Evolution of Science to Policy: Applications in

Food and Nutrition

Helen H. Jensen, Professor of Economics

Center for Agricultural and Rural Development

Iowa State University

hhjensen@iastate.edu http://www.card.iastate.edu/

November 2012

Learning Outcomes

Context of science and policy decisions Making Sense of Science in Policy and

Politics Case examples: fortification and food safety The role of economics in evaluation

Changes in consumer market

Declining share of expenditures on food U.S. consumers spend on average $0.11 of each $1 of income

on food

Increase in marketing share of food expenditures Marketing bill now 79% of food expenditures

Increasing value of time and demand for convenience in foods

Increase in demand for nutrition, food quality and food safety Proposed legislation for warning labels on products

Similar trends throughout the world (developed and developing countries)

http://www.ers.usda.gov/publications/eib12/

Prevalence* of Self-Reported Obesity Among U.S. AdultsBRFSS, 2011*Prevalence reflects BRFSS methodological changes in 2011, and these estimates should not be compared to previous years.

15%–<20% 20%–<25% 25%–<30% 30%–<35% ≥35%

New Scientific Findings – the Science Context

Dietary Guidelines for Americans 2010 Food Plate

Dietary Reference Intakes (DRIs), Institute of Medicine 2000 – present IOM Committee on sodium IOM review of vitamin D and calcium

Food Safety Technologies – irradiation, packaging Production – organic vs. conventional practices Food handling and distribution practices

Science, Policy and Politics

The obesity “epidemic” While rates for many diseases are decreasing,

increased rates of obesity and overweight Food vs supplements and fortification Production methods (e.g., Michael Pollan) Food safety outbreaks

Peanuts and salmonella, 2009, 2012 E-coli and spinach, 2006 E-coli and salmonella contamination of meats

Making Sense of Science in Policy and Politics

The “Pure Scientist” The “Science Arbitrator” The “Issue Advocate” The “Honest Broker of Policy Alternatives”

Ref. The Honest Broker: Making Sense of Science in Policy and Politics, R. Pielke, Jr. 2007

Making Sense of Science in Policy and Politics

The scientific application is not independent of policy and politics

Based on behavioral and communications sciences

Science, Policy and Politics

Science: the systematic pursuit of knowledge Policy: a decision Politics: bargaining and negotiation

Conditions for science offering “objective” knowledge Decision maker narrows choices Low rate of uncertainty

Policy Decisions and Market Influence Science

Who conducts research? What resources are available? Who has rights to the results?

Patent protection, publication policy Market influence on scientific development

R&D, innovation, orphan drugs Induced policy innovation

ref. Hayami and Ruttan

Case Example: Fortification with Folic Acid

Health problem: Spina bifida and anencephaly are birth defects

related to neural tube closure Affected children die shortly after birth

(anencephaly) and have permanent neurological deficits (spina bifida)

Scientific evidence: Folic acid supplementation lowers risk of neural

tube defects ( NTD) (reduce cases by 50-75%)

Case example:Fortification with Folic Acid 1992 US recommends all women of

childbearing age consume folic acid supplements

Consider fortification in the US To reach more women of child bearing age Evidence: 50% of live births are unplanned

1996 Folic acid fortification mandated FDA required manufacturers to fortify enriched

ceral-grain products with 140 ug of folic acid per 100 g cereal product

Ex ante: Folic Acid FortificationStudy NTD

Cases Averted

Cases Neuro. Damage

Benefit NTD Pre $ million

Fortific. Costs $ million

Adverse Health Costs ($)

Net Benefit$ million

FDA 116 (4.6%)

0 651-786 27 NA 624-759

California(1991)

304(10.5%)

500 121.5 11.5 16.4m 93.6

CDC(1993)

89(2.3%)

89 16.1 11 350,000 4.7

Source: Grosse, Waltzman, Romano, Mulinare, Am J Pub Health, 2005

Ex post: Folic Acid Fortification

NTD No. NTDs Averted

Total Cost/NTD Birth (Direct), $

Total Benefit, $ million

Net Benefit (minus $3 mil cost)

Total Direct Cost, $ million

Cost Savings (minus $3 mil cost)

Spina bifida

520 636,000(279,000)

331 145

Anen-cephaly

92 1,020,000(6000)

