Government, Public Health

Evidence: A critical basis for policy making…really

September 17, 2019 |4:59 min read

Effective government employees and advisors who rely on facts and data should not be ignored

Over the past 40 years, great advances have been made in developing the knowledge base about how to assess evidence.

Opinion is not evidence. The disregard and even contempt for evidence as a basis for policy making today is unlike anything I’ve ever seen. According to Michael Lewis, author of The Fifth Risk, the  administration is driving out experts who understand government, energy (including nuclear), agriculture, innovation, climate and a host of other topics, and filling offices (those that are filled—many important jobs are vacant) with people who lack any viable background except industry perspectives and having donated to the president’s campaign.

Lewis writes compellingly about the lack of appreciation current administration leaders have for the work of government. They don’t understand it and don’t recognize the danger of failing to assess the risks we face in a range of fields – from energy to water pollution, oversight of agriculture, drugs and so many other areas of life. He calls lack of expertise and competence among current government leaders the “Fifth Risk,” citing an appalling shortage of people who understand and can manage the lifecycle of projects, especially large ones.

Lewis describes how standards for auto emissions, fuel efficiency, national parks, protections of rivers and streams and our drinking water are tossed glibly into the wind because of biases, misperceptions and an unwillingness to examine evidence. That’s tragic, because sometimes, policies can make the difference between life and death. For example, when Medicare began covering dialysis many years ago, people with kidney disease could imagine futures for themselves. Conversely, in agriculture, changing USDA policies to speed the processing and inspection of animals in meat production can result in tainted meat and sick humans. But there are many examples of policies contributing to healthier cities, environments and people; the Community Guide, maintained by the Community Preventive Services Task Force (CPSTF) of the U.S. Department of Health and Human Services (DHHS), with the support of the Centers for Disease Control and Prevention (CDC), is full of them. A great example is when tobacco advertising was taken off the air – a policy that contributed to a steady decline in U.S. smoking rates.

The Cuyahoga River caught fire many times. This dramatic photo from 1952 was redistributed widely after the 1969 fire, helping boost support for the Clean Water Act, the Great Lakes Water Quality Agreement, and the creation of the federal and state Environmental Protection Agencies, according to the EPA. Photo courtesy of Cleveland State University Library.

Richard Nixon, in his January 1970 State of the Union address, spoke about reparations for the environment because of the harms caused by humans: “The great question of the seventies is, shall we surrender to our surroundings, or shall we make our peace with nature and begin to make reparations for the damage we have done to our air, to our land, and to our water?” Later that year, he announced creation of the Environmental Protection Agency (EPA) by executive order. That was an era in which the Cuyahoga River in Ohio had caught fire from pollution (see photo), and many rivers and streams across the country, including the majestic Potomac River, had degraded (see Time, “Here’s Why the Environmental Protection Agency Was Created”). A lot of the anger, angst and activism that led to formation of the EPA came from young people. It’s time to reignite our anger and turn it into action. Young people will bear the consequences of today’s misdeeds. This is their time to be heard.

The New York Times covered the first Earth Day, April 22, 1970, three months after President Nixon, in his State of the Union address, said, “Shall we make our peace with nature and begin to make reparations for the damage we have done…? Photo from The New York Times TimesMachine.

I mention Nixon’s words and actions because health of the environment was a bipartisan issue then, as it should be again. Support for cancer also was a bipartisan issue; the War on Cancer came about under Nixon and doubling of the NIH budget occurred during the Clinton administration. These advances could not have been made without bipartisan support.

We desperately need government leaders and staff members at every level who understand and respect the American people and the jobs they are doing for them. I still believe that service is a noble calling and hope that future presidents will regard government service as a worthy endeavor, and will understand that their personal legacies will come, in part, from preserving health and the environment, not only wealth. I say that as someone who did two stints working for the National Institutes of Health (NIH) and invested many years in volunteer leadership roles in government.

In the August 30, 2019, issue of Science, Adam Gamoran, president of the William T. Grant Foundation, opened an opinion piece with these words: “These are dark times for science and public policy in the United States.” I agree. In the past several days, there have been multiple reports of the administration’s dismantling of scientific panels, leaving an already bereft government without experts to push back against the blatant disregard for the consequences of dismantling policies grounded in evidence. One of our graduates, Sacoby Wilson, PhD, now an associate professor at the University of Maryland School of Public Health, spoke to this issue on NPR (see “Scuttling Science”). He serves on an EPA advisory panel that could be eliminated by the Trump executive order.

Now, more than ever, we must, as Gamoran wrote, support scientific inquiry and fund evidence-based solutions. “More researchers should collaborate with policy-makers to develop research agendas, to increase the chances that research findings will be used.” I could not agree more!

The views expressed in this blog are Barbara Rimer’s alone and do not represent the views and policies of The University of North Carolina or the Gillings School.

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The views expressed in this blog are Barbara Rimer’s alone and do not represent the views and policies of The University of North Carolina or the Gillings School.