FDA Commissioner Identifies Misinformation and Implementation of Scientific Knowledge as Top Health Care Concerns

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

At the opening session of the American Heart Association’s 2022 Scientific Sessions, FDA Commissioner Robert Califf, MD said that combating misinformation and effectively implementing change are 2 areas where the United States is currently failing.

Biomedical science and technology is in the midst of an amazing period of discovery and development, Califf said, but these benefits are not leading to improved health outcomes for the American population. Above all, Califf said the implementation phase is where the medical system really falls short.

“We are, and this is just my opinion of course, failing to implement right now,” Califf said. “We’re not in first place and we’re losing ground, and we better do 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 almost 5 years shorter in the United States than in other high-income countries, and Califf added that China has overtaken the United States in terms of life expectancy this year.

These disparities in life expectancy also vary widely across the United States, with rural areas having significantly lower life expectancy rates than coastal urban areas. It is important to note that these disparities are growing rather than improving.

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

Drug use is also on the rise, and Califf stressed the need to distribute naloxone nationwide in order to save lives. He compared his 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 people die each year from smoking, and 5.6 million children alive today are expected to die prematurely from smoking, Califf said.

To address all of these concerns, Califf said experts needed to change their approach.

“That word ‘account’ gets used a lot right now, and it has a lot of meanings,” Califf said. “I think as an American Heartland, we have a moment of judgment right now. We need to do something more than what we’re doing now and something different, because what we’re doing now isn’t working.

To that end, Califf made three suggestions. First, he said it was essential to reinvigorate the evidence generation system so that experts know what works and what doesn’t, with fewer arguments. Second, he said the entire health system must relentlessly focus on interventions that address the major sources of death and premature loss of function. Finally, he urged all clinicians to spend some time each day addressing misinformation, which he believes directly contributes to the destruction of health and well-being.

“I said misinformation is the most common 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. Bringing science into public health: lessons learned. Presented at the 2022 Scientific Sessions of the American Heart Association. November 5, 2022.

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