The year now drawing to a close has had more than its share of major public-health headlines, from encouraging (the increased legalization of marijuana for medical use) to alarming (the eruption of Ebola cases in West Africa and its arrival in the United States) to disheartening (the re-emergence of nearly vanquished infectious diseases preventable by vaccines). Here, in no particular order, is our Top 10 list of the most significant public health-related stories of 2014.
1. E-Cigarettes on Fire
Global sales (and advertising dollars) for these battery-powered nicotine-delivery devices continued to grow, while the FDA finally released long-awaited proposed rules for regulating e-cigs as tobacco devices. Perhaps the most telling evidence that these once-fringe products have gone mainstream? The Oxford Dictionary named "vape"—the process of inhaling and exhaling e-cigarettes’ nicotine-laced vapor—its word of the year for 2014.
2. Saturated Fat Is Okay After All. Or Not.
A meta-analysis of 60 studies in Annals of Internal Medicine made headlines in March 2014 when it called into question the accepted wisdom about heart-healthy eating—specifically by finding that higher intakes of saturated fat did not increase the risk of coronary disease, and that eating less saturated fat didn’t reduce it. But critics were quick to point out the paper’s flaws, including statistical errors and the omission of key studies in the analysis. And nearly all diets known to be heart-healthy, including vegetarian diets and the Mediterranean diet, are low in saturated fat. Bottom line: Don’t reach for the bacon just yet.
3. Medical Marijuana Gains Momentum
In July, New York became the 23rd state to legalize marijuana for medicinal use and two states and the District of Columbia now allow the sale of the drug for recreational smokers. We think the decriminalization of medical marijuana is an important win for people who live with chronic conditions that cannabis is known to help. Whether it’s a good idea to take up pot smoking for recreational purposes is, well, hazier.
4. Medical Quackery under the Microscope
It’s scary when a celebrity dispenses medical advice that’s not exactly science-based—but infinitely worse when that celebrity is a doctor. Berkeley Wellness has been sounding the alarm about Dr. Mehmet Oz's questionable medical advice for years, and in June 2014 our skepticism was further validated when the popular TV doctor was called before a Senate subcommittee to answer questions about touting unproven dietary supplements as a weight-loss "miracle" on his show. Here’s hoping his ordeal will serve as a cautionary tale to other would-be medical hucksters.
5. Old Diseases, New Outbreaks
Preventable illnesses like measles, mumps, and pertussis (better known as whooping cough) all saw significant outbreaks this year, continuing a trend that began a few years ago after decades of steady declines in the number and rate of incidences around the globe. Infectious disease experts attribute the rise in measles and mumps in part to a decline in "herd immunity" brought about largely by misinformed “anti-vaxxers,” who refuse to vaccinate themselves and, more importantly, their children. If anything, these outbreaks illustrate exactly why vaccines still matter.
6. Ebola in the USA
The Ebola virus outbreak that continues to wreak havoc in several African nations became a major news story in the Western world when the disease made its way to Europe and the United States. One patient, a Liberian man who traveled to Dallas in October 2014, died of the disease; several other people treated in the U.S. recovered. But the panic and misinformation that erupted around these cases suggest that unchallenged myths about Ebola and political fumbling of the crisis could pose as much of a threat to public safety as the virus itself.
7. New Warnings About Antibiotics in the Food Supply
In April 2014, the World Health Organization released its first-ever report on the global state of antibiotic resistance, a problem that’s been attributed largely to the rampant overuse of antibiotics in food animals (livestock consume an estimated 80 percent of the antibiotics sold in the U.S., mainly for growth-promotion purposes). The WHO’s message was sobering: Resistance to a growing range of medications has reached critical levels in many parts of the world, and we're rapidly approaching a "post-antibiotic future" in which countless people may die from ailments that today are successfully treated with drugs. Stateside, the FDA is attempting to rein in the problem by asking pharmaceutical companies to voluntarily remove the growth promotion indication from veterinary antibiotics, a move panned by some critics as too little, too late.
8. The Nation’s First Soda Tax Passes
The health hazards associated with sugary soft drinks—and with excessive consumption of sugar in general—are numerous and well documented: obesity, heart disease, diabetes, and other chronic and even lethal ailments. In November 2014, Berkeley, CA (where else?), became the first city in the country to adopt a tax on sugar-containing soft drinks, despite aggressive lobbying by the soda industry against the tax. The ballot measure, which won the support of an overwhelming 75 percent of voters, will levy a penny-per-ounce tax (12 cents on a can of soda, 68 cents on a two-liter bottle) on most sugar-sweetened beverages. A similar ballot measure across the bay in San Francisco fell short of the two-thirds majority needed for it to pass—perhaps because Big Soda outspent supporters of the tax by more than 25 to 1.
9. Obamacare Takes Full Effect
While some key elements of the Affordable Care Act took effect prior to this year, 2014 marked the implementation of Obamacare's signature provision: the individual mandate, which requires all adult American citizens not insured by an employer or the government to purchase insurance for themselves and their dependents through state exchanges, or pay a penalty. Supporters of the ACA have lauded the individual mandate as the fairest and most efficient way to ensure that all Americans are covered by health insurance; critics have excoriated it as unconstitutional. But for now, it’s the law of the land, and at least 8 million previously uninsured Americans now have coverage as a result.
10. Nutrition Labels Get Real
In the first major revision in two decades to the Nutrition Facts box that adorns virtually every container of food we buy, the FDA in February 2014 introduced sweeping proposed changes not only in the way information is presented, but in the kind of information that food manufacturers must now share. That includes more realistic serving sizes (a cup of ice cream, for example, instead of a half-cup) and the separate listing of added sugars vs. those naturally present in, say, milk or fruit. A public comment period on the proposed rules ended in August 2014. Once the rules are finalized, companies will have a couple of years to comply. Here’s what we like and don’t like about the proposed new labels.