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The philosophy of ignoring health journalism

August 11th, 2011

There’s an interesting opinion piece in the New York Times by Notre Dame philosopher Gary Gutting that starts out asking some questions that I find interesting, and then answers them in a way I find ridiculous. The problem statement:

Almost every day I read about a new medical study that says I would be healthier if, for example, I ate more fish, drank red rather than white wine, took enchinacea [sic], or began practicing yoga.   Do such studies represent a significant body of knowledge that I should pay attention to?

Good question, and particularly of interest given that this blog (and a large part of my professional journalistic output) is devoted to parsing and disseminating such studies. Gutting goes on to discuss the difference between observational studies and prospective trials — correlation and causation — and laments that the media chooses to cover so many observational findings. This is a problem, he suggests, because keeping up on the details of all these studies is so time-consuming, and the results are “subject to constant reevaluation as new results come in.” So what’s the solution?

Taking a broader view, it would seem preferable to keep healthy by a method that is simple, reliable and doesn’t require constant revision and fine-tuning.  We do, after all, have such a method available: simply follow the humdrum standard advice we’ve heard all our lives about eating sensibly, exercising regularly, and having recommended medical tests and exams. Doing this and foregoing the endless calibration of our behavior to the latest research results will be far less stressful, make it more likely that we’ll stick to the method, and allow more time for fulfilling pursuits.  From this point of view, the media’s constant updates on the latest observational studies are counterproductive.

Now, I’m certainly not going to argue against “eating sensibly, exercising regularly, and having recommended medical tests and exams.” That’s great advice. But where does he think that advice comes from? Does the great body of ancestral knowledge passed down from our caveman forebears include any guidance on when to start getting prostate exams, or what the pros and cons of regular mammography are? And what is eating “sensibly” — is that eating like people did 50 years ago? 100 ? 10,000? In Europe? Asia? Africa?

The “common sense” behaviours that Gutting suggests following (as opposed to following “the media’s constant updates on the latest observational studies”) aren’t some sort of innate knowledge that we’re all born with. Those behaviours are learned, and constantly evolving as society absorbs and assesses the studies he’s counselling us to ignore. What his argument really boils down to is a recommendation that we should defer to authority — let the experts decide what constitutes “sensible” living, and just do it. Don’t worry about what the studies say, because if they’re convincing enough, the results will eventually find their way into the canonical set of public health recommendations.

This is perfectly reasonable. I know plenty of people who aren’t interested in the gory details of how their bodies work: they just want to be told what to do, and they want the advice to be simple, easy to implement, and relatively unchanging. Fair enough. But there are also many people who are interested in peeking behind the curtains of the public-health-recommendation sausage factory and evaluating the evidence for themselves. If a new study suggests that previous recommendations about, say, salt recommendations are shakier (yes, that’s a pun) than previously thought, they want to know about it and evaluate its significance themselves.

Of course, there’s plenty of terrible health reporting out there. But even good health reporting is often complex and reports on studies than seem to contradict each other. It has to be that way, because health research is complex and often contradictory. We’re complicated animals in a complicated world. If you want a simple, reassuring message that promises to answer all your questions and solve all your problems, your best bet is probably late-night infomercials.

Anyway, back to Gutting. His final message is that it’s simply not worth the hassle of worrying about all the factors that may or may not improve health and prolong life:

We are all going to die sometime, from something.  Even if I find just the right blend of exercise, diet and herbs that saves me from a heart attack at 60, I may have merely ensured that I will die of cancer at 70.

And really, there’s not much I can argue with here. If dying at 60 and dying at 70 are entirely interchangeable to him, then he’s perfectly right not to waste his time worrying about health. But if you ascribe some value to an extra decade of life (or a greater probability thereof), then you might reach a different conclusion.

