Is anti-science sentiment threatening public health policy?
Thirty-five years ago I was a harried pediatric intern in a New York City emergency room. One night, I paged a neurosurgeon for an urgent consultation. He swooped in with a lighted cigarette and leaned over the child to begin his exam. I politely asked him to extinguish his cigarette; he was dripping ashes on my frightened patient.
Hard to believe, by today’s standards. For almost 20 years, bans on smoking in hospitals have not only protected patients from secondhand smoke, but also inspired hospital employees to quit smoking at higher rates than in other industries. What’s behind this dramatic change?
Science. Scientific knowledge, relentlessly promulgated through public health campaigns over many decades, alters behavioral norms. In 1964 Surgeon General Luther L. Terry knocked the Marlboro man off his horse when he announced that smoking causes lung and laryngeal cancer in men. Thirty-one Surgeon General’s Reports on smoking later, cigarette smoking is far from eradicated; yet smokers, who once felt glamorous, are now forced to confront the health hazards of their habit.
Similar claims of progress can be made in other spheres of public health, where robust scientific data have led to strong public policy: highway traffic safety, immunizations, H.I.V./AIDS, sudden infant death syndrome and childhood lead poisoning, to name a few.
But a disturbing trend threatens future public health initiatives. At the heart of successful public policy lies a shared, bipartisan assumption that science is trustworthy. Lately, politicians unashamedly issue proclamations tantamount to declaring, The world is flat. Climate change is a hoax. Vaccines cause autism. Intelligent design should be taught in biology class alongside evolution. The United States has the best health outcomes in the world.
In public health, knowledge is truly power. If politicians no longer agree that sound scientific knowledge is valid, our nation’s health will suffer for decades — or centuries — to come.
Baltimore, March 4, 2013
The writer is a psychiatrist in private practice, a pediatrician and a former senior staff member at the Institute of Medicine.
I am as dismayed as Dr. Weiss at what seems to be a growing disrespect for science. But let’s be clear about what’s going on — the rejection of science is often just a symptom of something else entirely. The surgeon general may have “knocked the Marlboro man off his horse” in 1964, but that didn’t stop the tobacco industry from spending the next few decades lying to us to protect its profits. Not only did cigarette makers deny the data when they knew better, they were actually using the science to addict their customers more efficiently.
Likewise, the idea that “climate change is a hoax” didn’t come from legitimate skeptics; it was oil industry propaganda, paid for by oil industry profits, which also finance the campaigns of pro-oil-industry politicians. There is no real controversy about climate change — there is only science on the one hand, and money on the other.
There is also no real controversy about the likely outcome of purchasing a handgun. The data clearly show that it is much more likely to be used in murder, suicide or tragic accident than for self-defense, but that scientific fact has been buried under an avalanche of pro-gun propaganda disguised as Second Amendment advocacy.
So while I agree with Dr. Weiss that public health policy depends on good science, I don’t think there is any serious disagreement that scientific knowledge is valid. There is, however, widespread corruption, and a willingness on the part of politicians to say anything, no matter how unscientific, to keep the money rolling in.
New York, March 6, 2013
Dr. Weiss bemoans the anti-science declarations of politicians. In fact, the damage is far beyond mere words.
Public support for science and scientific research in the United States has declined dramatically. Our biomedical research establishment, once the most productive in the world, is on the edge of collapse because of lack of support. One major consequence of science’s starvation is a disincentive for the college-educated to pursue a career in science.
The chance of getting a research grant is at an all-time low. Experienced lab directors spend enormous amounts of time that should be devoted to research in a (usually vain) attempt to find funds to support their research and trainees. Productive laboratories are going out of existence. Faculty positions in science are dwindling.
When college graduates are being offered high starting salaries in the financial world, along with the anticipation of becoming millionaires, who would go into science, with a decade or more of training and intensive study for minimal salary, with the anticipation of being unemployed or underemployed at the end?
President Obama has proposed “mapping” the human brain. Who is going to do the work?
DAVID A. GREENBERG
Columbus, Ohio, March 6, 2013
The writer is director of neurogenetics at Battelle Center for Mathematical Medicine, Nationwide Children’s Hospital.
Dr. Weiss makes an important point: public health and science policy will suffer at the hands of anti-science elected officials. Republicans seem to view the House Science, Space and Technology Committee as an unwelcome stepchild. Paul Broun, a Republican member, made this direct attack on science at a private (but recorded) event last September: “All that stuff I was taught about evolution and embryology and the Big Bang theory, all that is lies straight from the pit of hell.”
Dr. Broun, who is a physician, added: “You see, there are a lot of scientific data that I’ve found out as a scientist that actually show that this is really a young Earth. I don’t believe that the earth’s but about 9,000 years old. I believe it was created in six days as we know them. That’s what the Bible says.”
JAMES R. COLEMAN
Watertown, Mass., March 6, 2013
Dr. Weiss has correctly identified a significant problem in American society: the malignant distrust of science that prevails today among a major sector of our population. This sentiment, reminiscent of the Dark Ages, percolated to the surface during George W. Bush’s administration, when antipathy toward stem-cell research and a reversion to teaching creationism in our schools to the exclusion of evolution were promoted by many Republicans.
