Posing with FDR

What Presidential Checkups Tell Us About Self-Reports

Our president just had his annual medical exam and that ritual is providing us an important reminder. Self-reports – especially about obesity, nutrition, and physical activity – are not very reliable. That’s because most people misremember or shade the truth. We’re all lighter, taller, eating healthier, and more active when we do the reporting ourselves.

A Long History of False Reports About Presidential Health

To be sure, rosy reports about presidents with poor health are a very old tradition. For example, in 1893, Grover Cleveland had cancer surgery on a yacht over the Fourth of July weekend. While bobbing along on the water, a surgical team removed five teeth, along with part of his jaw and his palate. This maneuver was all about concealing the truth of his diagnosis. What did the public hear? The president has a toothache.

And then we have the incapacitating stroke that Woodrow Wilson suffered in office. The official diagnosis was a bit of exhaustion. While the president was confined to bed rest for more than a year, First Lady Edith Wilson took over.

Examples of this kind of misinformation are abundant. FDR’s poor health led to his death in office. The White House physician, Ross McIntyre, had just told the public his health was fine. President John Kennedy suffered from Addison’s disease, severe back pain, and colitis. But his public image was one of youthful vigor and perfect health.

Thus, the self-reports of our current president’s height and weight are neither surprising nor especially credible. He has a BMI of 29.9. No obesity there. And based upon his exam this year, the White House physician tells us he’s “in very good health.”

A Reminder About Self-Reports

So bear this in mind when you read research reports about obesity, nutrition, and physical activity. If a study relies on self-reports, it’s susceptible to bias and even false conclusions.

Rankings of obesity in different states? Those all come from self-reported height and weight. And this study suggests that differences in misreporting between states can mean that those rankings are false. Likewise, self-reports of dietary intake can be unreliable and misleading. The same goes for self-reports of physical activity, as this study demonstrates.

Algorithms might adjust for misreporting, but they can’t account for unknown variations in misreporting between segments. You don’t know what you don’t know.

Knowing What We Don’t Know

Is our president a paragon of “very good health” or a “ticking time bomb“? It’s best to deal with facts. And the fact is, we simply don’t know. That’s how it is when all you have is a self-report and no objective measures.

Click here and here for more on the history of presidential health reports. Click here for more on our current president’s health reports.

Posing with FDR, photograph © Y Nakanishi / flickr

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February 13, 2019