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.
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.
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.
—Mixed progress on cutting down infections spread in hospitals and medical clinics. Three kinds of infections declined. They haven't yet hit target levels, but there's some hope they will when more data are available. And rates for certain urinary tract infections didn't fall at all.
—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.