how recipients can use their benefits are few.[3]
Benefits can be used at any retail establishment that accepts them in order to purchase any brand of food items. The only limitation on eligible food items is that they cannot be “hot foods” or “foods that will be eaten in the store” (i.e., prepared foods).[4]
Recognizing that certain groups of people may find it difficult or impossible to prepare foods for themselves, several states, including Rhode Island, have passed exceptions to the prepared foods restriction.
Now, Rhode Island SNAP recipients who are homeless, disabled, or elderly may use their benefits to purchase prepared foods at federally-approved restaurants in the pilot program. Thus far, however, the only establishments that have been approved are five Subway restaurants.[5]
A chain like Subway probably recognizes the financial advantage of accepting SNAP benefits. The potential revenue from the prepared foods exception is large. Approximately half of the individuals in the U.S. receiving public assistance due to disability (Supplemental Security Income) reside in households receiving SNAP benefits.[6] Add homeless and elderly SNAP recipients to that mix and the magnitude of new customer dollars is substantial.
Given the general lack of restrictions in the SNAP program, some might find it surprising that a state sub-program of SNAP has only approved one restaurant chain to do business with. The decision will potentially funnel a large amount of public funds to one business, which may cause pause in the public policy community. In addition, the pilot program’s options for participating individuals are limited, which may seem counter to the general spirit of SNAP.
But a look at the history of food stamps reveals the program’s long-standing ties to specific food producers and food products.
Unmarketable food surpluses coupled with widespread unemployment in the late 1930s gave birth to the first Food Stamp Program (FSP). In this initial incarnation, recipients would receive an extra 50 cents for each dollar they spent on food. But the fifty cents in benefits could only be used to purchase what the U.S. Department of Agriculture (USDA) determined to be surplus items.[7] Federal funds, via the FSP, went toward supporting farmers who could not sell enough goods.
When the FSP became a permanent program in 1964, its official purposes were “strengthening the agricultural economy and providing improved levels of nutrition among low-income households.”[8] At this time, the main restriction on eligible foods was that they could not be imported – the U.S. food industry, therefore, continued to be supported by the policy. To this day, SNAP is funded through the USDA, which also approves retailers for the program.[9]
It is important to note that SNAP is not the only government nutrition program with ties to specific brands. Women, Infants and Children (WIC) is a federally-funded program that provides supplemental nutrition assistance to low-income pregnant women, new mothers, and children up to age five.[10] WIC is generally more restrictive than SNAP in its categories of eligible foods, but also in that only certain brands of those eligible foods are approved by the program.[11]
For instance, women in New York who would like to use their WIC benefits to purchase breakfast cereals may only purchase cereal from a limited number of brands, including: General Mills, Kellogg’s, Post, Quaker, and Malt-o-Meal.[12]
Given the history of food stamps being used to support American food industries, and given the brand specifications of WIC, the Rhode Island prepared foods exception that uses only the American franchise of Subway Sandwiches might seem less shocking. And, if the state’s pilot program is deemed a success, it’s possible that Rhode Island will add other restaurants to its prepared foods exception.
Of note, Subway is the second largest global restaurant operator in the world, next to YUM! Brands.[13], [14] Interestingly, YUM! Brands has also entered the SNAP arena. In September 2011, the Louisville-based corporation—which owns Taco Bell, KFC, Long John Silver’s, and Pizza Hut—was lobbying to make it easier for SNAP participants to use their benefits at restaurants.[15] Since 2009, Arizona residents who are disabled, elderly, or homeless can use their SNAP benefits to purchase prepared foods from certain fast food restaurants, including YUM! Brands’ Pizza Hut and KFC.[16]
Although ties between the U.S.-based food industry and federal nutrition assistance programs are long-standing, choice of foods has typically been a heavily guarded characteristic of SNAP. For instance, proposed public health interventions to remove sodas from the list of eligible foods under SNAP caused an uproar among anti-hunger advocates (including, among others, the soft-drink industry), who claimed that the government should not “micromanage” how low-income people shop.[17] Soda bans in SNAP have been thus far unsuccessful.
