The philosophy of ignoring health journalism
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.