The late Walter Lippmann once remarked, “When distant and unfamiliar things are communicated to great masses of people, the truth suffers a considerable…distortion. The complex is made over into the simple, the hypothetical into the dogmatic, and the relative into the absolute.”
Lippmann’s observations are at the heart of realigning this nation’s health priorities. For the last 10 years, my goal has been to bring the public the “other side” of the public health story, and to make sure that Americans can make correct decisions about their health and lifestyles. Let me explain with a short story:
When my daughter was very young, I received a parents’ newsletter with tips about childrearing. One issue recommended how to help your child overcome nightmares from monsters and goblins in the night. The editor suggested that Mom drive these demons out with a can of hair spray: Douse the affected area, announce the room was “clean,” and kiss your child goodnight. This was supposed to acknowledge the legitimate fears of children, put Mom in an active, rather than passive mode, and “solve” the problem—at least for that night.
In many respects, today’s public health policy reminds me of the hair spray approach.
Pandering to fears rather than facts may well be a temporary solution in a nursery, but this approach has created a crisis of public confidence and a huge misallocation of our energy and resources. Fear of getting sick is rampant. Conventional wisdom holds that we’re suffering from a host of dangerous and mysterious maladies that need to be unraveled in the laboratories.
Medical research is essential to give hope to thousands of people afflicted with debilitating or terminal illnesses, but that is not the issue here. The real issue is how to use what we already know to our best advantage. The shocking truth is that the major causes of sickness and death are no mystery. We don’t need more vaccines or new miracle cures for today’s Americans to live longer and healthier lives. What we do need is to act on scientific fact, not scientific fiction, and to set our priorities accordingly. To put it another way, if we are to hunt down and destroy premature death and disease, we have to stop squishing the public health ants and start attacking the elephants that are racing through our society.
Alar: The Scare That Wasn’t
That means stopping the search for minor and/or false culprits that make little or no difference. Look at the target of one such recent search: Alar. This useful product was driven from the nation’s apple orchards by public relations hype and a great deal of artificially generated public hysteria. In 1989, the Natural Resources Defense Council, a self-styled “environmental” group, launched a study claiming that chemical residues, especially on apples, elevated cancer risks among children. “Launched” is an appropriate word,because the study was sent into media orbit with a glitzy campaign featuring super personas Ed Bradley of CBS and Meryl Streep, the Academy Award-winning actress.
NRDC held news conferences in a dozen cities to warn that over 5,000 children might die from preschool exposure from Alar, a growth regulator used on apples. Ed Bradley solemnly declared that Alar was “the most potent cancer-causing agent in our food supply.” The report hit like a bombshell, and almost no reporter questioned the results. Herd journalism began a stampede with headlines asking whether kids faced an “intolerable risk,” and, “Are We Poisoning Our Children?”
Apples disappeared by the millions from grocery shelves and cafeteria lines. At least one panicky mother called a food trade association to find out whether to pour apple sauce down the drain or take the tainted fruit to a toxic waste dump. Meanwhile, Meryl Streep appeared on “Donahue” and “Today,” announcing the formation of Mothers and Others for Pesticide Limits. The NRDC projectile made a direct hit on the apple industry, which suffered a $100 million loss. Many of its small growers were forced out of business. A bill was also introduced in the U.S. Senate to ban Alan. This led Mar’s manufacturer, Uniroyal, to withdraw the product from the marketplace. Meanwhile, the media showered NRDC with praise for its humanitarian efforts to “protect” children from cancer.
Now there’s a new spin on the story. Reader’s Digest and other major news sources have called the Alar scare a “hoax.” Many American scientists, as well as the British government and the World Health Organization, have given Alar a clean bill of health. And the National Academy of Sciences publication, Issues In Science and Technology, says Alar is no true health threat.
The Alar scare shows just how far we’ve come in mixing fact with fiction. We see an alleged environmental organization, the NRDC, still urging mothers to keep their children from eating fruits and vegetables when the National Academy of Science report examining 6,000 studies found “no evidence that pesticides or natural toxins in food contribute significantly to cancer risk in the United States.” The same report goes on to urge Americans to eat twice as many fruits and vegetables to improve health. But, as the old saying goes, a half-truth is like half a brick: You can throw it twice as far. That gives a self-appointed group like the NRDC a great advantage over the National Academy of Science. And it is also free to use all the elements of a Stephen King novel—the mixture of the unknown, fear, and children—to create a best-selling horror tale that it can market to the public.
“Mouse Terrorism”
Why do they do it? Well, for one thing, there is fierce competition among environmental organizations competing for public contributions. To get attention they use the same shameful negative campaigning we see in so many political contests. And there is another reason: For the past 20 years, environmental, safety and health issues have been on the front burner of politics. Reporting on risk in these areas has moved from the professional journals of researchers to the assignment desks of the popular media. It has also moved to the political stump, where concern for the environment is often expressed in hundreds more regulations and billions of dollars of added costs, regardless of risk to public health or the environment.
