What You Should Think About Medical News

“The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not.”

–Mark Twain

Rarely a day passes without some new proclamation about the nature of a healthy diet. In some households this can produce grumbling about the overconfidence of doctors. Usually medical researchers are not at fault. It just happens that as the story passes through layers of intermediaries, it becomes distorted. Researchers publish with an eye toward being critiqued by peers. Popular medical journals borrow from this and publish with an eye toward keeping professionals up to speed. By the time someone involved with a general media organization decides to do a story about new findings, the emphasis is much more on storytelling than relating the actual findings.

In fairness, this is not just because original medical papers would be unpopular items in daily papers and television newscasts. Most readers would also find raw research uninformative. Competent dutiful science journalists build a bridge between general audiences and the original research. They assess it with expert eyes, then parse it in such a way that their own work is the most accurate and informative retelling their abilities permit. Generating interest with this model involves having some passion for the subject and being exposed to enough research as to have no shortage of genuinely fascinating topics.

I believe the emphasis on cutting corners does even more damage here than crass commercialism. Like a children’s soccer team, reporters in any given niche seem to act as a mob in pursuit of a single thing. After all, why stick your head in academic papers day after day when it is possible to skim somebody else’s report, perhaps glance at another document or two, put it in your own words, and still look like you’ve done the job of a diligent professional? When someone completely fabricates a report (or in Dan Rather’s case, when someone lets one fabrication slip into a report,) the result is scandal. Yet the “do just enough not to get fired” paradigm generates plenty of work that borders on scandalously poor quality.

On the other hand, commercialization is not blameless in all this either. It probably has much to do with a tendency to decontextualize statistics. For many conditions, risk of mortality is less than 1%. If eating a particular food causes a 0.08% chance of mortality to become a 0.17% chance of dying from that same condition, that food is far from toxic. Yet many editors would be much happier to oversee a report claiming “problem food doubles your chance of dying from <insert cause here>” than something like “this food may increase your risk of <insert condition here>.”

A difference like that may seem subtle. Yet a subtle difference in language combined with a dramatic difference in tone can turn a humdrum observation into an alarming report. I dispute the idea that alarming reports make for more popular news than fascinating observations (especially when the alarm is rooted in trivia.) However, I do understand production of fascinating science journalism is hard work, while making people scared of everything but their own shadows can be an easy day at the office.

Medical journalism in mainstream venues is especially problematic because it easily plays into a common misconception — immortality. Sure, everyone on the tall side of puberty should be well aware that death is a human inevitability. Yet how many people really think about it? How many people have come to accept the weight of such a thing? For many young adults, death is something that happens to other people. Even as the years take loved ones from most and provide personal close calls for some, this profound matter is still often left on the fringes of awareness. No doubt this is sensible and healthy — a constant preoccupation with death is generally regarded as one sign of a troubled mind.

Thus, in between the bombastic music and dramatic graphics, an ominous report about how this habit or that diet might have a 2% chance of causing your death is not typically met with the thought, “well, something’s got to do it.” The lack of context transforms new findings that only deserve a little consideration among those intent on a healthy lifestyle into some sort of dramatic threat to which all decent self-loving Americans must be strongly averse.

Of course, basic common sense has some say in the matter too. As legitimate information is transformed into unnecessarily dire warnings, the general public only develops a thicker skin as applied to medical risks. “So what if oil-based paint causes cancer when it seeps into groundwater? Last month ‘they’ said fried chicken could kill you!” goes the final interpretation of a story. The abstract “They” responsible for all expert opinions increasingly fades into background noise.

Commercial media then must strive harder to succeed in efforts to attract audiences through hyperbolic alarmism. The mechanism reinforces itself. This not only wastes people’s time by failing to provide more informative content; it also minimizes the impact of medical expertise when something that truly deserves alarm comes to light. Be it an obesity epidemic, overmedicated children, undermedicated hospice patients, etc. the medical issues of the day that should be a big deal sometimes get lumped in with the noise made about fresh research of trivial consequence.

One way to address this is simply to lose interest in those types of stories. If you go to the media to have an emotional reaction, both broadcasters and publishers offer up no shortage of excellent drama (or reality shows, for the shallow folks.) If you go to the media to become more informed, consider filtering out alarmism even if that means ignoring the majority of “health news” items. Of course, that approach is not for everyone.

In the alternative, get in the habit of digging the facts out of whatever journalistic coverage happens to encase them. Distinguish between research that quantitatively assesses risk and research that manages to establish a mechanism of causation. When practical, try to find out whether reports related to risk factors were normalized or based on raw data.

I would never deny that smoking is an unhealthy habit, but in a broad sample the higher mortality rate of smokers would be significantly attributable to a range of other factors from childhood nutrition history to occupational hazards. Without knowing what efforts have been made to factor out other influences, it is difficult to formulate any context for health risks ranging from the pesticides on apples to the tannins in Zinfandel. If you can get down to the facts without being moved by an emotionally charged presentation, then there is still much that can be learned from medical research . . . even after it percolates through the filters of commercial media.