94 1

Both 612 425 $422 mil 146 $143 m

Source: Grosse, Waltzman, Romano, Mulinare, Am J Pub Health, 2005

Ex post: Folic Acid Fortification

Surveillance: Reduction in NTD 20-30% Reasons for the large decrease:

Higher folic acid intake Larger dose response No evidence of harm (effect on B12 deficiency)

Higher benefit cost ratio, cost effectiveness

The Debate: UK Fortification

Should Folic Acid Fortification be Mandatory? YES

Delay not justified Voluntary efforts inadequate Evidence supports

NO Evidence not strong, weigh other risks Folate in foods may differ from fortification Level of exposure important (low vs. high)

The Debate: Fortification

Risk analysis: the “precautionary principle” Approach 1. The “selective approach”

No fortification unless a documented need Iodine in salt; iron for targeted population

Approach 2. The Non-selective approach” Food manufacturers -- voluntary

Science, Policy and Politics

Cost benefit analysis Cost effectiveness analysis

Disability adjusted life years (DALY) Analysis and assumptions

Effectiveness and efficacy Cost Vehicle and exposure Related behaviors

Consumer choice

Science, Policy and Politics: Food Safety

Improved science (+) Changes in production practices, distribution (+,-) Increased trade and imports (-) Tracing food safety problems (+) Public Regulation

US Dept of Agriculture: meats and poultry US Food and Drug Administration: seafood, eggs, imports,

processed, drugs, supplements, fresh fruits & vegetables Environmental Protection Agency (drinking water, pesticides, toxic

substances) State and local health authorities

Food Safety in the US

Estimated 76 million cases of foodborne illness in the US Only about 20% are attributed to specific food

Meats: Improvements since mid 1990s Seafood Produce: New problems in raw produce Imports

Food Marketing InstituteTrends Survey 2009

Slide from Gale Price

Consumer Confidence in Food Safety Somewhat & Completely Confident

Source: U.S. Grocery Shopper Trends 2009

85% 82%

66%

43%

81%

65%

83%

68%

Slide from Gale Price

Food Is as Safe or SaferThan Five Years Ago

CompletelyDisagree

15%15% 8%8%10%10%

27%27%41%41%

SomewhatDisagree

CompletelyAgree

SomewhatAgree

Neutral

CompletelyDisagree

23%23%10%10%

10%10%

18%18%

39%39%

SomewhatDisagree

CompletelyAgree

SomewhatAgree

Neutral

Source: U.S. Grocery Shopper Trends 2009

Food Is Less Safe Than Five Years Ago

Slide from Gale Price

Health Risks Perceived as “Serious”

13%

17%

19%

19%

21%

22%

25%

36%

39%

41%

43%

45%

47%

53%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55%

Eating food past the Best-by date

Eating food past the Sell-by date

Additives and preservatives

Eating food past the Use-by date

Food handling in supermarkets

Irradiated foods

Foods produced by biotechnology and GMOs

Antibiotics and hormones used on poultry or livestock

Avian influenza

Terrorist tampering

Pesticide and herbicide residues

Product tampering

BSE (Mad Cow Disease)

Confirmation by bacteria or germs

Source: U.S. Grocery Shopper Trends 2009 Slide from Gale Price

Shoppers’ Comfort Level with Foods Grown/ Produced In and Outside the United States

Source: U.S. Grocery Shopper Trends 2009

27%

63%

37%

9%

40%

2%

18%

5%

Slide from Gale Price

Questions…

Does economics play a key role in the implementation of proper food safety and sanitation practices in the food industry?

How much food safety is “enough”? Public policy and public health Private industry

What would a market for food safety look like?

Price

Quantity – food safety

Supply

Demand

Food Safety has Value

To individuals avoidance of suffering risk reduction greater for those at higher risk

To society health care costs loss of productivity

Key question: How much are consumers (or is society) willing to pay for safer food?

What is the cost of a “food safe” hamburger?

Would you be willing to pay double the price for a completely safe hamburger? (100% tax)

How about 20%? What is the producer obligation? Should there be a “law” that requires

producers to produce a safe burger? Should there be a choice?

Raw oysters? Fresh cider?

