FDA Commissioner Identifies Misinformation, Scientific Knowledge Implementation as Top Healthcare Concern

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

In the opening session of the American Heart Association’s 2022 Scientific Sessions, FDA Commissioner Robert Califf, MD, said tackling misinformation and making effective change are two areas where the United States is currently falling short.

Biomedical science and technology are in the midst of an amazing period of discovery and development, Califf said, but those benefits aren’t leading to better health outcomes for the U.S. population. Importantly, Califf said the implementation phase is where the medical system really falls short.

“We are, and it’s just my opinion, of course, that implementation is failing at the moment,” Califf said. “We’re not in first place and we’re losing ground, and we’d better do better for our people.”

The United States spends significantly more on health care but has had worse outcomes 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 has surpassed the United States in life expectancy this year.

These differences in life expectancy also vary considerably within the United States, with rural regions having significantly shorter life expectancies than coastal, urban areas. Importantly, these inequalities widen rather than improve.

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

Drug use is also on the rise, and Califf stressed the need to distribute naloxone across the country to save lives. He compared its distribution to the use of defibrillators and said that prior to its 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 tobacco use, 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 need to change their approach.

“This word ‘checkout’ is widely used right now, and it has many meanings,” Califf said. “I think that as people of the American heart we now have a moment of reckoning. We need to do something more than we are doing now and something else because what we are doing now is not working.”

To this end, Califf made three suggestions. First, he said it’s essential to revive the evidence generation system so that experts know what works and what doesn’t, with fewer arguments. Second, he said the entire healthcare system must relentlessly focus on interventions that work to address the main sources of death and premature loss of function. Finally, he urged all clinicians to spend some time each day addressing misinformation, which he believes is directly contributing to the destruction of health and wellness.

“I’ve been saying all along that misinformation is the most common cause of death in the United States,” Califf said. “There’s no way to prove that, but I believe so.”


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

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