September 15, 2014
Is It True Public Health Advocacy… Or Is It Fearmongering And Fads?
By Michael D. Shaw
A classical definition of “public health” describes it as the art and science of preventing disease, prolonging life, and promoting physical and mental health, sanitation, personal hygiene, control of infection, and organization of health services. The practice of public health derives from dim antiquity, at least with respect to sanitation and personal hygiene, which was often done for religious purposes. The Greeks—including Hippocrates—in the 4th and 5th centuries BC, are considered the first to have applied logic and right reason to the causation of disease.
The Middle Ages would see various plagues, and an organized response to control further outbreaks. With scientific progress came such developments as Scottish surgeon James Lind figuring out that scurvy was caused by a deficiency of Vitamin C (his famous treatise published in 1753). By the turn of the next century, however, a somewhat less idealistic philosophy would creep into public health.
English economist and demographer Thomas Malthus’ theories of excessive population growth, a limited food supply, and the necessity for population control would emerge in 1798, preceded by utilitarian philosopher Jeremy Bentham’s principle of the greatest good for the greatest number. As such, the pure notion of saving and improving lives is compromised, raising questions often rendered in Latin: cui bono (Who benefits?—literally “as a benefit to whom”) and qui decernit (Who decides?)
Of course, it is easy enough to maintain an uncompromising approach when dealing with fundamental problems, such as water purification, or gold standard epidemiological findings such as the relationship between cigarette smoking and lung cancer. But is it really public health advocacy when the long-debunked lipid/cholesterol theory of coronary heart disease is still promoted by officialdom, along with the ensuing bonanza of statin drugs, including their massive side effects?
What about the demonization of parabens, used safely for decades as cosmetic preservatives, or the endlessly tested, but still stigmatized BPA? Need I mention the mindless promotion of a low salt diet, against all evidence to the contrary, or the faddish recoiling from gluten, even though a tiny number of people actually have problems with it?
Cui bono? On the chemophobia side, we can name a wide assortment of “environmental” fear entrepreneurs such as EWG, NRDC, Greenpeace, and Sierra Club. As to mindless and destructive medical orthodoxy, we can name the top three disease trade organizations: American Cancer Society, American Heart Association, and American Diabetes Association, and their keen sponsors in Big Pharma. Consider that both ACS and AHA are at best lukewarm in their support of the obvious harm reduction in e-cigarettes, and all three groups incredibly still support a low fat/high-carb diet.
There are also public health issues, that while technically legitimate, are subject to extreme hyperbole. A case in point is the relentless campaign against sunlight, let alone tanning salons. Indeed, on July 29th, the US Public Health Service issued a 101-page report entitled “The Surgeon General’s Call To Action To Prevent Skin Cancer.” The imprimatur of the Surgeon General evokes the outstanding 1964 “Smoking and Health” report and infers a similar gravity to the issue. But is this justified?
For starters, the report fails to acknowledge that only a small fraction of skin cancer cases result in anything more than mole removal. Likewise, of the last five crises reported on by the Surgeon General, skin cancer ranks far below the others in terms of annual mortality and severity. To wit…
- Tobacco use – 443,000 deaths
- Obesity – 112,000 deaths
- Deep vein thrombosis/pulmonary embolism – 100,000 deaths
- Suicide – 33,000 deaths
- Skin cancer – 9,000 deaths
Within the report’s more than 35,000 words, a scant 114 are devoted to “potential unintended consequences of interventions”—a euphemism for draconian government action. Listed are skin reactions to sunscreen chemicals; restrictions on tanning salons leading to people tanning themselves in less-regulated settings; reductions in physical activity; and reduction in peoples’ Vitamin D levels.
It should be noted that the science behind UV exposure and skin cancer is far from settled, and prominent dermatologists are not toeing the company line. Moreover, analysis of UV/cancer data takes on a whole new light, once unsupervised home tanning and high-dose medical phototherapy is removed from the mix. In fact, no statistically significant increase in risk was attributable to commercial tanning facility usage, while large increases (40 percent and 96 percent) were attributable to home and medical usage of tanning equipment.
Cui bono? It is no secret that the American Academy of Dermatology receives millions from the sunscreen industry. Could the AAD be demonizing the tanning salons because phototherapy sessions delivered in dermatology offices have fallen off dramatically?
Qui decernit? Why does this issue provoke such implacable treatment from the US Surgeon General? Makes you wonder…