The ascendancy of religious extremism is the source of the problem. I do not begrudge any religions the tenets and beliefs they hold sacred, but they do not have the right to impose these beliefs on me. The United States must restore separation of church and state to regain the scientific hegemony we once enjoyed but have now lost to the nations of Asia that are not beholden to the restrictions imposed by religious zealots.
Mountainside, N.J., March 6, 2013
Dr. Weiss correctly notes widespread anti-knowledge views, but inadvertently perpetuates the true problem by contributing to the politicization of science. Politicians are largely a reflection of widespread scientific illiteracy among constituents.
Implicitly, Dr. Weiss advocates coercive, punitive and confiscatory actions based upon (alleged) scientific consensus. Some broadly accepted scientific conclusions have turned out to be wrong, and others have been used to justify unthinkable evil (eugenics, for example).
The commingling of science and politics has engendered as much public disaster as it has public good.
Dr. Weiss says, “In public health, knowledge is truly power.” Not quite. Instead, it is just power that is power. The implicit argument presented is that science is inherently moral as well as infallible. That’s dangerously wrong.
Toms River, N.J., March 6, 2013
Threats to science-based policy and education are not a novel trend. The tobacco industry’s response to the antismoking campaign was a full-scale laboratory for all the modern denialist tactics employed today by those whose industries or beliefs are threatened by science.
The industry memorably set up the Tobacco Institute, whose tame “scientists” produced report after report purporting to debunk the surgeon general’s warnings. Those reports were perfect parodies of actual science, magnifying and exploiting small ambiguities in evidence to undermine the unwelcome conclusions that would otherwise be forced by that evidence. They were used systematically as weapons to defeat scores of liability cases against tobacco companies. This campaign was far more successful, for far longer, than one might infer from Dr. Weiss’s tribute to the antismoking campaign.
In funding, organization and tactics, modern efforts by climate-change denialists to discredit peer-reviewed science on behalf of the coal and oil industries tread the path blazed by the Tobacco Institute. Unfortunately, these sorts of appeals to credulousness and self-interest have a proven record of success.
Chicago, March 6, 2013
The writer is a research scientist in the department of astronomy and astrophysics at the University of Chicago.
During the late 1950s and early 1960s, our concern as a nation was Communism and the cold war. We developed technology, including that which put men on the moon, as part of our arms race with the Soviet Union. Funding such work required public enthusiasm for science. Hence, our politicians extolled scientific research and, in the name of national security and national pride, the public followed along.
Today, advances in science are funded for the most part by private investors. Research in new computer technology, for instance, promises much profit to entrepreneurs.
The takeaway is that a public commitment to science is predicated on national political and economic goals. The creationists, climate change deniers and others who reject the findings of science have always been out there — witness the Scopes trial — but were eclipsed in the ’50s and ’60s because of political realities that propelled scientific advances. Not so today.
When climate change begins to cost the public real money, we will see the influence of the deniers recede. Representative Eric Cantor will not apologize for the anti-science crowd when Virginia Beach is underwater.
We will always have a Flat Earth Society. What we need is a political society motivated by common scientific goals; unfortunately, that won’t happen until the economy or concern about national security give interest in science a jump-start.
RITA C. TOBIN
Chappaqua, N.Y., March 6, 2013
We would be very lucky if the problem were simply one of ignorance. In fact, however, as the history of Big Tobacco makes so clear, sustaining doubt about the known — for example, whether cigarettes are linked to lung cancer — was a deliberate, extremely well-financed and well-organized campaign. “Experts” and their institutions were paid large sums to write articles that suggested there was still a question; members of Congress were similarly recruited.
Doubt about the proven doesn’t just happen. It has to be carefully taught. And bought.
Ann Arbor, Mich., March 6, 2013
The Writer Responds
Mr. Berman is correct that industry has created pernicious obstacles to public health campaigns when they interfere with profits. The National Rifle Association (and its industry supporters) has been particularly savvy about the threat scientific information poses to its goals: It successfully lobbied Congress in 1996 to block funding for gun research by the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control. President Obama lifted the ban in January.
Yet pro-industry propaganda and corruption, which have been constants for decades, are not the whole story. Mr. Gottdenker powerfully captures the mood, calling forth the Dark Ages, that has gained a stronghold in the country, and therefore among our elected officials. Mr. Coleman quotes one representative in flagrant disregard of First Amendment separation of church and state — a trespass that is all too common among lawmakers these days.
Those are some symptoms; what’s the treatment?
My own experience formulating AIDS policy at the Institute of Medicine in the 1980s convinced me that the majority of Americans are reasonable, and respond to enlightened scientific leadership.
In 1988, Surgeon General C. Everett Koop, a Republican appointed by Ronald Reagan, mailed more than 100 million AIDS educational brochures — one to each family in the United States. He had become convinced that knowledge about H.I.V. transmission could equip each citizen to avoid infection and stay alive.
We desperately need brave, visible scientific leadership now, from both political parties, to step up and correct our course.
Baltimore, March 8, 2013