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13 Urgent Science and Health Issues the Candidates Have Not Been Talking About

Plenty of sex, lies and videotape, but silence on pressing science policy issues from the presidential aspirants

In this election season science and health have taken a backseat. Worse, presidential candidate Donald Trump dismissed climate change as a Chinese hoax. His opponent, Hillary Clinton, vowed to dig up what the government knows about UFOs. Science is hardly getting its due.

Meanwhile in labs and institutions around the country, scientists are hard at work: inventing technologies to make guns safer, developing antibiotics to quell treatment-resistant infections and searching for more efficient forms of renewable, clean energy. This research addresses complex scientific and social issues that require thoughtful policy-making and debate. The country's next Congress and president will have much to consider.

To that end, Scientific American corralled some of the key scientific issues that U.S. politicians should be paying attention to, but aren’t—from the threat of nuclear Armageddon to the ethics of medically assisted suicide. We spoke with top thinkers in each field—policy experts at universities, members of foundations and nonprofits, and the scientists themselves. What, our reporters asked, should government be doing to keep Americans healthy, safe and productive?


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To learn the answers, read on. We hope those who would be our leaders will do the same.—Emily Laber-Warren

The End of Antibiotics

Tuberculosis. Gonorrhea. Pneumonia. All these infections were once readily cured but overuse of antibiotics has created “superbugs”—bacteria that are resistant to even last-resort medicines.

Twenty-three thousand people die in the U.S. each year from antibiotic-resistant infections, and by 2050, experts estimate that rogue bacteria will kill more people than cancer. The United Nations recently held an unprecedented conference on how to combat superbugs. Here in the U.S. experts endorse a three-pronged approach: Congress should invest in drug development, ban the wanton feeding of antibiotics to cows and pigs, and attempt to reduce the number of patient infections. Hopefully, says Kathy Talkington, director of the Antibiotic Resistance Project at The Pew Charitable Trusts, “we can move something in the near future through Congress while the iron is hot.”

Unlike medicines for heart disease or diabetes, a good antibiotic is usually used by patients for just a single occurrence of an illness, which makes pharmaceutical companies reluctant to pour money into developing new ones. Congress could help by funding some of the research as well as by enacting legislation that eases the economic burden of testing new antibiotics.

Meanwhile 80 percent of all antibiotics sold in the U.S. are given to cattle and other food animals, so legislators like Rep. Louise Slaughter (D–N.Y.) are turning their attention to the farmyard. Antibiotics make animals grow faster, and poultry, beef and pork farmers include regular doses in their animals’ feed. Slaughter has proposed legislation that would prohibit the use of antibiotics in healthy animals.

Experts say we should also try to prevent the spread of infections in the first place—by encouraging hand washing and safe cooking practices.Elyssa Bernfeld

Clean Drinking Water

In Flint, Mich., thousands of children live with brain damage because lead from aging pipes leached into their drinking water. More than 360,000 underground waterreserves have been polluted by waste from industrial processes. Severe droughts in the western states threaten water supplies for some 43 million people.

Of all the services Americans depend on, clean drinking water is the most precious. But crumbling infrastructure, contamination from fracking and farming, and climate change–related drought are depriving many Americans of this essential resource. Experts say Congress must take a range of actions—from helping cities identify toxins in their water systems to setting stricter limits for the dumping of industrial waste. “Drinking water is a basic human need,” says Erin Derrington, a Pacific Northwest–based environmental consultant who specializes in wetlands. “Without wise management—a goal that does not seem to be at the top of either the Republican or Democratic nominees’ agenda—we face real risks of degraded drinking water quality.”

Experts say Congress should close a loophole in the Safe Drinking Water Act that allows energy companies to inject wastewater into the ground, where it contaminates underground water supplies that could be useful in the future. In addition, they say, the federal government needs to invest more than the $5.4 billion it spent in 2014 to help states replace old water mains and pipes—an investment that will pay off by preventing costly public health crises like the recent one in Flint.Nicole Lewis

Making Guns Safer

When the automobile was introduced, it was a death trap. But in the 1950s universities began crash testing—research that ultimately led to safer cars, better driver education and speed limits—and that slashed vehicular fatalities by 90 percent.

Now public health experts—including the American Medical Association, which put out a statement in June—want the government to take a similar approach to gun violence, which is responsible for more than 30,000 deaths a year.

