U. S. Food and Drug Administration
Center for Food Safety and Applied Nutrition
Healthy People 2000
National Health Promotion and Disease Prevention Objectives
September 1995

5. BARRIERS AND CHALLENGES

Some of the primary barriers and key challenges that the agencies face in striving to achieve the Healthy People 2000 objectives are summarized below:

• Reduction in budget and work force resources with the need for maintained or expanded programs.

• Significant data gaps in the current incidence of foodborne illness and the exact modes of transmission. Key scientific data are lacking to identify controls and develop precise programs to eliminate pathogenic microorganisms in raw food.

• The elusive and changing nature of microbial pathogens. Outbreaks of illness have been caused by microorganisms not known to be human pathogens (the first E. coli O157:H7 human outbreak occurred in 1982) or by pathogens in foods not expected to be vehicles of transmission (C. botulinum in baked potatoes).

• The introduction of new food processing and packaging technologies. For example, the use of modified atmospheres to prolong the shelflife and maintain the quality of vegetables may enable anaerobic organisms, including human pathogens, to proliferate.

• The public's distrust of new technologies, such as food irradiation, and regulatory constraints on the use of new technologies and chemicals. Like pasteurization, irradiation can be used to kill pathogens or to sterilize food to yield a safe food product.

• The increasing proportion of the domestic food supply which is distributed widely, and an increase in food imported from foreign countries. The food supply has become more global, making it difficult for agencies to monitor the safety of the food supply. For example, about 135 different countries now supply seafood to the United States. Within the United States, wide distribution of contaminated food products has resulted in widespread outbreaks.

• The increase in numbers of people who are susceptible to foodborne disease. The percentage of the population that is older than 65 will grow from about 12% in 1980 to over 22% in 2004. In addition, the number of immunocompromised people has grown significantly because of the Human Immunodeficiency Virus (HIV) epidemic, the increase in cancer, and the use of immunosuppressive drugs. Some experts believe immunocompromised people currently make up 25% of the U.S. population.

• The difficulty of providing effective educational programs to food service workers. The food service industry is characterized by a large, diverse population of employees, high rates of employee turnover, language and literacy barriers, and non- uniform systems among states for training and certifying workers.

• The difficulty of motivating all those who prepare food to follow proper food preparation practices. Effective education does not simply provide more information. The education challenge is to tailor the kind of information, the channel of communication, and the educational approach to each of the different audiences. For example, we are not yet sure how to change the behavior of someone who knowingly eats raw animal protein products or how to target our message to specific consumers, such as those who inadvertently undercook high-risk foods.

• The increasingly diverse population impacts the effectiveness of food safety education materials. With limited resources it is difficult to target people of different cultures who may speak different languages and eat different food prepared in different ways.