Health Guidance in an Age of Low Public Trust

Perhaps you’ve noticed that public trust has evaporated this year. Recently, Edelman reported that trust in government, business, nonprofits, and the media dropped across the board and around the world in 2016. In nearly two decades of tracking public trust, Edelman has never before seen such a broad and dramatic drop.

A vigorous discussion about the reliability of public health guidance is growing in the midst of this crisis in trust. Writing in the New York Times this week, pediatrics professor Aaron Carroll advises us:

Take your medical news and recommendations with a dose of healthy skepticism, especially regarding nutrition.

Pick any food fad, be it low-fat, low-carb, gluten-free, or peanut avoidance, and you’ll see the markers. Some people benefit from avoiding certain foods, so organizations proclaim that all people will benefit. They have observational studies that support their beliefs, and if other such studies contradict them, well, those can be ignored.

Expanding on this theme, Nina Teicholz writes thoughtfully in the Atlantic. Pay attention to gaps in evidence for recommending specific limits on sugar consumption, she says:

We’ve been down this road before, with experts, pressed into urgency on behalf of the public health, convincing themselves that insufficient evidence could suffice. Therefore, in the matter of national guidelines, it’s worth being cautious – and not immediately dismissing those who send up cautionary flags.

In the Guardian, Professor Linda Bauld calls out flawed guidance on another critical health concern – smoking. Some health organizations are encouraging the public to fear e-cigarettes as much as smoking. But smoking is uniquely deadly. E-cigarettes are indisputably safer. She writes:

I believe that e-cigarettes have huge potential to save lives by providing an alternative to smoking. Yet this can only be realised if we address negative harm perceptions and communicate honestly with the public.

Widespread mistrust creates a challenging environment for health promotion. Stretching the evidence thin only adds to the challenges. Consistent, disciplined honesty is the only way out.

Health guidance in an age of mistrust must never stray beyond the limits of evidence.

Click here for more from Edelman, here for more from the Times, here for more from the Atlantic, and here for more from the Guardian.

Trust, photograph © dietertimmerman / flickr

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January 19, 2017

3 Responses to “Health Guidance in an Age of Low Public Trust”

  1. January 19, 2017 at 9:29 am, Joe Gitchell said:

    Thank you, Ted. My only additional comment is that I believe we have ALWAYS lived in a post-fact world (we can’t forget our TS Kuhn) we’re just able to see it more clearly and quickly now. Moral minds binding and blinding and all that.

    Reminds me of the Voltaire quote you gifted to me long ago: “Cherish those who seek the truth; doubt those who have found it.”

    Though given the times, I’d prefer to think that it was actually Emilie, Marquiese du Chatelet who coined it!


  2. January 19, 2017 at 9:42 am, David Brown said:

    Public health dietary guidance will never be trustworthy as long as consensus science is used to justify public policy.

    “… scientific reviewers of journal articles or grant applications—typically in biomedical research—may use the term (e.g., “….it is the consensus in the field…”) often as a justification for shutting down ideas not associated with their beliefs.

    The U.S. Government made a big mistake when it declared saturated fat a health hazard back in the early 1980s.

    Demonizing sugar may also be a mistake. It seems to require both fat and sugar to really derange the appetite.

    Also this: Dr. Grove and researchers at some other centers say the high-fructose corn syrup appears to accelerate the development of obesity and diabetes. “It wasn’t until we added those carbs that we got all those other changes, including those changes in body fat,” said Anthony G. Comuzzie, who helped create an obese baboon colony at the Southwest National Primate Research Center in San Antonio.

  3. January 22, 2017 at 11:27 am, Allen Browne said:

    As my 95 year old father in law says, “All things in moderation”