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Strategic Planning Document -
Health, Safety and Food R&D

Executive Summary

PURPOSE

Improved health, safety and food security depends on scientific progress. CHSF will coordinate research and development, disseminate new knowledge, and support the development of sound and cost-effective national health, safety and food policies. CHSF plans an interactive mix of research and development investments that will improve our nation's health, safety and food, expand technological capabilities and stimulate growth. Fundamental scientific discovery will support technological development. Active surveillance will monitor current and emerging health, safety and food security issues. Knowledge- based evaluation will maximize program results and improvement. Multiple educational tools will inform the public about issues regarding their health, safety and food. CHSF scientists--fueled by accurate integrated information--will act on this plan in partnership with other dedicated professionals domestically and internationally.

THE CHALLENGE

CHSF is committed to developing the science base needed to meet complex challenges to health, safety and food security in a cost- effective manner. The U.S. science enterprise is at a juncture where rapid growth in science and technology can improve the health, safety and food of U.S. citizens, and national productivity, competitiveness, and economic security. The CHSF strategy supports "Science in the National Interest" by identifying research and development investments to help address national priorities such as health care quality and cost, welfare reform, food safety, violence and injury prevention, and improved health through proper nutrition and new medical treatments and technologies. The challenges we face include the following:

Every day disease claims lives, causes suffering and costs money. For example, Alzheimer's disease currently affects 4 million Americans and costs about $90 billion annually. The cumulative costs of treating HIV-infected persons are forecast to increase 48% over the next three years.
Health care spending has risen to 14% of the U.S. Gross Domestic Product, but by many indicators Americans are receiving less for their health care dollars than citizens of several other countries.
Approximately 2/3 of premature deaths in the United States are the result of behavioral and environmental factors--many of which can be modified or prevented. Effective prevention can greatly reduce suffering and treatment costs. Injuries alone cost about $215 billion annually.
The world population is expected to double by the year 2050. Growing demands for food and water need to be met. Abundant and safe food supplied through sustainable agricultural systems have many health, social, environmental and economic benefits.
In the United States, dietary factors and sedentary activity patterns have been identified as the second leading underlying cause of death, accounting for 14% of total deaths in 1990. Obesity is increasing--over one third of adults, or 50 million people, are obese.

MEETING THE CHALLENGE: HEALTH, SAFETY AND FOOD FOR AMERICA

On November 21-22, 1994 the CHSF and OSTP sponsored a national forum: "Meeting the Challenge: Health, Safety and Food for America". The purpose of this Forum was to convene 450 scientific experts from a mix of disciplines, organizations and areas to review and improve CHSF plans, share ideas, and help develop and support our country's health, safety and food R&D objectives. The Forum endorsed the following priority areas: Biomedical, Socio-Cultural and Behavioral R&;D; Health Systems and Services R&D; Health Promotion and Disease and Injury Prevention R&D; Food Safety, Security and Production R&D; and Human Nutrition R&D. In each area, planned R&D investments will yield positive returns, expand public and private capabilities, improve the nation's health, safety and food, and reduce the incidence and cost of disease and injury. CHSF plans in all areas were developed to optimize the focus, balance and inter-disciplinary interaction of basic and applied research, technological applications, surveillance, evaluation, intervention and communication. Health, safety and food research and development also play an integral role in building strong industrial partnerships. These partnerships will transfer research into new biomedical and agricultural technologies, support economic growth and job training and development in areas like health systems and services; continue basic research and graduate education in all areas of health, safety and food research, and support global competitiveness and economic security in areas like agricultural and biomedical production.

The biomedical and socio-cultural and behavioral research strategy reflects recent assessments of Federal efforts to develop safe and effective HIV and cancer therapies, which have indicated that much basic research remains to be done. To improve health, research is needed on the biomedical, social, cultural, psychological and behavioral factors which influence individuals' exposure, susceptibility, treatment and recovery from disease. Variations in ability to comply with treatment regimens need to be better understood. The influences of social context, peer, family and community pressure in such situations also need to be better understood. Gender, socioeconomic, as well as racial/ethnic differences in disease incidence and prevalence must be examined.