Is it any wonder that on the six o’clock news and the campaign trail the most daunting scientific problems are reduced to simple solutions and catchy slogans? Or that the mere perception of risk is reality to millions of people?
I don’t think anything illustrates the public’s confusion about health risks more than “mouse terrorism.” That’s right: “mouse terrorism.” How do the groups like the NRDC “prove” that something is harmful? They cite experiments on laboratory mice, and they are insistent that any dose of a chemical causing cancer in mice is a definite and unacceptable cancer risk to humans. Now, correctly handled, animal testing can help predict health effects from anticipated exposure to chemicals and other substances—we need more of it—but animal testing is useless and dangerous if it ignores a fundamental toxicological principle: “the dose makes the poison.” It is an egregious departure from science and logic when a substance is labeled “cancer-causing” based on a response in a single animal study using high doses of a test material.
Even more absurd is treating natural and synthetic carcinogens differently. In September of 1990, one of the most respected scientific journals in the country, Science magazine, pointed out that in animal testing of chemicals naturally occurring in food 27 of the 52 substances tested were carcinogenic. Furthermore, the editors of Science observed, carcinogens occur naturally in 57 food varieties in quantities thousands of times greater than occur in synthetic pesticides.
That’s right. Your food is full of natural so-called “cancer causing agents.” For the past several years, the American Council on Science and Health has sent to newspapers a publication called “Natural Carcinogens in Your Holiday Menu” to bring this point home. For instance, one mushroom has an estimated cancer hazard 167 times greater than the daily dietary intake of the chemicals PCB and EDB. Or take malonaldehyde, a mutagen found in turkey: again, “the dose makes the poison.” You’d have to eat 3.8 tons of turkey to get a toxic dose of this chemical.
And that’s precisely the point about mouse terrorism: It is based upon unreal dosages. We don’t drink 100 cups of coffee at a time, or eat 10 pounds of spinach, or drink a fifth of liquor at a sitting. And our bodies metabolize and excrete these chemicals unchanged without doing damage. No animal on earth could survive were it not capable of handling small amounts of foreign chemicals.
Health Risks We Can Do Something About
The main cause of death and sickness in our country isn’t pesticide residues of low-level radiation from nuclear plants. And it isn’t fluoride in toothpaste or dioxin II paper towels either. In this case, the “Four Horseman of the Apocalypse” are cigarette smoking, alcohol and drug abuse, sexually permissive behavior, and the failure to use available life-saving technology. Consider a few facts:
Cigarette smoking’s toll is now a half million premature deaths out of the two million annual fatalities in this country. By the time you’ve finished reading the morning newspaper, fifty-five Americans will have died from this insidious killer—and not just from lung cancer, but heart disease, emphysema and a host of other illnesses. In his most recent report, the Surgeon General says cigarette smoking is still the single most preventable cause of death in society. Every holiday weekend in the United States the news is filled with reminders about driving safely, and there is always a grim statistical accounting of the number of deaths on the nation’s highways. Where is the Grim Reaper’s scoreboard for a killer that’s 10 times greater than the carnage from auto accidents?
Then there’s alcohol and drug abuse, which take perhaps a hundred thousand people to the grave each year. They are a major cause of homicide and other violent deaths, and are linked with a long list of physiological and psychological problems afflicting the population, especially youngsters of high school and college age.
Perhaps no disease in our history has received more attention than AIDS. There are some one million Americans now infected with the AIDS virus. AIDS will be responsible for at least 40,000 deaths this year. We know that the overwhelming majority of cases are transmitted by sexually permissive behavior and drug addicts. We need more education, more introspection about our lifestyles, as well as understanding and compassion for those afflicted with the disease, but we also need to track this killer the way we track other infectious diseases—for the good of those most at risk now, and those who may be at great risk tomorrow.
There is a fourth category of risks we should also be concerned about: the failure to use life-saving technology. Remember the recent advertisement on TV showing the man walking away from pieces of his car spread across the highway? He’s alive because he took the time to buckle his seatbelt. Last year, twenty-five thousand others didn’t. And, believe it or not, another ten thousand people forfeited their lives last year because they didn’t have a smoke detector to warn of impending peril.
These are the elephant killers stampeding through our society, and they all have something in common: Every one of them could be prevented with a change in lifestyle—like eating properly and exercising regularly, avoiding smoking, alcohol, drugs, sexual imprudence, and taking a few seconds for extra protection against auto accidents and fire. These are strategic weapons in the war against premature death and disease in this country.
