FDA Commissioner Identifies Misinformation, Implementation of Scientific Knowledge as Top Concern in Health Care

FDA Commissioner Identifies Misinformation, Implementation of Scientific Knowledge as Top Concern in Health Care

FDA Commissioner Robert Califf said misinformation is the leading cause of death in the United States.

In a keynote session at the American Heart Association’s 2022 Scientific Sessions, FDA Commissioner Robert Califf, MD, said that combating misinformation and effectively implementing change are two areas where the United States is currently failing.

Biomedical science and technology is in the midst of an incredible period of discovery and development, Califf said, but those gains are not resulting in better health outcomes for the U.S. population. Importantly, Califf said the implementation phase is where the medical system is really lacking.

“We are, and this is just my opinion of course, currently unsuccessful in implementation,” Califf said. “We’re not in first place and we’re losing ground, and we better be better for our people.”

The United States spends significantly more money on health care, but performs worse 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 areas having significantly lower life expectancy rates than coastal, urban areas. Importantly, these disparities are widening, not improving.

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

Drug use is also on the rise, and Califf stressed the need to distribute naloxone nationwide to save lives. He compared its distribution to the use of defibrillators, saying that before their distribution many more people died of heart attacks.

Finally, Califf identified tobacco use 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 these concerns, Califf said experts need to change their approach.

“This word ‘reckoning’ is being used a lot right now and has a lot of meanings,” Califf said. “I think as American people of the heart, we have a moment of reckoning right now. We have to do something more than what we’re doing right now and something different, because what we’re doing right now isn’t working.”

To that end, Califf made three suggestions. First, he said it is essential to strengthen the evidence collection system so that experts know what works and what doesn’t, with less argument. Second, he said the entire health care system must focus relentlessly on interventions that work to curb the main sources of death and premature loss of function. Finally, he urged all clinicians to spend some time each day fighting misinformation, which he said directly contributes to the destruction of health and well-being.

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


Adams J, Albert M, Benjamin R, Califf R, Patel M. Moving science into public health: lessons learned. Presented at the 2022 American Heart Association Scientific Sessions November 5, 2022.

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