The health systems and services research strategy supports research on how to deliver more cost-effective mix of preventive, treatment and population-based health services to all population groups, and on research that enables citizens and other public and private decision-makers to make more informed decisions. For example, two recent clinical practice guidelines, addressing problems of low back pain and fluid in the inner ear of children, could reduce health care expenditures by more than $15 billion. It is clear that research and development investments on the effectiveness of the entire health care system--from clinical, preventive, and public health interventions to managerial, organizational, and financial strategies--coupled with research on the effective dissemination of these findings--can improve the value we receive for our health care dollars. It is also important to link existing public health and personal care data bases in the public and private sectors. This will call for an unprecedented level of federal-state and public-private sector cooperation.

The health promotion and disease and injury prevention R&D strategy is to develop the knowledge base to manage and reduce the human and financial burden of preventable injury, disease and disability. This strategy will also provide individuals, communities and the government with the information they need to promote healthier lives, and to reduce disease, injury and disability. This strategy includes monitoring health problems, surveying health measures, developing and testing effective strategies, and strengthening individual and community involvement and responsibility for sustainable prevention.

The food safety, security and production research strategy is to meet the growing food needs of the nation and the world with a technology base for a sustainable system to efficiently produce and deliver abundant, safe, and healthful food to the public while strengthening the economy and contributing to ecosystem harmony. The strategy will focus on research to improve food safety and quality and to preserve, maintain, characterize and utilize the genetic resources of life forms important to food production.

The human nutrition research strategy is to enhance our knowledge of the critical role of diet and physical activity in human health and disease, and to support Americans in achieving healthier and more productive lives. The strategy will facilitate research and development coordination across agencies, help disseminate new knowledge to the public, and support the development of sound national food and nutrition policies.

To be successful, strong partnerships among researchers and disciplines, across organizations, and with the public, industry, academia and government at all levels are required for a successful scientific enterprise that will support and cost- effectively expand national technological capabilities, economic growth and competitiveness. CHSF and forum participants have identified both CHSF-specific research and development initiatives and cross-cutting research and development issues that are important not only to CHSF but also to other NSTC committees. These areas are outlined below, and information on current and future CHSF agency activities is provided in this strategic planning document. CHSF will continue to refine these plans in the future.

RECOMMENDED CHSF-SPECIFIC R&D INITIATIVES

HUMAN NUTRITION INITIATIVE--This initiative includes research and development needed to achieve a healthier and more productive society through enhanced knowledge of the critical role of diet and physical activity in human health and disease. Diet is one of the leading risk factors for chronic diseases such as heart disease, cancer, stroke and diabetes. Over the past decade, obesity in the U.S. has increased dramatically. Now over one third of adults, or 50 million people, are obese. Research is needed to identify the causes of obesity, who is at risk, and how to reduce the incidence of obesity. The initiative will facilitate coordination across agencies, translation of new knowledge to the public, and development of sound national food and nutrition policies.

HEALTH SYSTEMS AND SERVICES INITIATIVE--This initiative includes research and development needed to deliver a more cost-effective mix of preventive, treatment and population-based health services to all population groups. It would also provide information to enable citizens and other decision-makers to make more informed health service decisions. This initiative includes research to increase the understanding of public and private decision-makers on how to integrate population-based public health and personal care services, and on how to improve the balance between prevention and treatment. This initiative supports public and private innovation and reforms now underway in U.S. and international health care marketplaces by providing the information needed to improve private and public sector operations. This initiative also improves how research results are disseminated and used by consumers and policy-makers.

GENETIC RESOURCES FOR FOOD INITIATIVE--This initiative is a comprehensive program to preserve, maintain, characterize, and utilize the genetic resources of life forms important to food production. This research and development is needed to meet the growing food needs of the nation and the world with a technology base for a sustainable system to efficiently produce and deliver abundant and healthful food to the public while strengthening the economy and contributing to ecosystem harmony.