The cruel irony is, with the exception of the politically-charged AIDS disease, death from these elephant killers is more or less accepted as routine. Strange as it seems, premature death for many has become just a part of living.
How Cancerphobia Diverts Precious Resources
So what difference does it make if Alar gets a lot of print? Who cares if lots of our resources are devoted to getting it out of our food supply? What is the harm in some hype about pesticides as long as it sounds the alarm about good health? Why not spend a little extra money to be sure our kids are safe?
Why? Because it is a moral outrage and a political fraud to ask the American people to invest their money and emotions in something that gives no return in improved health, no peace of mind, and causes serious economic damage in the process. We need to be deeply concerned about the welfare of our families when public health policy is set not by scientists but by political operatives and special interests with axes to grind and agendas to fulfill. But most important of all, spending money on wrongly identified problems—and remember, I’m talking about billions of dollars—wastes precious resources that could be spent fighting the real killers.
Look at the so-called “Big Green” initiative that went before the people of California in the fall of 1990. It was an environmental wish-list to help cure a bundle of ills, from the allegedly depleting ozone layer to “unsafe” foods. Big Green was also proof that a hippo is a mouse built to government specifications: Specifically, it mandated that any pesticide, in any amount, causing cancer in laboratory animals would be banned, regardless of risks or benefits associated with its use.
What also made “Big Green” notable was the vocal support of many of America’s most famous personalities. Predictably, there was not a scientist or a cancer expert among them. Scaring the public was the order of the day: Oliver Stone, the director of “Platoon,” claimed that Americans are “choking to death.” Jack Lemmon said swimmers are contracting “mysterious diseases.” Other stars warned of “deadly fruit”. An ad for “Big Green” declared that “scientists are unable to find uncontaminated fish in California waters. Cancer in children is up by 20 percent since 1950.” And, we were told, “20,000 Americans will develop cancer and 3,000 will die because of pesticide exposure this year.”
There is absolutely no scientific evidence to support any of these charges. State officials and many distinguished scientists have repeatedly said so. But it doesn’t make any difference. Big Green and other environmental initiatives since then are political debates, not scientific exercises. Fact and reality aren’t important. As Big Green campaign spokesman Bob Mulholland confided: “In a political debate, science doesn’t matter much. It’s really how you feel about the issue.”
Today, people are regularly asked to make judgments about public health policy based on negative advertising and media hype. And when it comes to environmental and health issues, everything is supposedly black-and-white: You are either for the environment and against greedy industrial polluters, or you are in the enemy camp. And Ed Bradley, Meryl Streep, Oliver Stone and the others don’t have to worry about growing apples or vegetables, or whether new regulations will drive small businesses into bankruptcy.
Nor do they have to worry about the fact that Big Green would have drastically lowered all crop production in the nation’s largest agricultural state by an estimated 40 percent. It would have sent the cost of food skyrocketing—with many prices 50 percent higher—for millions of people. Clearly this would have increased the risks of poverty and disease for the people who are the least able to pay in society—the poor and the elderly. Big Green would have also amounted to an environmental tax of $6 billion per year on local governments without any benefits. And, ironically, it would have undermined the very economic expansion that is needed to ensure financing of sound environmental and public programs.
This shouldn’t be happening in this country. We are healthier than ever. We live longer than ever—doubling our longevity in the past 50 years. We have stamped out most of the infectious diseases that ravaged our grandparents. We also know there is no cancer epidemic. Most cancer rates have been constant for decades. (A major exception is lung cancer because of cigarette smoking.) What a marvelous time to live, and to be born! We are giving ourselves and our children the gift of better health and longer lives.
But the praises of progress are being drowned out by the apocalyptic anthems of adversity. We aren’t a sick society. We are a society that merely believes it is sick. That has to change, and soon. As I emphasized earlier, wasting our precious resources on hypothetical risks systematically undermines our economy, but also diverts resources from fighting the true killer diseases in our society.
The Environmental Protection Agency’s own recent study, “Unfinished Business,” found its priorities inverted. It spent according to the perceptions of the public, which the EPA deemed the lowest risk, and the most costly to research. The dangers EPA scientists put in the top risk category commanded the least attention by the public, and also the least amount of the agency’s time and resources. How do we switch our attack toward scientific reality and quit throwing money and time at the public’s misperceptions?
Academics and scientists have to step out of the relative obscurity of their classrooms and laboratories and into the limelight of the public health policy debate. Polls show that scientists, engineers and academic leaders have the highest credibility with the public and the media. We can’t complain about the media for chasing controversy; we scientists, doctors and teachers can only blame ourselves for staying silent on these issues. All citizens need to encourage industry and business to have more backbone—to stand up to self-styled groups using sensationalism, bad testing and economic intimidation.
