Sequestering Meals on Wheels Could Cost the Nation $489 Million per Year
Source: Center for Effective Government
Sequestering Meals on Wheels funds could cost taxpayers far more than it saves. While across-the-board spending cuts that began March 1, called sequestration, are expected to reduce spending on Meals on Wheels programs this year by an estimated $10 million, these savings will be dwarfed by at least $489 million per year in increased spending on Medicaid, both this year and in each subsequent year that sequestration remains in place.
Outside of Washington, waiting lists for Meals on Wheels enrollees have received media attention, but the expected savings have remained largely unquestioned. In reality, cutting Meals on Wheels will very likely increase the federal deficit by increasing the overall cost burden and shifting it to Medicaid, local charities, and other programs.
Overall, Meals on Wheels saves the federal taxpayers money by helping participants live at home instead of living in comparatively expensive nursing homes. The average cost to Medicaid of nursing home care per patient is approximately $57,878 annually.
By contrast, the cost to Medicaid of home care is much lower, approximately $15,371 annually, or $42,507 less than nursing home care. Nationally, according to a survey by the Administration on Aging, as many as "92% [of enrollees] say Meals on Wheels means they can continue to live in their own home."
Based on these estimates, our analysis suggests that sequestering Meals on Wheels funds will actually cost the U.S. taxpayer $479 million dollars over the seven months it will be implemented during this federal fiscal year, which ends September 30 (see the appendix for details of this estimate). Moreover, because sequestration-related cuts are expected to increase in FY 2014 and beyond, if sequestration is not reversed, Medicaid-related costs will increase even more in those years.
Source: Institute of Medicine
From press release:
Recent studies that examine links between sodium consumption and health outcomes support recommendations to lower sodium intake from the very high levels some Americans consume now, but evidence from these studies does not support reduction in sodium intake to below 2,300 mg per day, says a new report from the Institute of Medicine.
Despite efforts over the past several decades to reduce dietary intake of sodium, a main component of table salt, the average American adult still consumes 3,400 mg or more of sodium a day – equivalent to about 1 ½ teaspoons of salt. The current Dietary Guidelines for Americans urge most people ages 14 to 50 to limit their sodium intake to 2,300 mg daily. People ages 51 or older, African Americans, and people with hypertension, diabetes, or chronic kidney disease – groups that together make up more than 50 percent of the U.S. population – are advised to follow an even stricter limit of 1,500 mg per day. These recommendations are based largely on a body of research that links higher sodium intakes to certain “surrogate markers” such as high blood pressure, an established risk factor for heart disease.
The expert committee that wrote the new report reviewed recent studies that in contrast examined how sodium consumption affects direct health outcomes like heart disease and death. “These new studies support previous findings that reducing sodium from very high intake levels to moderate levels improves health,” said committee chair Brian Strom, George S. Pepper Professor of Public Health and Preventive Medicine at the University of Pennsylvania Perelman School of Medicine. “But they also suggest that lowering sodium intake too much may actually increase a person’s risk of some health problems.”
New GAO Reports
Source: Government Accountability Office
1. Agricultural Research: Two USDA Agencies Can Enhance Safeguards against Project Duplication and Strengthen Collaborative Planning. GAO-13-255, April 12.
Highlights – http://www.gao.gov/assets/660/653753.pdf
2. Management Report: Improvements Are Needed to Enhance the Internal Revenue Service’s Internal Controls. GAO-13-420R, May 13.
3. President’s Emergency Plan for AIDS Relief: Shift toward Partner-Country Treatment Programs Will Require Better Information on Results. GAO-13-460, April 12.
Highlights – http://www.gao.gov/assets/660/653767.pdf
4. Defense Logistics: The Department of Defense’s Report on Strategic Seaports Addressed All Congressionally Directed Elements. GAO-13-511R, May 13.
Roxarsone, Inorganic Arsenic, and Other Arsenic Species in Chicken: A U.S.-Based Market Basket Sample
Source: Environmental Health Perspectives
Background: Arsenic-based drugs are permitted in poultry production. Inorganic arsenic (iAs) causes cancer and maybe other adverse health outcomes. The contribution of chicken consumption to iAs intake, however, is unknown.
Objectives: To characterize arsenic species profile in chicken meat and estimate bladder and lung cancer risk associated with consuming chicken produced with arsenic-based drugs.
Methods: Conventional, conventional antibiotic-free, and organic chicken samples were collected from grocery stores in ten US metropolitan areas from December 2010 to June 2011. 116 raw and 142 cooked samples were tested for total arsenic, and 78 samples ≥10µg/kg dry weight underwent speciation.
