DPH needed comprehensive information concerning the health consequences, costs, and arguments for and against increasing access to raw milk. Auerbach was confident that HC-CHIRP would be able to provide timely, accurate, credible information. This is the second time that DPH has turned to this program and HSPH students for help solving a public policy issue. Given the positive results thus far, it appears that many more opportunities will arise in the future. Raw-milk advocates claim that pasteurization destroys nutrients as well as enzymes important for calcium absorption. Opponents, among them scientists from the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention (CDC), and other public health officials, warn of the danger of consum-
HSPH doctoral student Kathryn Falb (left) and Harvard Medical School epidemiologist Sharon Greene
ing the product. Raw milk, they say, may carry at least
the boarding and milking of a cow), as well as the re-
11 disease-causing organisms that can lead to diarrhea,
strictions in the 26 states where raw-milk sales are legal.
stomach cramps, vomiting, and, less commonly, kidney
Those restrictions include where the raw milk can be
failure, paralysis, chronic disorders, and even death.
sold (on the farm, in retail stores, by delivery) and rules
Kathryn Falb, a third-year doctoral student in HSPH’s
regarding advertising, warning labels, permits, licenses,
Department of Society, Human Development, and
and bottling. The report also investigates the economic
Health, jumped at the chance to be paired with Sharon
cost to dairies of loosening restrictions, given the in-
Greene, an epidemiologist in the Department of Popu-
creased monitoring such changes may require.
lation Medicine at Harvard Medical School and Harvard
What rose to the surface in her analysis? From 2006
Pilgrim Health Care Institute, and an expert on food-
to 2008, the states with the most restrictions on the sale
borne illnesses. Greene was paired with Falb by Charles
of raw milk had the lowest annual rate of illnesses from
Deutsch, a senior research scientist at HSPH and head of
raw-milk outbreaks—just 0.01 per 100,000 people. Mod-
the HC-CHIRP effort, who used the Harvard Catalyst Pro-
erately restrictive states came in a close second: 0.02–
files to find the best faculty adviser for this project.
0.04 illnesses per 100,000 people. The least restrictive
“A lot of our coursework centers on research meth-
states had the highest annual rate: 0.04–0.13 illnesses
odology and study design and analysis,” said Falb. “This
per 100,000 people. Over the 11-year span the report
provided the opportunity to work with people mak-
covered, a total of 1,204 illnesses were reported.
ing real, concrete policy at DPH, where you know your Opposite, Getty Images; right, Aubrey LaMedica/HSPH
research will be implemented almost immediately and
Further analysis raises estimates of illness
help people make informed decisions.”
But Falb and Greene didn’t stop the analysis there. Because such illnesses are both underdiagnosed and
Looking at state-by-state data
underreported, the scientists adjusted their figures to
With Greene’s guidance, Falb scoured CDC databases
estimate the true incidence of foodborne illnesses as-
on foodborne outbreaks around the country from 1998
sociated with raw milk. The difference is striking. “We
through 2008, the scientific literature on the epidemiol-
estimate that approximately 35,000 illnesses may have
ogy of raw-milk disease outbreaks, and current raw-milk
occurred,” says Greene, referring to the 11-year pe-
statutes. Her detailed 16-page report provides a state-
riod. Most of those—some 23,000—were linked to the
by-state analysis of the legality of raw-milk sales and
Campylobacter organism.
cow-sharing programs (in which consumers pay a fee for
continued on page 29 Winter 2012
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