Sunday, August 2, 2009

Have public health authorities gone mad?

One distressing thing about the possibility that the global warming scare was taken much too far, based on very little data, from the beginning, is that if true, this means reputable people at NASA and elsewhere have associated themselves with what amounts to nonsense. (Not simply a hoax or a scam; some combination of over-hyping of dubious or hypothetical claims by real scientists, lying, and cluelessness). Could this actually happen? Are there other similar examples?

This is where Sandy Szwarc's blog Junkfood Science is so interesting. She documents how public health authorities, regularly quoted as scientific experts, have associated themselves with dubious pseudo-science, in the face of solid evidence that what they are saying is exaggerated at best. On the obesity scare, there came a time when real scientists at the Centres for Disease Control reported, as several other groups of researchers have done, that obesity is not bad for you by any known long-term measure.

As regular readers remember, in 2005, after CDC scientists published the CDC’s own national data and nearly brought down the government’s entire war on obesity, a press conference was hastily called to, as then director Dr. Julie Gerberding said, “translate our science more effectively so that we avoid this kind of communication in the future.” [The CDC’s evidence had shown that, instead of being deadly, obesity (BMI 30 to <35) was associated with a 24% lower risk for premature death than those of ‘normal’ weight, and that even most fat people outlive those of normal weight.]

It was at this conference, the public first learned that the CDC had been massively restructured to create what its director called, “the new CDC.” It created the National Center for Health Marketing and a second center on public health informatics, as well as four new coordinating centers. “At the new CDC, we are engaging the entire agency in the development of our strategies around obesity,” said Dr.Gerberding.

I have suggested that this is health care as delivered by social workers, rather than by health care experts, and there is certainly an element of wanting to interfere in people's lives, make them feel guilty, and push them around, especially if they are poor. What I had not thought much about before is that this is also empire-building on the part of IT people with computer models, as opposed to other experts who actually work in the field, with patients or (in the case of global warming) plants, animals, ice, etc.

More than two years ago, a Dr. Miguel A. Faria, Jr., M.D., made troubling observations in the journal Surgical Neurology about the misuse of statistics and epidemiology surrounding most of the studies associated with the Healthy People 2010 agenda. There is a worrying trend in academic medicine, he said, that “equates statistics with science, and sophistication in quantitative procedures with research excellence.”

The corollary of this trend is a tendency to look for answers to medical problems from people with expertise in mathematical manipulation and information technology, rather than from people with an understanding of disease and its causes…
Much of CDC-funded research and Healthy People 2010 initiatives, he explained, “are generally geared toward promoting social engineering and enlarging the scope and collective role of government in the lives of citizens… than with making genuine scientific advances and improving the health of humanity.”

In some cases, these [CDC] grant proposals (many of which are actually funded) use or misuse statistics, collect data of dubious validity, and even use “legal strategies” to reach social goals and formulate health care policies that the public health researchers believe may achieve “social justice.”… The reader will be surprised to learn that I found probably as many lawyers and social workers as practicing physicians and nurses applying for public health “scientific” research grants!

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