The Study of Epidemiology and Preventing Chronic Illness

Neil Degrasse Tyson, the host of the Netflix series “Cosmos,” spends a good deal of one episode talking about a scientist named Clair Patterson. Clair, through his quest to uncover the true age of the Earth, stumbled upon a major public health crisis: lead poisoning. He wasn’t setting out to take on industry giants; he just wanted to do the math and date the Earth accurately. After his discoveries about lead during the process, however, he found himself becoming an impromptu epidemiologist. Suddenly, he was taking part in one of the most reviled sciences among fuel, power, and pharmaceutical industries and their lobbyists.

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Clair Patterson is one of the greatest unsung heroes of public health. He didn’t just draw attention to the human-created epidemic of lead poisoning, but also to the lengths that powerful industries will go to in order to avoid regulation, including tampering with the scientific process and political results through bribes, threats, and smear campaigns. He uncovered a great deal of animosity that players in big business have toward epidemiology and the sciences of public safety.

After a difficult fight, Clair’s stubborn pursuit of the truth resulted in legislation that limited the use of lead in commercial and industrial products, as well as vehicle emissions. A victory for scientific truth and public health, but only one step along the journey. Lobbying of scientific research and political action regarding it still continues, which results in a surprising amount of dangerous materials remaining in common use.

The anti-science sentiment is gaining momentum in North America, often fueled by business interests. Industry lobbyists, however, aren’t always at odds with the scientific truth. Generally, they are very pro-science when research is producing new ways to cut costs or improve profit. Pharmaceutical giants often fund and research new medicine, while simultaneously creating new crises by pushing addictive substances in spite of poor testing, or in spite of warnings from scientists.

The problem with epidemiology is that it’s not so much about curing disease, but preventing it from happening in the first place. Eradicating a disease means you can’t treat people for it, and that means you can’t charge them for treatment. Industries tend not to respond well to inconvenient truths about the processes and materials they use. Even when they can’t stop the truth from coming out, there are many successful lobbyists who stall political responses to public health issues.

The pursuit of science and truth has given America and American industry a great deal. It turned us into the most powerful economy in the world. You can’t, however, pick and choose truth — at least, not ethically. Epidemiology is an area of study that has saved millions upon millions of lives through tireless pursuit of the truth. It’s time to stop interfering with it.

Cholera in the Water Pump: A Brief Origin of Epidemiology

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Epidemiology is the study and science of public health. Under its umbrella fall things such as communicable diseases, but the field is not limited to diseases. The CDC, for example, keeps track of anything that poses a wide public risk such as mental health, violence, and motor vehicle safety.

Arguably, in the Western world epidemiology began with an English doctor by the name of John Snow and his long battle with Cholera. Cholera is a particularly nasty disease that, in the early to mid-1800s when John was training to be a doctor, was thought to be caused by “miasma,” thought to surround graveyards and sewage tunnels. His process of scientific investigation leads him to discover that the disease was spread through water and that contaminated water pumps were the source of outbreaks. Unfortunately, no one in conventional medicine at the time believed him.

Snow founded the study of epidemiology to prove his discovery to the scientific community. To prove his findings, he needed something that we took for granted in the modern world but was extremely difficult to come by in the 1850s. To safeguard the public from disease, he needed data — data about where people lived, which water sources they used, and how many people in their families contracted cholera. Data and its gathering, mapping, and examination became an integral component of epidemiology.

To disprove conventional wisdom at the time, and convince other doctors that he was right, John Snow needed a rigorous process of study that would satisfy the most skeptical minds and stand up to scrutiny. His study of the statistics involved with how disease spreads through public spaces pioneered many of the techniques that modern epidemiologists use. He was determined to study not just a disease and how to cure it, but how to limit its damage through good public planning and legislation. In this way, diseases can be fought, and even prevented and eradicated entirely, without the need for distributing medical aid on a massive scale.

Epidemiology is, therefore, an extremely consequential area of study. The results of epidemiological investigations often result in laws being passed and public policy being enacted through government.

That’s why it’s a bad idea to meddle with it.

Back to Clair Patterson: Why He Encountered Resistance

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Knowing the goals and outcomes of the epidemiological study, it’s easy to see why some people might despise it. Epidemiological studies regularly lead directly to legal and regulatory action that undercut profits to enact safety measures. It’s not difficult to understand why industries that rely on science, such as the healthcare and the auto industry, would turn around and quickly dismiss the kind of science that epidemiologists do. These industries like science used for technological progress and profit. On the other hand, science used to temper those things, to evaluate the dangers of technology they rely on, that won’t be so popular.

That’s where the tension came in with lead. Lead is useful. It’s extremely malleable and resistant to corrosion. In gasoline, it helped to prevent wear and tear on engines. If it weren’t such a toxic material, it would be used in all manner of industries today. Before the 1970s, lead was used in all sorts of American products and projects such as gasoline, paint, and pipes. Communities are still reeling from the effects of lead to this day.

In the 1960s when Clair was working, one of the reasons he encountered so much opposition is that companies like the Ethyl Corporation not only possessed great lobbying power but employed the scientists conducting lead research. He didn’t just have to contend with the business interests themselves, he had to prove that the experimental methods used by the scientists they employed were wrong — scientists who were at the same time the recognized authorities, and incentivized to produce results that were positive for the lead industry.

