separating health facts from health hysteria

Despite the gloom and doom you see on the news, we're actually making huge strides in improving medicine and have a pretty good handle on what the media insists are crises.

ambushing death
Illustration by Sven Prim

One of the things Americans seem to like even more than football and fast food, is hyperbole. Just turn on the average news channel, or read a current events blog and you’ll find that we’re in the middle of a war on drugs, a war on terrorism, and suffering from epidemics of autism, cancer, and obesity. And while the wars might be an interesting subject of debate, especially the wars in question, the epidemics we’re often told about by both the media and activist groups, might not really be actual epidemics per se, and the urge to find the convenient scapegoats for them is rather misguided, if not outright dangerous, sometimes leading to conspiracy-prone, quack promoting anti-vaccination groups, various cranks fooling countless people by promoting their “only cure for cancer” while ignoring that cancer is actually a whole host of diseases, and even those who’ll deny links between being overweight and a significantly higher risk for diabetes, hypertension and heart disease.

Now, we could chalk up the current fear of the aforementioned epidemics and the desire to find a convenient scapegoat to the human tendency to confuse causation and correlation. But these problems go even further, reaching back to how health issues are tracked by experts and reported by the media. Rather than suddenly being overwhelmed with cases of cancers and autism, advances in medical technology and ongoing studies are just now letting us pin down the true extent of the problems. And while American waistlines are exploding with frightening speed, this uptick in girth is due to a confluence of factors that have been playing out for more than three decades and show no sign of stopping. Of course, as I’ve noted many times before, the media has a knack for reporting facts in a particularly inept manner and packaging everything as a controversy, even if the only controversy taking place is in the minds of rabid activists and cranks making money off their passion. So we’re hit with reports that show growing numbers of this or that, but with zero back story, or other numbers we could use to build a more complete mental picture.

There are few health hysterias in which the media has been more complicit than the autism scare. From free passes for the greedy, immoral, profiteering quack that is Andy Wakefield, who eagerly helped a trial lawyer manufacture the entire autism-vaccine link for fame and profit, to writing softball, fawning editorials about his fanatical disciples, and promoting a whole army of conspiracy mongering cranks who make a living with scare tactics about autism and vaccines, editors and writers did just about everything possible to propel what doctors call autism spectrum disorders right to the top of the public’s consciousness. So what happens when a certain disorder, especially a rather vaguely defined one, is given so much attention? More parents will rush kids to doctors should they fail to miss a developmental milestone by more than a week. This is partly why we can expect an area where well-off families tend to live to have much higher rates of autism diagnoses. What’s the other reason? It may be the parents themselves since older parents tend to see a higher risk of autism in their children, which could very well be related to recent findings about autism’s genetic triggers.

Not helping matters is the drastic liberalization of autism’s diagnostic criteria which can easily lead to a high rate of over-diagnosis. In other words, the so-called autism epidemic is actually more of a process in which doctors are trying to establish the true incidences of autism, and during which, parents scared by media hype and profiteering quacks rush more and more kids to medical professionals more and more likely to diagnose more and more cases of autism. It’s hard to know how many kids today are being over-diagnosed, but today’s autism could become tomorrow’s ADHD. Or did anyone forget the sudden ADHD epidemic we had just ten or so years ago and quietly swept under the rug when doctors started diagnosing it less and less, seeing huge, unwarranted rates of ADD and ADHD diagnoses sweeping across the nation and ever more kids being given medication for few good reasons? Even though the average rates of autism diagnoses today are hovering at roughly 1% of adults, teens and kids, that number could be extremely inflated thanks to a double punch of the media’s trademark hysterics, and the medical bureaucracy loosening up diagnostic standards to excess.

Cancers are a different story, one where a higher number of diagnoses can actually mean good news. Yes, it sounds very counter-intuitive if more and more people have cancer, but we need to take a look at how most of these statistics are tabulated. Today, cancers are being detected earlier and earlier, in some cases as just a few clumps of abnormal, potentially malignant cells. In fact, the rates of diagnosis are so high, there’s even talk of over-diagnosis in the cancer field, with some physicians arguing that some of the cancers we’re now detecting simply don’t have enough time to harm the patient who is overwhelmingly likely to die of something else long before the tumor fully develops and starts doing its damage. And on the other end of the diagnostic spectrum, more and more people are surviving their cancers as chemotherapy, radiation, and surgery bring a growing number of patients from the brink of death. There are even nano-mechanical cancer treatments in the works, treatments that could extend patients’ lives even more if they’re proven to be effective in a standard randomized, double-blind clinical study involving thousands of patients. Together with new cases, more early diagnoses, and more cancer survivors, the rates of the diseases appear to be climbing, but the numbers bury a story of substantial progress against a once unconditionally terminal menace.

Finally, I wanted to tackle a stranger media-promoted epidemic, that of obesity. It’s true that Americans see an ever growing rate of accreting waistlines and even if we were to fix the BMI measurements to differentiate what could be called healthy weight (i.e. lean muscle mass) from fat, obesity rates would still be extremely high. In an effort to find a scapegoat, many people will blame the food we eat and it’s quality. In other cases, there are advocates for “fat acceptance” that go in the other direction, saying that extra weight is a-ok and that all the very extensive studies linking excess heft to serious health risks that can easily shave years off people’s lives, are actually inconclusive. In reality, the problem behind obesity rates is compound, including our natural cravings for calorie dense foods, lack of exercise, ridiculously oversized portions which are sometimes less about how much food someone needs to be satiated and more of a testament to human gluttony, and yes, the quality of what we eat. The epidemic of obesity is actually real, but what the media often fails to report is that it’s not just a sudden explosion, but something we’ve entirely done to ourselves and for which we have no one to blame in the matter but our own lack of self control and decision-making. And today, that lack of control is pulling down the average life expectancy of Americans, another fact you don’t often hear in the media reports…

# health // epidemic / healthcare / mass media / public health

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