  1. August 11th, 2011 at 13:36 | #1

    I loved this post! I agree with you completely. Sure, many people (the public) are mislead when the media jumps the gun, or makes assumptions from a published paper. However, each adds to our (scientists and health professionals) knowledge base and furthers science. All I can say is, someone who doesn’t value an entire decade on this earth, should not be giving a public opinion on health journalism.

  2. August 11th, 2011 at 16:03 | #2

    Let’s take a look at the “average” American. They aren’t inclined to spend several hours a day doing research on research studies. They will indeed gravitate towards the news sound bite of the day. That’s the category he’s addressing. These people cherry pick the latest study that clicks with their own world view. Next level up you’ve got the “broscience” crowd who think that a research study proving their view means it’s the only way to go. These folks drive me to drink because it’s impossible to shake them off their “science based” opinion. You find these types all over the web. They are in barefoot forums saying science proves that bare footing is ideal. They are in bodybuilding forums insisting that hydrolyzed whey with added isotope 34765236 is the only way to go.

    These people prove the old adage that a little knowledge can be dangerous. Then there’s the last category. People who have the time and the mental flexibility to dig through studies and understand that a 6 person study does not a trend make. These are the people who will patiently keep repeating the “conventional wisdom” while backing it up with quality work. They keep an open mind, explore the world around them, and are driven to help others.

    Too much information without context or background just creates noise.

  3. Bob Lotz
    August 11th, 2011 at 16:52 | #3

    “I may have merely ensured…” Merely! All of medicine is a great effort to push back the encroachment of death, but Prof. Gutting may “merely” be granted another decade! If he wants to have “more time for fulfilling pursuits,” perhaps he can find it in that decade! Are they just handing out philosophy professorships on the street corners now? If he has one, you should have at least two, Alex!

  4. August 11th, 2011 at 16:53 | #4

    I’ve always found the “we’re all going to die sometime anyway” line a cop-out. Of course it’s true, technically. And no amount of healthy living guarantees one a long, vibrant life. But I think there is a lot to be said for having a body that feels good, functions properly, and (because on some level, we all care about this too) looks decent. In that regard, I think advertising healthy eating and exercise as some sort of life extending elixir, while potentially true, misses the point somewhat. I don’t run because it keeps me thin, or my resting HR in the mid 40′s; I do it because of the sense of accomplishment at the end of a series of intervals, the shared agony at the end of a trail race, the moments where you learn how much you’re really capable of. It’s not about when you die, but how you live.

  5. alex
    August 11th, 2011 at 21:53 | #5

    Thanks for the comments, folks – I agree!

    @Clara: Of course I agree with you about the frustration of people who read a headline, ignore the context, and then insist that “scientists have proven” that substance X will make you bigger or live longer or whatever. You say “that’s the category [Gutting] is addressing.” In that context, I agree with him (and you) entirely. If you’re not going to pay attention and read critically, then you may well be better off ignoring health journalism entirely. It’s like Alexander Pope said 300 years ago:

    “A little learning is a dangerous thing; drink deep, or taste not the Pierian spring: there shallow draughts intoxicate the brain, and drinking largely sobers us again.”

    I guess I’m probably a little touchy, as someone who does a fair amount of health-related journalism, about Gutting’s “blame the messenger” tone. He comes off as pretty snide about the “counterproductive” approach of the “popular medical media.” I think that the consumers of this media have to take some responsibility for how they use the information. Personally, I’m quite fond of the Lichtenberg quote that was printed on the bags from the McGill University bookstore back when I was an undergrad there:

    “A book is like a mirror: if an ass peers in, you can’t expect an apostle to peer out.”

    Fortunately, we’re all apostles here. ;)

  6. August 26th, 2011 at 11:53 | #6

    Oh my gosh, I just came across your site and this post and … how refreshing. I cover health/nutrition/fitness for a women’s health site, and … yeah. There’s a lot of bad health reporting out there, and a lot of bizarre reactions/thoughts about it …

  1. August 11th, 2011 at 13:28 | #1
  2. August 11th, 2011 at 23:30 | #2