Results: Total arsenic geometric mean (GM) in cooked chicken meat samples was 3.0 µg/kg (95% CI: 2.5, 3.6). Among 78 cooked samples that were speciated, iAs concentrations were higher in conventional samples (GM = 1.8 µg/kg; 95% CI: 1.4, 2.3) than antibiotic-free (GM = 0.7 µg/kg; 95% CI: 0.5, 1.0) or organic (GM = 0.6 µg/kg; 95% CI: 0.5, 0.8) samples. Roxarsone was detected in 20 of 40 conventional samples, one of 13 antibiotic-free samples, and none of the 25 organic samples. iAs concentrations in roxarsone-positive samples (GM = 2.3 µg/kg; 95% CI: 1.7, 3.1) were significantly higher than in roxarsone-negative samples (GM = 0.8 µg/kg; 95% CI: 0.7, 1.0). Cooking increased iAs and decreased roxarsone concentrations. Compared to organic chicken consumers, we estimated that conventional chicken consumers would ingest an additional 0.11µg/day iAs (in an 82g serving). Assuming lifetime exposure and a proposed cancer slope factor of 25.7 (mg kgBW-1 day-1)-1, this could result in 3.7 extra lifetime bladder and lung cancer cases per 100,000 exposed-persons.
Conclusions: Conventional chicken meat had higher iAs concentrations than conventional antibiotic-free and organic chicken meat samples. Cessation of arsenical drug use could reduce exposure and the burden of arsenic-related disease in chicken consumers.
‘Globesization’: ecological evidence on the relationship between fast food outlets and obesity among 26 advanced economies
‘Globesization’: ecological evidence on the relationship between fast food outlets and obesity among 26 advanced economies
Source: Critical Public Health
The aim of this study was to investigate the relationship between the density of fast food restaurants and the prevalence of obesity by gender across affluent nations. Data on Subway’s restaurants per 100,000 people and proportions of men and women aged 15 years or older with a body mass index higher or equal than 30 kg/m2 were obtained for 26 of 34 advanced economies. Countries with the highest density of Subway restaurants such as the USA (7.52 per 100,000) and Canada (7.43 per 100,000) also tend to have a higher prevalence of obesity in both men (31.3% and 23.2%, respectively) and women (33.2% and 22.9%, respectively). On the other hand, countries with a relatively low density of Subway restaurants such as Japan (0.13 per 100,000) and Norway (0.19 per 100,000) had a lower prevalence of obesity in both men (2.9% and 6.4%, respectively) and women (3.3% and 5.9%, respectively). Unadjusted linear regression models showed a significant correlation between the density of Subway’s outlets and the prevalence of adult obesity (β = 0.46; p = 0.02 in men and β = 0.48; p = 0.013 in women). When the data were weighted by population size, the associations became substantially stronger in both men and women (β = 0.85; p = 0.0001 and β = 0.84; p = 0.0001, respectively). Covariate adjustment did not reduce the size of the associations. Our study raises serious concerns about the diffusion of fast food outlets worldwide and calls for coordinated political actions to address what we term ‘globesization’, the ongoing globalization of the obesity epidemic.
New Report: The Law That’s Saving American Fisheries
Source: Ocean Conservancy
“The Law That’s Saving American Fisheries: The Magnuson-Stevens Fishery Conservation and Management Act” is a primer and collection of stories that highlight pioneers of American fishery management as well as innovators who are opening fishing frontiers, revealing:
- How a salmon fishing pioneer’s courage in making sacrifices for long-term sustainability set the stage for Alaska’s success
- How successful fishermen from Alaska to Florida used discipline to turn around two decades of overfishing
- How West Coast fishermen found the flexibility to make a living within rebuilding programs
- How fishing entrepreneurs in Port Clyde, Maine, turned leadership into opportunity
- Why rebuilding important recreational species such as summer flounder, bluefish and lingcod provides economic as well as enjoyment payoffs
- What commercial and recreational fishermen believe we get from good stewardship
Report on the National Stakeholders Conference on Honey Bee Health (PDF)
Source: U.S. Department of Agriculture and U.S. Environmental Protection Agency
From press release:
The U.S. Department of Agriculture (USDA) and the U.S. Environmental Protection Agency (EPA) today released a comprehensive scientific report on honey bee health. The report states that there are multiple factors playing a role in honey bee colony declines, including parasites and disease, genetics, poor nutrition and pesticide exposure.
“There is an important link between the health of American agriculture and the health of our honeybees for our country’s long term agricultural productivity,” said Agriculture Deputy Secretary Kathleen Merrigan. “The forces impacting honeybee health are complex and USDA, our research partners, and key stakeholders will be engaged in addressing this challenge.”