Given the program’s emphasis on choice, it is somewhat surprising that the state-level specific-brand-restricted prepared meals exceptions within SNAP have not received greater attention. They highlight an on-going tension within the SNAP program, between respecting participating individuals’ autonomy relative to food choices and giving preferential treatment to specific food vendors. If prepared foods exceptions within SNAP continue to proliferate, the public health community should be prepared to bring an additional perspective to the debate, namely the need to ensure that healthy (or at least healthier) eating options are available and easily accessible for SNAP recipients. This is the surest way to truly respect the program’s traditional emphases on choice and nutrition for participating individuals.
Sarah O. Rodman is a doctoral student in Health Policy and Management and a pre-doctoral fellow at the Center for a Livable Future at the Johns Hopkins Bloomberg School of Public Health.
References:
[1] Rhode Island Department of Human Services, The Rhode Island Supplemental Nutrition Assistance Program (SNAP) Prepared Meals “Food Access Pilot Project” (Oct. 2011), http://www.dhs.ri.gov/Portals/0/Uploads/Documents/SNAP/Q_and_A.pdf.
[2] Food Research and Action Center, SNAP/Food Participation 2011 (last visited Mar. 14, 2012), http://frac.org/reports-and-resources/snapfood-stamp-monthly-participation-data/.
[3] Food Research and Action Center, SNAP/Food Participation 2011 (last visited Mar. 14, 2012), http://frac.org/reports-and-resources/snapfood-stamp-monthly-participation-data/.
[4] United States Department of Agriculture, Supplemental Nutrition Assistance Program (2012), http://www.fns.usda.gov/snap/retailers/eligible.htm.
[5] Rhode Island Department of Human Services, The Rhode Island Supplemental Nutrition Assistance Program (SNAP) Prepared Meals “Food Access Pilot Project” (Oct. 2011), http://www.dhs.ri.gov/Portals/0/Uploads/Documents/SNAP/Q_and_A.pdf.
[6] Trenkamp B, Wiseman M. The Food Stamp Program and Supplemental Security Income. Soc Secur Bull. 2007;67(4):71–87. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18777670.
[7] United States Department of Agriculture, A Short History of SNAP (2012), http://www.fns.usda.gov/snap/rules/Legislation/about.htm.
[8] United States Department of Agriculture, A Short History of SNAP (2012), http://www.fns.usda.gov/snap/rules/Legislation/about.htm.
[9] United States Department of Agriculture, A Short History of SNAP (2012), http://www.fns.usda.gov/snap/rules/Legislation/about.htm.
[10] New York State Department of Health, Current WIC Acceptable Foods Card (2010), http://www.health.ny.gov/prevention/nutrition/wic/wic_acceptable_foods_card.htm.
[11] New York State Department of Health, Current WIC Acceptable Foods Card (2010), http://www.health.ny.gov/prevention/nutrition/wic/wic_acceptable_foods_card.htm.
[12] New York State Department of Health, Current WIC Acceptable Foods Card (2010), http://www.health.ny.gov/prevention/nutrition/wic/wic_acceptable_foods_card.htm.
[13] Subway (last visited Mar. 14, 2012), http://www.subway.com/subwayroot/default.aspx.
[14] YUM! Brands, Inc. (last visitied Mar. 14, 2012), http://www.hoovers.com/company/YUM!_Brands_Inc/hyssyi-1.html.
[15] Ellis J, Luther M. Restaurants Want a Piece of Food Stamp Pie, USA Today (Sept. 7, 2011), http://www.usatoday.com/money/industries/food/story/2011-09-05/More-restaurants-are-targeting-customers-who-use-food-stamps/50267864/1.
[16] Arizona Department of Economic Security, Arizona Restaurants/Retailers Participating in the USDA/FNS Restaurant Meals Program (2011), https://extranet.azdes.gov/faapolicymanual/FAA1/baggage/MealsProgramRestaurants.pdf.