Market Failure

Neither producers nor consumers may know if the product is safe

Costly to measure, test Contamination or control can take place

throughout food chain

Food Safety Policy

Government is involved because markets “fail” to allocate food safety (get the “right” amount)

New approaches - Shared responsibility for food safety throughout

food chain by government, industry and consumers

Development and implementation of risk-based approaches to regulation

Recent legislation – risk based Food Quality Protection Act (1996) Seafood HACCP regulation for all seafood

processors (1997) Pathogen reduction/HACCP for meat

implemented 1998 and fully implemented 2000 (1996)

Fruits and vegetables juice HACCP (1998) Egg safety Action Plan (2000);

implementation of final rule (2010)

FDA Food Safety Modernization Act, Jan (2011)

Preventive controls Move from response to outbreaks to system designed to prevent outbreaks.

Requires food facilities to evaluate, implement, monitor hazards FDA to establish science-based standards for safe production and harvest of

fruits & vegetables New ability to hold companies accountable

Inspection and Compliance – risk-based system Imported Food Safety – system enhanced Response – provides FDA with mandatory

recall authority Enhanced Partnerships

FDA shuts down New Mexico peanut butter plant – Nov 2012 Outbreak: 41 people ill in 20 states Traced to peanut butter from NM plant and

sold through Trader Joe’s Use 2011 FDA authority to halt operations:

“suspend registration” because of reasonable probability of causing serious health problems

FDA will require implementation of preventive measures before allowing plant to ship

Agency has found unclean equipment, improper handling, uncovered trailers, etc.

Economic Analysis of Regulations for Health and Safety

Compare benefits of regulation to costs Measure the reduction in the level of risk

of illness and death for large populations (i.e. benefits) to the costs

Note, the benefits are not the value to an individual

Estimated Benefits and Costs of HACCP Rule

Benefit Scenario Low High Low HighBillion dollars (1995)

Preliminary FSIS 1995 proposal 8.4 42.1 2.32 2.3Low-range benefits estimates 1.9 9.3 1.1 1.3Mid-range benefits estimates I 4.7 23.4 1.1 1.3High-range benefits estimates 47.2 171.8 1.1 1.3

Benefits Costs

Source: USDA Economic Research Service

Responsibility for Making SureFood Is Safe

Source: U.S. Grocery Shopper Trends 2009

55%

32%28%

32%

22%25%

8%12%

55%

33%

Myself asan individual

7% 8%

Foodprocessors

Government Institutions

Foodstores

Consumergroups

Farmers

Slide from Gale Price

Where Do You Think Food Safety Problems Are Most Likely to Occur?

At food processing plants 30 32 45 53 57

While stored in a warehouse awaiting distribution 11 10 9 9 9

At restaurants 20 18 11 9 8

On the farm 1 1 6 5 5

At home 18 16 9 5 4

In grocery stores 5 9 3 4 3

During transportation 5 4 3 3 3

Source: U.S. Grocery Shopper Trends 2009

2005 2006 20072008 2009

% % % %%

Slide from Gale Price

Regulatory Approaches for Least Cost Compliance

Legal liability forces investment but limited incentives if costs of

identification are high Other incentives based approaches

shift risky activity to where returns are highest Performance standards

allow firms flexibility in compliance Process standards

specify particular ways to reduce risk Nature of risk determines what is feasible

Peanut Butter 2009

Source: CDC 030609 Slide from Gale Price

Peanut Butter 2009

Source: CDC 030609

Slide from Gale Price

PCA Peanut Product Related RecallsJan 10 – Mar 31, 2009

0

10

20

30

40

10-Jan

17-Jan

24-Jan

31-Jan

7-Feb

14-Feb

21-Feb

28-Feb

7-Mar

14-Mar

21-Mar

28-Mar

Recalls

Slide from Gale Price

MN HD

State of TX Orders Recall

~ 500 Recalls Involving > 3,900 Products as of 3/31, 9 Deaths

Other Food Companies Recalls

PCA Recall

PCA Expands Recall

Role for Scientists in Policy

How do scientists relate their work to needs of decision makers?

1. Is the decision context characterized by consensus on values and low uncertainty?

Role for science advisor or pure scientist

2. Is there concern about consensus on values and high uncertainty?

Need to narrow scope of choice

Role for Honest broker or issue advocate