“The decline in honey bee health is a complex problem caused by a combination of stressors, and at EPA we are committed to continuing our work with USDA, researchers, beekeepers, growers and the public to address this challenge,” said Acting EPA Administrator Bob Perciasepe. “The report we’ve released today is the product of unprecedented collaboration, and our work in concert must continue. As the report makes clear, we’ve made significant progress, but there is still much work to be done to protect the honey bee population.”
Source: Institute of Medicine
For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families.
In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA’s Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments.
Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.
Source: Chatham House
Food crises are the deadliest natural disasters, resulting in up to 2 million deaths since 1970, yet responses to them are reactive, slow and fragmented.
A new report, Managing Famine Risk: Linking Early Warning to Early Action argues that whilst famine early warning systems have a good track record of predicting food crises, they have a poor track record of triggering early action to protect lives and livelihoods.
Major improvements in the sophistication and capabilities of famine early warning systems provide the opportunity for decisive early action, but also the opportunity for prevarication, delay and buck-passing among governments and humanitarian agencies.
There is also added political pressure not to report food crises, says Rob Bailey, the report’s author.
‘Governments in at-risk countries may suppress famine early warnings if they are concerned it will challenge their record on hunger reduction,’ he said.
2012 Global Hunger Index
Source: International Food Policy Research Institute
The 2012 Global Hunger Index (GHI) report—the seventh in an annual series—presents a multidimensional measure of global, regional, and national hunger. It shows that progress in reducing the proportion of hungry people in the world has been tragically slow. According to the index, hunger on a global scale remains “serious.” The 2012 GHI report also focuses particularly on how to ensure sustainable food security under conditions of land, water, and energy stress. The stark reality is that the world needs to produce more food with fewer resources, while eliminating wasteful practices and policies.
In the coming decades food security will be increasingly challenged by land, water, and energy scarcity. To improve poor people’s nutrition and food security in this environment, we will need to make a diverse range of foods more available and accessible, identify and address wasteful practices and policies, and ensure that local communities have greater control over and access to productive resources. In other words, we need to build a sustainable world, where the degradation of ecosystems is halted or reversed and all people have access to food, clean water, and modern energy and are empowered to use them for their own well-being.
Source: PLoS ONE
We examined whether a sugary drink limit would still be effective if larger-sized drinks were converted into bundles of smaller-sized drinks.
In a behavioral simulation, participants were offered varying food and drink menus. One menu offered 16 oz, 24 oz, or 32 oz drinks for sale. A second menu offered 16 oz drinks, a bundle of two 12 oz drinks, or a bundle of two 16 oz drinks. A third menu offered only 16 oz drinks for sale. The method involved repeated elicitation of choices, and the instructions did not mention a limit on drink size.
Participants bought significantly more ounces of soda with bundles than with varying-sized drinks. Total business revenue was also higher when bundles rather than only small-sized drinks were sold.
Our research suggests that businesses have a strong incentive to offer bundles of soda when drink size is limited. Restricting larger-sized drinks may have the unintended consequence of increasing soda consumption rather than decreasing it.
Source: Chatham House
In a move that is likely to prove expensive for motorists and consumers, the UK government, on 15 April, is set to increase its target for biofuel use to 5 per cent of transport fuels.
But new research from Chatham House estimates that as this target is reached, biofuels will cost UK motorists in the region of £460 million in the coming year. This figure represents the increased cost of fuel from higher prices at the pump and the need to fill-up the car more often because biofuels have lower energy content. Further increases to comply with EU biofuels targets mean that this could triple to around £1.3 billion a year by 2020.
The report, The Trouble with Biofuels, by Rob Bailey, argues that this does not represent good value for money. Biofuels are an expensive way to reduce greenhouse gas emissions – the research found that typically the cost of emissions reductions from biofuels are several times what the government has identified as an appropriate price to pay.
Expanding biofuel use is also leading to higher food prices. This has damaging implications for food security in poor countries and is also likely to contribute to higher emissions, as farmers respond to higher prices by expanding production, sometimes into rainforest. After incorporating these ‘indirect emission’ effects, the analysis found that biofuels produced from vegetable oils are likely to be worse for the climate than fossil fuels.
Primary Prevention of Cardiovascular Disease with a Mediterranean Diet
Source: New England Journal of Medicine
The risk of stroke was reduced significantly in the two Mediterranean-diet groups. This is consistent with epidemiologic studies that showed an inverse association between the Mediterranean diet or olive-oil consumption and incident stroke.