[17] McGeehan P, U.S. Rejects Mayor’s Plan to Ban Use of Food Stamps to Buy Soda, NY Times (Aug. 19, 2011), http://www.nytimes.com/2011/08/20/nyregion/ban-on-using-food-stamps-to-buy-soda-rejected-by-usda.html.
Image Credits:
1. Supplemental Nutrition Assistance Program
2. NCReedplayer via Flickr.
FDA May Ban Antibiotics in Livestock Feed
The Jurist reports that the U.S. District Court for the Southern District of New York has issued an order to the FDA to continue proceedings, begun in 1977, that could lead to the removal of penicillin and tetracycline from agricultural livestock feed. If companies are unable to demonstrate that these antibiotics are safe, the FDA must prohibit their inclusion in feed. As Gardiner Harris writes in the New York Times, use of antibiotics in livestock feed can lead to the growth of antibiotic-resistant “superbugs,” a significant public health concern.
McDonald’s CEO to Retire – Good News for Public Health?
After 41 years with McDonald’s, Jim Skinner will be replaced as CEO by Donald Thompson, the company’s current president, reports Time. In a press release, Corporate Accountability International (CAI) reflects on Skinner’s tenure. Child obesity rates have risen in his eight years as CEO, with studies linking fast food and its marketing to the epidemic of diet-related diseases. McDonald’s has dismissed health concerns, fought menu labeling and spent millions on misleading PR. CAI hopes that Thompson will reverse these trends that have sacrificed health to boost profit.
Whistleblower to Maker of Pink Slime: “Quit Harassing Me”
Cross-posted from Appetite for Profit.
This past week, the media woke up to the shocking reality that our meat supply is in fact industrialized. Long gone are the days of your friendly local butcher grinding meat for your kids’ hamburgers. Taking its place is a corporate behemoth you probably never heard of called Beef Products Inc.
BPI now finds itself on the receiving end of consumer outrage over its ammonia-treated ground beef filler a former USDA official coined “pink slime.” Thus far, a petition aimed at getting current USDA officials to stop using the scary stuff in school lunches has garnered more than 200,000 signatures in about a week.
All the hullaballoo reminded me of a dramatic talk I witnessed about a year ago on this very topic. Last February, I spoke at a conference organized by the Government Accountability Project’s Food Integrity Campaign called “Employee Rights and the Food Safety Modernization Act” in Washington, D.C. The event’s focus was the little-known, but critical aspects of the newly-enacted food safety law that would give whistleblowers added protection.
The show-stopping presentation came from Kit Foshee, a whistleblower fired by Beef Products Inc., the very same company now in the news for pink slime.
So I went back to watch his presentation again, which the conference organizers were kind enough to make available. (But only after Foshee’s attorneys gave their approval – it will soon become apparent why that huddle was needed.)
What made Foshee’s talk so remarkable was its content – he spoke in great detail about BPI’s ammoniated beef process – but also his bravery at confronting his former employers, who just happened to be in the room.
A few minutes into his talk, as Foshee was pointing out the absurdity of BPI’s food safety awards on their website, he dramatically turned to his left to the BPI attorneys and asked if they were there to protect whistleblowers and to support the Food Safety Modernization Act, like the rest of us were?
I stopped taking notes and looked over, as everyone else in the room did. I can’t recall ever being at a conference hearing a whistleblower speak, let alone one that was confronting the company that fired him. The tension in the room was palpable but Foshee plowed ahead, with some nervousness in his voice.
He answered for the BPI reps, who weren’t interested in dialogue:
No, I am going to tell you right now, they’re not here to protect whistleblowers. This is about me. They’re here with their tape recorder because they are going to find a way to shut me up. They’ve got sealed documents, that if I say anything about, they’re going to persecute me. So we’re going to stick with the publicly available information, from their website, to stay safe.
(Foshee was referring to sealed court documents that resulted from his wrongful termination lawsuit against BPI.)
He described the adding of ammonia as “Mr. Clean.” He asked if people would buy hamburgers if they knew BPI used ammonia “to clean it up,” and spoke of the awful smell of the filler material. But “you don’t know that,” he said, and “you should be able to make a choice.”