The question of whether to regulate guns has become polarized, quelling progress on reducing deaths. But scientific research could liberate the issue from politics. Instead of debating whether people should have guns, science can suggest ways to make people safer: For example, how to prevent accidents and suicides in the 22 percent of U.S. homes where there are guns—by understanding how to best keep loaded guns out of the hands of children and distraught people who might act impulsively. Everytown.org, a leading gun violence prevention organization, wants Congress to fund research into technology such as biometric gun locks and safeties that would make it impossible for anyone but a gun’s owner to fire it. “The truth is, whether you want gun rights or you support gun control, you should want these kinds of detailed academic, scientifically rigorous studies,” says Adam Winkler, a constitutional law expert at the University of California, Los Angeles. “That is what a public health approach takes.”Stephanie Daniel

Keeping Our Technological Edge

U.S. scientists and engineers produced the defining technologies of the modern era: the car, the airplane, the atom bomb, the iPhone. But the nation is quickly losing its edge. Foreign-born scientists and engineers are filling key slots at universities and in private labs, in part because of a dearth of qualified Americans.

Most experts trace the problem to the U.S. educational system. Our students rank far below other industrialized countries in math and science. The average American 15-year-old has difficulty solving an equation using pi. But there is a huge variation in how students fare depending on the state they live in; some Bible belt states shirk teaching evolution science or present it as a competing theory with religious creationism whereas states like New Hampshire offer excellent math and science instruction.

The solution, policy experts say, is for the federal government to create uniform, up-to-date requirements for the science and math concepts students should know at each grade level, as is done in other countries. But recent attempts at implementing national curricular conformity such as the Common Core have met resistance.

For now, experts say, the best approach is to suggest, not require. The Next Generation Science Standards, led by educators from nonprofits, philanthropies and state governments, are an attempt to codify a national baseline of math and science achievement. But so far only 18 states and the District of Columbia have signed on. The standards are optional but their authors hope that more state legislatures will sign them into law.W. Harry Fortuna

Protecting National Parks

America’s national parks and forests are facing many challenges. In recent years legislators have stymied attempts to increase park funding and pushed for privatization of publicly owned lands. The National Park Service is some $11 billion behind on repairs and maintenance. Meanwhile, Arizona’s congressional representatives support new uranium mines on public land near the Grand Canyon—and legislators from other states have similar projects such as oil and gas development in the lands around Arches National Park in Utah. “There’s constant pressure to develop the land surrounding parks,” says Kristen Brengel, vice president of government affairs at the National Parks Conservation Association.

But Pres. Barack Obama has taken steps to protect public lands. Earlier this year the U.S. Bureau of Land Management created a plan to protect Utah’s public landscapes from energy developers. The Department of the Interior also recently canceled an oil-and-gas lease that threatened wildlife-rich regions around Montana’s Glacier National Park.

Meanwhile private groups are taking their own steps to protect the nation’s public lands. The nonprofit Trust for Public Land recently worked with a philanthropist to add 282 acres to Arizona’s Saguaro National Park.

But whether the money comes from Congress or private pocketbooks, some advocates say it would be better spent readying parks for the impacts of climate change or fixing trails and roads at heavily-visited sites like Yellowstone. “We shouldn’t be expanding our parks. We should be maintaining them,” says Bonner Cohen, senior fellow at The National Center for Public Policy Research.Samantha Lee

Meeting Our Climate Change Promises

Last year in Paris the U.S. was one of 191 countries to sign a global agreement to slash the emissions that fuel climate change. It was an historic moment, but the hard work is yet to come: figuring out how to reduce the country’s greenhouse gases to at least 26 percent below 2005 levels within the next nine years.

Climate change has gotten little attention during this presidential election season. Although Democrat Hillary Clinton has called climate change an “urgent threat” and pledged to carry on Obama’s climate initiatives, GOP candidate Donald Trump has openly denied climate change and said he would withdraw the U.S. from the Paris agreement.

Part of the Obama administration’s solution—dubbed the Clean Power Plan—would require power plants to limit their emissions, but it has been blocked both by the Republican-controlled Congress and the Supreme Court. Most policy experts agree that Obama’s power plan is the best tool to meet the nation’s emissions reduction target.

If Democrats win the presidency and control of both houses of Congress, the Clean Power Plan might get new legs. Other solutions include taxing carbon or allowing companies to profit when they reduce emissions more than required, says Daniel Fiorino, director of the Center for Environmental Policy at American University.

If Republicans remain in control, experts say, Congress might do better to focus on investing in renewable energy sources such as wind and solar power, an approach that might appeal to the GOP because it could stimulate the economy by adding new jobs.Suzanna Masih

Genetically Enhanced Humans

Scientists are inching closer to the holy grail of genetic engineering—the ability to add or remove DNA from an organism to change specific traits.

