CENTER FOR THE ADVANCEMENT OF HEALTH OCTOBER 2007 Science Message Muddled, Public Befuddled GoodBehavior! archives Watching sausage be made is enough to ruin your appetite and probably best avoided, unless, of course, you’re an aspiring sausage maker in which case the process can be interesting and instructive. The same rule applies in other areas of life. Legislators know it is imprudent to allow the voters to watch their process (known internally as “making the sausage”) lest they be repelled by the arcane rules and endless compromises required before a law is enacted. It is wiser to allow the product to be examined once the process is completed. That may be relevant to science where the public has had increasing opportunities in recent years to watch the scientific sausage produced. Seekers of universal rules will be pleased to note that the result there has been the same -- confusing and negative. Jessie Gruman President and Executive Director Center for the Advancement of Health The resulting tensions are expertly discussed in articles that appeared recently in the New York Times and Los Angeles Times.* Both articles conclude that scientists are interested in process while the public is looking for product. The two don’t always mesh well. That means that scientists are comfortable with hypotheses that a re changed regularly as new research is done, acknowledge that the progress is jagged and incremental and that today’s apparent truth may have a very short shelf life. The rest of us are looking for stable answers that will allow us to live better. I want to know whether it makes sense for my 81-year-old mom to take estrogen and you want to know whether consuming an apple daily will keep you healthy. Tentative and temporary answers don’t meet that need. When such answers are transmitted by a press that’s not always as expert as it could be or cautious as it should be, that’s a recipe for trouble. The rubber meets the road when correlation, which is relatively easy to document, is construed as causality, which is much more difficult to pin down. Computers abet the search for correlation, which is one reason we get a lot of it, including the Canadian study reporting that Sagittarians were 38 percent more likely to suffer a broken leg than those with other star signs. Such conclusions can be entertaining and interesting, which is why the media sees them as catnip. The problem is that they can confuse the public (if tall coffee drinkers are more likely to get cancer and athletic coffee drinkers less so, what’s a tall athlete to do?) simultaneously undermining respect for science and sensible public health advice (like “eat your vegetables”). It is easy to tell people to practice healthy habits. But studies that can distract people from the basics (eat moderately, exercise regularly) can create an environment that’s more confusing than constructive. The conversations among scientists and between science and the public are quite different. The former happens on a minute-by minute basis. The latter is almost exclusively mediated by journalists. Perhaps more direct communication with the public -- not about new findings, but about the processes of science -- would help. FROM THE HEALTH BEHAVIOR NEWS SERVICE The Health Behavior News Service regularly distributes stories summarizing new research on health behavior issues. These stories can be found online at http://www.cfah.org/hbns/current.cfm. Here are some stories released in September: Early Childbirth Linked to Poor Health in Middle Age Women who have their first child before age 20 are at a higher risk of chronic diseases and death when they reach middle age, a new study shows. Those Who Stay in School, Stay Healthier Both education and income can determine whether a person will remain healthy, but those who stay in school longer have the best odds, largely because education so strongly influences income, say the authors of a new study. Heart Medications: The More You Skip, the More You Risk A new study finds that heart patients who most frequently miss a dose are more than twice as likely to suffer heart attack, stroke and death. Depression Is Significant Cause of Early Retirement Men in late middle age with depressive symptoms are more likely to leave the labor force than men without such symptoms are. Nicotine Replacement Therapy an Option for Pregnant Smokers Pregnant women trying to quit smoking could find it easier with help from nicotine replacement therapy, a new study finds, despite safety concerns about the risk of early delivery. Tiered Medicare Plans Cut Drug Costs, Boost Generics Use Seniors enrolled in Medicare plans that charge higher copayments for brand name or non- preferred medications could spend less and fill fewer prescriptions, thereby lowering drug spending, say the authors of a new study.