The main way BPI and the meat industry has defended using ammonia (see this silly website just up – http://pinkslimeisamyth.com) is by claiming the safety benefits in reducing bacteria. This, by the way, was soundly disputed back in 2009 in an award-winning expose by the New York Times.
Foshee (who worked as BPI’s Corporate Quality Assurance Manager for ten years) – disputed the company’s safety claims in great detail. He called claims of reduced levels of the deadly strain of E. coli 0157:H7 “totally misleading.”
He said BPI would manipulate test results in various ways, including raising pH levels and not using the most effective testing methods available for detection. He called BPI’s claims that its testing was the best in the industry “a farce” and that “all they wanted was a test to give a negative result” and move on.
He added, directing his remarks to the BPI attorneys in the audience, “you want to promote that you’re a safe company to further your sales” but (pointing to their webpage) “this is false advertising.”
He noted that BPI is actually a detriment to food safety because many companies eliminated their own testing, relying instead on BPI’s claims of safety. “I don’t blame companies for believing it, because what idiot would claim that?”
In another dramatic moment, he challenged the BPI reps by saying “You want to sue me? Sue me, but quote your own studies correctly. It’s on your website. Quit trying to mislead consumers to thinking that if they buy from a company’s that uses BPI products in its ground beef, it’s safer – that’s absolutely false.”
In keeping with the theme of the conference, he explained why we need to protect whistleblowers: “because companies falsify data. This is still happening. This is real. This is a company is still falsely advertising right now. Their product is in all the ground beef that you’re eating every day.”
He also explained how painful it was to get fired. He divorced because of the toll the experience took on his marriage. “You try to explain to your spouse why you’re giving up $30,000 bonuses.” He had made over $100,000, but no more.
He finished with a challenge directed at the BPI attorneys in the room:
I wonder if there’s something in those sealed documents that they don’t want to know about, that I can’t talk about right now. I challenge BPI: why don’t you come here to promote whistleblowers and instead of to persecute me? Let’s open up these documents and see who’s lying? Let’s get this all out into the open. Why don’t you quit harassing me?
Why indeed. What’s in those documents? What is BPI trying to hide?
Next time you read sorry excuses from BPI like these, check out Foshee’s talk online and ask yourself, is this really a reliable company?
According to Amanda Hitt, director of the Food Integrity Campaign, within hours of Foshee’s talk, BPI removed entire sections of its website. She also disputes BPI’s claims of food safety and says the goal was to offer up cheap filler for hamburgers: “This product was never about safety, it’s about economics.”
Meantime, pink slime is just one of many problems with industrialized meat, so let’s not lose sight of that bigger picture. What to do about it? Demand labeling, buy organic, or just don’t eat ground beef.
Read more about Foshee and the Government Accountability Project’s Food Integrity Campaign. Thanks to brave whistleblowers like Kit Foshee for speaking out and let’s hope the media pays more than just passing attention to these critical issues.
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Indian Government Ends Bayer’s Monopoly on Cancer Drug
The Indian government will allow a local company to manufacture a generic version of the cancer drug Nexevar, which is currently patented by Bayer. A Common Dreams post explained that the the government’s ruling is based on a trade law that gives the government power to allow the manufacturing of generic versions of otherwise unaffordable drugs. It enables Natco Pharma to create a version of Nexevar that will cost $176 for 120 tablets. Bayer was charging about $5,600 for the same amount. Bayer spokeswoman Sabina Cusimano told the Associated Press, “We will see if we can further defend our intellectual property rights in India.”
China Considers Raising Taxes to Cut Tobacco Use
China is studying the possibility of increasing prices and tax hikes to curb tobacco consumption, reports China Radio International. A senior official with the country’s tobacco use regulator, Miao Wei, Minister of Industry and Information Technology (MIIT) and a deputy to the National People’s Congress (NPC), says the effects of raising tobacco prices in order to curb tobacco use need to be tested in practice, given that tobacco prices and the tax on tobacco are already at a high level in China. Miao earlier admitted that more efforts are needed to control tobacco use and curb the number of smokers, which in China is now 350 million.
Corporations and Health Watch 