Genetic engineering, also known as gene editing, has been used for years to enhance agriculture and treat disease. But a new technology that harnesses the CRISPR–Cas9 gene–protein complex makes it possible to add and remove genes with unprecedented speed and precision, bringing designer babies and other sci-fi capabilities closer to reality.

Scientists are testing whether gene editing can help treat diseases such as HIV and hemophilia. But CRISPR opens the door to editing for human enhancement—such as adding genes for bigger muscles or whiter teeth—possibilities that are “soon to be on the horizon,” says Fyodor Urnov, a geneticist at the University of California, Berkeley.

There are as yet no laws regulating gene editing for enhancement. Bioethicist Jonathan Moreno of the University of Pennsylvania says that’s proper, because the technology is not yet developed, and “once you legislate, it’s very hard to unlegislate [sic].”

For now experts are wrestling with the ethical implications of gene editing and making recommendations: In December a committee of the National Academies of Sciences, Engineering and Medicine, comprising specialists in health, science and bioethics, will publish their recommendations on how to legislate as the technology develops.Michael R. Murphy

Nuclear Safeguards

Nuclear war is no longer a two-player game, as it largely was during the cold war, with the U.S. and NATO facing off against the Soviet Union and Warsaw Pact. The geopolitical nuclear landscape has grown more fraught and complex than ever. China, India, Pakistan and Israel all have nuclear weapons. North Korea’s dictator is conducting missile tests with great fanfare. These new configurations multiply exponentially the rivalries and passions, global and regional, that could ignite a regional or global nuclear conflict.

Experts are divided over how the U.S. should act to minimize the threat. Some say we should publicly embrace a “no first use” policy, solidifying our implicit vow never to be first to push the button. But Obama’s advisers maintain that any change of policy could upset the status quo—and hence the safest action is no action at all.

Another issue is how to respond to a perceived nuclear attack. The current policy is “launch on warning,” meaning that we will fire as soon as we learn that another country has attacked us. This policy has led several times to near-catastrophe, when our warning systems were mistakenly tripped by a satellite, a faulty computer chip and even the moon.

A safer doctrine, say experts including former Secretary of Defense William J. Perry, is to avoid mistakes by retaliating only after being struck. Once nukes have been launched against us, there’s nothing we can do to stop them. But we can strike back—even after being hit—using our fleet of nuclear subs and bombers. “We’re not going to change,” Perry says, “until people understand what those dangers are.”Michael O’Brien

The Right to Die

Two years ago, a 29-year-old woman named Brittany Maynard who was dying of brain cancer decided to end her life. But she did not want to swallow a bunch of pills. She wanted to die safely and without pain, under a doctor’s supervision. That meant Maynard had to move from California to Oregon, one of the few states where medically assisted suicide was legal at the time.

Maynard’s story made the cover of People magazine. Suddenly the “right to die” had become a national issue—a far cry from the 1990s, when physician Jack Kevorkian was nicknamed “Dr. Death” and convicted of murder for helping his dying patients end their lives.

The U.S. Supreme Court ruled in 1997 that the right to medically assisted death is not constitutionally protected, leaving legislation up to the states. Assisted suicide is now legal in Montana, Vermont, Washington State and California as well as Oregon—and 20 other states and the District of Columbia are considering the move. But as right-to-die legislation gains traction, it is becoming as polarizing as the abortion debate, raising similar religious and ethical questions about an individual’s rights and who should have authority in matters of life and death.Alyssa Pagano

The Threat of Microplastics

In 2013 the U.S. threw away more than 32.5 million tons of plastic waste, up from around 390,000 tons in 1960. Much of this plastic litter reaches rivers and makes its way to the sea. Plastic bags, balloons and six-pack rings pose known dangers to birds, sea turtles and other wildlife. But recent research suggests that once in the ocean, plastics degrade into microscopic particles that can be hazardous not only to animals and the environment but to humans as well. These so-called microplastics—particles smaller than one fifth of an inch—are ingested by fish, then by people if they eat the affected seafood. A new study by researchers atPlymouth Universityin England found that a single washing machine cycle can release hundreds of thousands of microplastic particles from fleece and other synthetic fabrics. The U.N. has singled out microplastics for their potential to cause infertility and other health issues.