Our results compare favorably with those of the Women’s Health Initiative Dietary Modification Trial, wherein a low-fat dietary approach resulted in no cardiovascular benefit.35 Salient components of the Mediterranean diet reportedly associated with better survival include moderate consumption of ethanol (mostly from wine), low consumption of meat and meat products, and high consumption of vegetables, fruits, nuts, legumes, fish, and olive oil. 36,37 Perhaps there is a synergy among the nutrient-rich foods included in the Mediterranean diet that fosters favorable changes in intermediate pathways of cardiometabolic risk, such as blood lipids, insulin sensitivity, resistance to oxidation, inflammation, and vasoreactivity.
Source: PLoS ONE
Fresh fruits and vegetables can harbor large and diverse populations of bacteria. However, most of the work on produce-associated bacteria has focused on a relatively small number of pathogenic bacteria and, as a result, we know far less about the overall diversity and composition of those bacterial communities found on produce and how the structure of these communities varies across produce types. Moreover, we lack a comprehensive view of the potential effects of differing farming practices on the bacterial communities to which consumers are exposed. We addressed these knowledge gaps by assessing bacterial community structure on conventional and organic analogs of eleven store-bought produce types using a culture-independent approach, 16 S rRNA gene pyrosequencing. Our results demonstrated that the fruits and vegetables harbored diverse bacterial communities, and the communities on each produce type were significantly distinct from one another. However, certain produce types (i.e., sprouts, spinach, lettuce, tomatoes, peppers, and strawberries) tended to share more similar communities as they all had high relative abundances of taxa belonging to the family Enterobacteriaceae when compared to the other produce types (i.e., apples, peaches, grapes, and mushrooms) which were dominated by taxa belonging to the Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria phyla. Although potentially driven by factors other than farming practice, we also observed significant differences in community composition between conventional and organic analogs within produce types. These differences were often attributable to distinctions in the relative abundances of Enterobacteriaceae taxa, which were generally less abundant in organically-grown produce. Taken together, our results suggest that humans are exposed to substantially different bacteria depending on the types of fresh produce they consume with differences between conventionally and organically farmed varieties contributing to this variation.
Despite inflationary heat affecting many of our wallets, fresh foods continue to maintain healthy sales contributions at retail. In fact, fresh foods can comprise between 30-60 percent of total food, grocery and personal care expenses on average, depending on country and type of fresh product. Let’s face it, fresh foods are high-traffic volume boosters. They are a staple to a healthy diet, and we shop for fresh foods often.
New findings from the Nielsen Global Survey of Fresh Foods reveal how much fresh foods we consume, where we shop for fresh products and why we shop these preferred retail channels. By combining global survey research with Nielsen sales information collected from around the world, we unearth insights that re-define retail strategies to bolster sales in both the perimeter and center store aisles. The Shopper Trends Survey findings are based on a global study, covering 54 markets across 58 countries, with a total sample size of 87,000 respondents.
Source: Congressional Research Service (via Federation of American Scientists)
As the U.S. and global economies continue to struggle, some inside and outside of Congress have expressed concern about how environmental regulation may stifle growth and productivity. Much of the criticism has focused on environmental regulations promulgated by the Environmental Protection Agency (EPA). Some claim that EPA is overreaching its regulatory authority and imposing costly and burdensome requirements on society. In general, the agriculture community, among others, has been vocal in its concerns, contending that EPA appears to be focusing some of its recent regulatory efforts on agriculture. Many public health and environmental advocates, on the other hand, support many of EPA’s overall regulatory efforts and in some cases argue that EPA has not taken adequate action to control the impacts of certain agricultural activities. Where agriculture contributes to environmental impairment, these groups say, it is appropriate to consider ways to minimize or eliminate the adverse impacts.
Growing interest in the impact of regulatory actions on many sectors of the economy is evident in Congress, which continues to examine the role of EPA and other federal agencies in regulating environmental protection. Congress has a number of policy options to address or respond to potential regulatory impacts.
Most environmental regulations, in terms of permitting, inspection and enforcement, are implemented by state and local governments, often based on federal EPA regulatory guidance. In some cases, agriculture is the direct or primary focus of the regulatory actions. In other cases, agriculture is one of many affected sectors. Traditionally, farm and ranch operations have been exempt or excluded from many environmental regulations. Given the agricultural sector’s size and its potential to affect its surrounding environment, there is interest in both managing potential impacts of agricultural actions on the environment and also maintaining an economically viable agricultural industry. Of particular interest to agriculture are a number of regulatory actions affecting air, water, energy, and chemicals.
