Progress in the U.S. against obesity, food poisoning, and infections spread in hospitals has been uneven and disappointing, despite dedicated efforts to fight these health threats by the nation's top public health agency.
The Centers for Disease Control and Prevention issued a frank self-assessment Monday of its campaign to focus on certain health problems, an effort it called "winnable battles." While there have been clear successes in areas like smoking and teen pregnancy, other areas have seen little change or even gotten worse.
Particularly disappointing is the battle against childhood obesity, said Dr. Tom Frieden, the CDC's director.
"The data speak for themselves," Frieden said of the obesity statistics. "If you look for the goal we set for ourselves, and look at what happened, we didn't achieve it."
Frieden set a list of priorities he called "winnable battles" shortly after he was named to lead the CDC in 2009. The list included smoking, AIDS, obesity and nutrition, teen pregnancy, auto injuries and health care infections. It later grew to include food poisoning.
On Monday, the agency released what it described as its third and final report card on the campaign. Frieden is expected to leave office next month, as the Trump administration takes control of federal agencies and appoints its own administrators.
The most clear-cut progress was in cigarette smoking and teen pregnancy. Last year, national goals were met for reducing adult smoking by more than 17 percent, and youth smoking by 12 percent. The goal of cutting the teen birth rate by 20 percent was also met.
Critics argued that those were relatively easy goals — smoking and teen pregnancy rates were already trending down before Frieden arrived. But Frieden argued that the goals his agency set were ambitious and never assured.
Another goal once considered within easy reach was the reduction of car crash deaths by 31 percent by 2015. Earlier in this decade those deaths were plummeting and the goal seemed well within reach. But crash deaths only fell 21 percent because of a recent uptick, which many attribute to distracted driving.
Hospitals failed to make major in-roads in cutting down infections spread in hospitals and medical clinics. Three kinds of infections declined, but not to target levels. And rates for certain urinary tract infections didn't fall at all.
The rate of central line-associated bloodstream infections saw the sharpest decline among hospital-acquired infections, falling by 50% between 2008 and 2014 but yet it failed to meet the CDC's target of a 60% decrease by 2015.
Other targets for reducing hospital-acquired infections were not as successful. Surgical-site infections fell by 17% between 2006 and 2014, missing the agency's goal of a 36% decrease by 2015.
The rate of catheter-associated urinary tract infections stayed relatively unchanged between 2009 and 2014, falling short of the 30% decline target.
Rates of MRSA bacteria infections fell by 36% between 2008 and 2014 but failed to reach the goal of a 60% decline targeted by the CDC.
The report card also found:
—Disappointing results in meeting two food safety goals. Rates of illness from harmful E. coli bacteria dropped, but didn't reach the goal of a 29 percent reduction goal. And illness rates from salmonella increased.
—Inability reduce the number of new HIV cases by 25 percent. The number of new cases fell by 18 percent.
—Failure to reduce obesity rates for toddlers and older children. Instead, the rate grew slightly, to more than 17 percent.
Despite the mixed grades in the CDC's report card on itself, some experts applauded CDC efforts, saying the agency had only limited abilities to prevent illness or stop people from doing things that hurt their own health.
"I think, to CDC's credit, they picked a broad range of public health challenges and they set the bar high enough that they could not automatically declare success at the end of an administration," said Jeff Levi, a George Washington University professor of health management and policy.
The Atlanta-based CDC has an annual budget of more than $13 billion and a staff of more than 15,000. Much of its funding is distributed to state and local health departments, and many of them follow the CDC's agenda-setting lead.
Steven Johnson contributed to this report.