The conflict of interest may have been clear to him, but politicians needed to be convinced that there was a reason to mistrust the experimentation and studies of the established experts. The companies profiting from dangerous materials that harmed public health were in direct control of the people most trusted to protect public health.

It went further than that, however. After he began to criticize lead, Patterson was effectively cut out of the scientific community. Organizations that were ostensibly neutral, like the United States Public Health Service, refused to work with him. This went beyond lobbying against his findings and process. The businesses whose interests he threatened aimed to destroy his character, stop him from working and pull any funding he had, all because he noticed that people were falling ill and dying due to a material that made a lot of money for powerful people.

Patterson’s story exemplifies the need for neutrality in the scientific process. Outside influences don’t just contaminate the process, they change results and produce lies. Industry lobbyists can’t be trusted to self-regulate, and they also hold a great deal of sway over decisions made in government. Decisions about how to respond to the results of truthful research can also be tampered with.

 

Keeping Bad Actors Out of Epidemiology

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In theory, epidemiology is a logical and precise way of safeguarding the public from major sources of harm. It’s the kind of science that saves lives on a massive scale.

Unfortunately, political lobbying can have a heavy impact not only on how organizations like the CDC study public health but what they can study in the first place. This is one way that lobbyists continue to exert control over the scientific process. They can’t control the scientists anymore, but budgets are complicated beasts, and it’s not difficult to add in caveats to an organization’s public funding that determines what they can and can’t study in the first place.

Funding has to come from somewhere, and it’s generally agreed that to be unbiased and free from corporate interests, scientific study is best when publicly funded. Public funding, unfortunately, is not free of political maneuvering, and agencies that issue funding and grade results like the CDC can be effectively dictated to about what they study through spending bills. As one example, the CDC has long been extremely limited in its ability to research gun violence due to spending bills passed by the government.

In fact, there are a number of cases where funding has been held over the heads of researchers and organizations as an indirect way to control them. A study on sugar and its relationship to cancer was refused additional funding to continue its investigation in the 1960s due to potential regulatory fallout resulting from its findings for the sugar industry. The results were hardly set in stone and required further proof, but the research agency allegedly decided that further scrutiny from the FDA was too great a risk to take to continue the study to completion and uncover the truth.

Untangling the webs of corporate and political interests and their effects on the integrity and truth of scientific research can be extremely difficult. Knowing which research to trust is a vital part of making good public policy, and enacting regulation that preserves public health. Industry lobby groups often disguise themselves as neutral research groups and produce biased or incomplete studies. “Think tanks” are one of the largest culprits in North America — research organizations that are consistently accused of conflicts of interest. They are marketed as independent researchers, but often have close ties to large industry donors and espouse very particular political points of view. They regularly influence government policy.

It’s also important to remember that public policy is not always as far-reaching as it appears. The US may have stopped producing asbestos, but that hasn’t stopped companies from shipping it in from other countries and continuing to use it in their products. Loopholes are easy to create and to exploit, and so in this case rules that only addressed production and not imports proved to be extremely exploitable.

For the protection of all of us, science needs funding that doesn’t come with strings, and epidemiologists need broad autonomy to study whatever takes their notice — because they are trained to notice issues that require research. They are then trained or at least should be, to follow those issues to whatever conclusions are presented by truthful and accurate observation. Keeping “good science” in epidemiology is vital for the benefit of society, the environment, and everyone we know and love.

Truth is Everyone’s Responsibility

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We are, all of us, investigative and inquisitive creatures. Humans have the drive to know more about the world, and in today’s age, finding things out about the world is a lot easier than back in John Snow’s time. However, ease of access to information comes with a price. It is still very difficult to distinguish pseudoscience from tested, peer-reviewed scientific analysis. One scientist releases a study and news outlets jump on their results, proudly declaring “science says:” — but good medical research is more than just one study.

Also, we still battle with charlatans who take the guise of science and use it for political or profit-driven purposes. Citizens, politicians, and scientists too need to see the recognition of truth as continuing education. Because as science and technology develop, there are people who will use it to find new ways to lie.

In our everyday lives and choices, we have to choose to be informed. Not just about scientific truth, such as the importance of vaccines, but about the corporate interests that go into even good science. Vaccines may be a force for good, but they are not free from price-gouging and monopoly by pharmaceutical companies. It’s on us to understand that situations are nuanced and that being committed to truth means accepting answers we don’t like instead of refusing to hear them or fund them.

Using budgets to prevent unbiased research is restricting the public’s access to the truth. It restricts our ability, as a society, to make informed decisions. Epidemiology needs to be a field of study untouched by the influence of industry. While doctors were telling John Snow that he was wrong about well water, people were drinking it and dying of cholera. While paid-off scientists were battling it out with Clair Patterson, people were contracting lead poisoning. People still contract mesothelioma from asbestos. Flint doesn’t have clean water. There’s mounting evidence that the opioid epidemic was fueled by over-prescription and outright lies by pharmaceutical companies, and their lobbying of doctors. Epidemiology is sorely needed, and it’s sorely needed to be neutral.

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Brooke Faulkner

Brooke Faulkner is a mom and writer in the Pacific Northwest. She is passionate about sharing her knowledge about the healthcare industry to help both healthcare providers in providing quality care, and families like hers in getting the healthcare they need.

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