Source: Institute of Medicine
The childhood obesity epidemic is an urgent public health problem. The most recent data available show that nearly 19 percent of boys and about 15 percent of girls aged 2-19 are obese, and almost a third of U.S. children and adolescents are overweight or obese (Ogden et al., 2012). The obesity epidemic will continue to take a substantial toll on the health of Americans. In the midst of this epidemic, children are exposed to an enormous amount of commercial advertising and marketing for food. In 2009, children aged 2-11 saw an average of more than 10 television food ads per day (Powell et al., 2011). Children see and hear advertising and marketing messages for food through many other channels as well, including radio, movies, billboards, and print media. Most notably, many new digital media venues and vehicles for food marketing have emerged in recent years, including Internet-based advergames, couponing on cell phones, and marketing on social networks, and much of this advertising is invisible to parents.
The marketing of high-calorie, low-nutrient foods and beverages is linked to overweight and obesity. A major 2006 report from the Institute of Medicine (IOM) documents evidence that television advertising influences the food and beverage preferences, requests, and short-term consumption of children aged 2-11 (IOM, 2006). Challenges and Opportunities for Change in Food Marketing to Children and Youth also documents a body of evidence showing an association of television advertising with the adiposity of children and adolescents aged 2-18. The report notes the prevailing pattern that food and beverage products marketed to children and youth are often high in calories, fat, sugar, and sodium; are of low nutritional value; and tend to be from food groups Americans are already overconsuming. Furthermore, marketing messages that promote nutrition, healthful foods, or physical activity are scarce (IOM, 2006). To review progress and explore opportunities for action on food and beverage marketing that targets children and youth, the IOM’s Standing Committee on Childhood Obesity Prevention held a workshop in Washington, DC, on November 5, 2012, titled "New Challenges and Opportunities in Food Marketing to Children and Youth."
Source: University of Pittsburgh Center for Biosecurity
Foodborne illness sickens or kills an extraordinary number of people each year. It also has great economic costs. Last year, an outbreak linked to contaminated cantaloupe in the United States sickened 146 and killed 30. In 2011, another outbreak in Germany that was eventually linked to contaminated sprouts, sickened more than 4,000 and caused at least 50 deaths. Foodborne disease outbreak response is a critical part of reducing the consequences of outbreaks that will occur in the future. If public health officials can more quickly recognize when a foodborne illness outbreak has occurred and identify the food causing the outbreak, lives can be saved and economic losses averted. The lessons learned from outbreak investigations can be used by industry and government to address the underlying causes of contamination that lead to illness, thus making food safer for everyone.
The Center for Biosecurity of UPMC produced this report to catalyze improvements in the country’s ability to respond to large foodborne disease outbreaks. We analyzed the existing data and studies on foodborne illness outbreak response, identified emerging trends, and interviewed dozens of federal and state level officials and experts from industry, professional organizations, academia, and relevant international organizations. The report puts forth a series of recommendations to accelerate and strengthen responses to foodborne illness outbreaks in the US.
New GAO Reports
Source: Government Accountability Office
A Better Defined and Implemented National Strategy Is Needed to Address Persistent Challenges
GAO-13-462T, Mar 7, 2013
DEFENSE TECHNOLOGY DEVELOPMENT
Technology Transition Programs Support Military Users, but Opportunities Exist to Improve Measurement of Outcomes
GAO-13-286, Mar 7, 2012
Department of Defense’s Waiver of Competitive Prototyping Requirement for Combat Rescue Helicopter Program
GAO-13-313R, Mar 7, 2013
Briefing on U.S. Department of Agriculture’s Food Assistance Procurement Process
GAO-13-395R, Mar 7, 2013
Overview of GAO’s Past Work on FHA’s Single-Family Mortgage Insurance Programs
GAO-13-400R, Mar 7, 2013
Use of Remanufactured Parts in the Federal Vehicle Fleet Is Based On a Variety of Factors
GAO-13-316R, Mar 7, 2013
Meat consumption and mortality – results from the European Prospective Investigation into Cancer and Nutrition
Source: BMC Medicine
Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC).
Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality.
Until June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (HR=1.14, 95% CI 1.01-1.28, 160+ vs. 10-19.9 g/day), and the association was stronger for processed meat (HR=1.44, 95% CI 1.24-1.66, 160+ vs. 10-19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR=1.18, 95% CI 1.11-1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5-5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g per day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and ‘other causes of death’. The consumption of poultry was not related to all-cause mortality.
The results of our analysis support a moderate positive association between processed meat consumption and mortality in particular due to cardiovascular diseases, but also cancer.