Navigating an evidence-free zone
I’ve been thinking a lot about the ways in which the 2016 Presidential election changed the currency of evidence, including what counts and the value we place on evidence, particularly scientific evidence.
As a person trained in the science of epidemiology, I studied how evidence is accumulated, and how one designs studies to avoid or minimize bias. As a researcher, I spent many years contributing to the evidence base in cancer control. As a public health professional, I served on a number of evidence review teams and, for a decade, was a member of the CDC’s Community Preventive Services Task Force.
As a dean, increasingly I’m trying to understand the evidence in fields that are not my own, such as climate change. As I have read my weekly issues of Science magazine and listened to faculty members, such as Jason West, PhD, I’ve concluded that the case for climate change has been made, not with polemics, or by saying “trust me,” but by the careful accumulation of data, piece after piece, using objective measurements of Arctic ice and other methods of documentation. (For example, see “Connecting Air Quality and Climate Change,” in Journal of the Air and Waste Management Association, by Michael T. Kleinman, PhD, and others, including Dr. West, who is an associate professor of environmental sciences and engineering in the Gillings School.) The long-term risks of climate change may be devastating for the planet. And yet, too many people reject scientific projections, preferring to believe the changes are normal fluctuations that appear in one’s lifetime. Similarly, we have seen how the efficacy of vaccines has been undermined because of a purported relationship to autism that was retracted some time ago. Unfounded beliefs persist and are perpetuated, sometimes with the help of the internet.
This isn’t just an academic matter. Children in California should not have succumbed to measles, but their parents believed they were protecting them from the harms of vaccines. Those theoretical harms were inconsequential compared to the very real risks associated with measles. A 2016 article by Peter J. Hotez, MD, PhD, provided detailed information and projections regarding the consequences of a growing population of unvaccinated children in Texas.
As a person who has spent her professional life committed to improving lives through building evidence, and who now is committed to training students in the skills of evidence building and dissemination, it is painful and incredibly sad to wake up in a world in which evidence no longer matters to many of our leaders.
In a March 1, 2017, article in the New England Journal of Medicine, “Resisting the Suppression of Science,” Lisa Rosenbaum, MD, offered strategies for resisting the suppression of science and evidence. She found a silver lining in the current state of things, arguing that we, as scientists and people who care about science and evidence, now must recognize the need to become more effective communicators about these issues.
I am heartened that some of our students and alumni have come to me recently asking for more training in science communication. That’s a wake-up call we all should hear and heed. Sometimes, questions about evidence can be matters of life and death.