FOOD SAFETY AND QUALITY INITIATIVE--This initiative includes research and development needed to assure the safety and quality of food for consumers. This initiative would include research and development to identify and reduce significant food-borne risks for human health, including surveillance and quality assurance. Research is needed to improve food processing technologies, sterilization and irradiation techniques, and waste management. This initiative supports research and development on compositionally enhanced foods and better understanding of how food components improve health.

HEALTH PROMOTION AND DISEASE AND INJURY PREVENTION INITIATIVE--Promoting health through preventing disease, injury and disability is a necessary companion to health care. Research and development in this area can reduce the human and financial costs of health care and long-term disability, and support increased individual and community responsibility and involvement. Expanded research and development is necessary in areas such as the following: vaccine development, emerging health threats, aggressive and violence- related behaviors, drug abuse and smoking, mental disorders, reproductive and child health, environmental and occupational health risks, chronic disease control, injury control and prevention.

CROSS-CUTTING R&D INITIATIVES INVOLVING
OTHER NSTC COMMITTEES

The following cross-cutting initiatives are important not only to CHSF, but also to other NSTC committees.

INFORMATION SYSTEMS FOR RESEARCH AND DECISION-MAKING--This includes the design, development and implementation of data systems for current and future R&D and surveillance needed to improve the nation's health, safety and food. This includes national health, safety and food data systems needed to maintain active surveillance, collect national health statistics, monitor risks, fuel vital research, evaluate results and inform the public. This includes coordinating and integrating ongoing public and private data and information collection, and improving use of existing information and surveillance systems by expanding them to include factors such as environmental, behavioral, occupational and socioeconomic factors. The need to maintain, update, build, integrate and better use information systems necessary to conduct research, maintain surveillance, and evaluate performance is the single greatest obstacle to CHSF agency efforts. The systems need to be automated, linkable and accessible, as well as timely and complete.

INVESTING IN THE RESEARCH CONTINUUM--The nation needs a multidisciplinary scientific agenda with a core of long term, high risk fundamental research that is interactively linked to applied research, clinical and field trials, technology applications, and marketed products. Private sector incentives to conduct fundamental research should be improved. Federally- supported research should be peer reviewed. This scientific agenda will enable the nation to use research results to support knowledge-based, cost-effective health, safety and food policies; and sustainable economic growth and competitiveness. Greater attention is needed to improve the interface between fundamental research, evaluation, information dissemination, and technology transfer.

PARTNERSHIP FOR A NEW GENERATION OF 21ST CENTURY SCIENTISTS--This includes training and supporting creative investigators, especially beginning investigators, to conduct fundamental, applied and cross-disciplinary research on health, safety and food. This research drives the scientific enterprise. Maintaining the leadership position of the United States in the life sciences depends on producing outstanding beginning investigators and supporting an array of professional opportunities for them. This includes assessing the effectiveness of programs supporting beginning investigators.

INFORMATION DISSEMINATION AND PUBLIC EDUCATION (SCIENCE LITERACY)--A continuous effort to effectively communicate the results of research to the public is needed. This includes basic K-12 science education in all areas of health, safety and food; science writing and reporting; a variety of electronic media, information resources, extension services, product labeling, and other targeted communications. Widely disseminating the results of research will increase the public's capability to make more informed personal choices, improve their health and make a difference in their daily lives.

PARTNERSHIP FOR HUMAN PRODUCTIVITY--People are the world's most important resource. This research will clarify the processes that shape the intellectual, physical and emotional capacities of people. This includes multidisciplinary research to understand the biomedical, socio-cultural and behavioral factors that contribute to mental and physical health, as well as research that examines the interrelationships among individual action, family behavior, schools and other institutions. This partnership includes research on violence, and the Human Capital Agenda, which is intended to increase our understanding and ability to maximize human capacities, as well as violence-related research.

Strategic Planning Document - Health, Safety and Food R&D