One approach to the problem has been to institute bans or taxes on plastic shopping bags, but only three of 77 such proposals have passed in recent years, according to the National Conference of State Legislatures. Similar efforts are being made to ban so-called microbeads—tiny plastics manufactured for use in soaps and cosmetics. Conservation groups also organize beach and road cleanups, to prevent plastics from lingering in the environment.—Michael H. Wilson

Tackling Obesity

Obesity now affects more than a third of American adults. It’s associated with myriad diseases—the treatment of which costs over $147 billion a year. And almost one in fivechildren are now obese, detracting from their self-esteem, emotional well-being and health. “If we continue on this course, this generation of children could be the first in U.S. history to live shorter, less healthy lives than their parents,” Donald Schwarz, vice president, Program, of the Robert Wood Johnson Foundation, the nation’s largest public health philanthropy, said during a telephone press conference.

Experts say there is no single way to reduce obesity, because so many factors can impact weight—income, education, access to healthful food, physical activity. This is confounded by the fact that weight is not necessarily an indicator of overall health.

States and even city governments have introduced policies aimed at changing people’s exercise and eating habits and fighting the hold fast food has on the U.S. diet. For example, the cities of Philadelphia and Berkeley, Calif., recently instituted a tax on sugary sodas—something that New York City tried and failed to do several years ago. Critics reject such programs as government overreach, calling them behavior taxes, but a similar program in Mexico has curbed soda consumption substantially. “We know it works,” says spokesperson David Goldberg of Healthy Food America, a science-based nonprofit.—Kazi Awal

Abandoning the Coasts

Hurricane Matthew, which devastated Haiti and deluged huge swaths of North Carolina earlier this month, was the latest in a barrage of catastrophic storms to hit U.S. coastlines in recent years. With storms and flooding along the coasts intensifying due to climate change, experts say it is time for a paradigm shift in how we think about our coasts, home to nearly 40 percent of the U.S. population. “I wouldn’t put my money in investing in real estate at the coast, certainly not in the long term,” says Jeff Williams, a coastal marine geologist and scientist emeritus at the U.S. Geological Survey.

The most sensible strategy, however difficult to stomach, is for the government to buy damaged property so that it never gets built on again, and people need to move inland. “Basically coastal communities in this country are staring down the loaded gun of climate change,” says Shiva Polefka, an ocean policy analyst with the liberal-leaning think tank, the Center for American Progress. “Due to sea level rise, we’re going to have to pull back from the coast.”

Instead, the approach that towns and cities have been taking, with financial support from the federal government, has been to build walls around their shorelines or dump tons of sand on eroding beaches.

Experts say Congress should reallocate money into large-scale programs to buy property from coastal homeowners. Buyout programs do exist, but they are tiny. After Hurricane Sandy in 2012, for example, New YorkCity helped rebuild more than 10,000 houses, but bought fewer than a thousand.—Meaghan Lee Callaghan

Cleaner Energy

The next president will inherit a national patchwork of renewable energy policies. Only 30 states mandate renewable energy. Top on the list are Maine and Idaho, which derive 100 percent of their energy from renewable sources such as biomass and hydropower. But Pennsylvania produces a paltry 4 percent of its energy from renewables. And the states that have set no requirements lag even further behind. Wyoming, for instance, generates less than 1 percent of its energy from renewables.

The U.S. has around 4 percent of the world’s population but emits some 25 percent of global CO2, the main driver of climate change. Yet only about 13 percent of the nation’s electricity comes from renewable sources like wind, solar, hydropower and biomass.

Many believe it is high time for Congress to create a national standard. The Union of Concerned Scientists, a nonprofit advocacy group, points out that half of U.S. wind production between 2001 and 2006 was the result of state energy standards. Others contend that, given the huge differences in natural resources around the country, it makes sense for states to retain flexibility on how to meet their energy needs. A Great Plains state like Iowa, for example, may be well situated to harness energy from windmills whereas sunny Arizona would do better to rely on solar. Most attempts at national renewable energy policy take this geographic variability into account, allowing states to develop individualized portfolios while adhering to strict standards that increase over time.

Standards aside, experts say the federal government needs to modernize the energy grid. Renewable energy is not evenly distributed across the country. For example, lots of wind is collected in the western plains, and most solar energy is generated in the Southwest, but the areas with highest energy demand are on the coasts. Territorial battles among the states hold up necessary permits, leading to delays in connecting the isolated segments of the energy grid, according to policy expert Jules Kortenhorst, CEO of the Rocky Mountain Institute, a nonprofit research center in Colorado.

Kortenhorst suggests that a future president could institute a “federal override” that would allow the government to step in and force the integration of various regional grids, as it currently does with pipelines.Roshan Abraham

The reporters are students in Emily Laber-Warren's science journalism class at the C.U.N.Y. Graduate School of Journalism.