Are public health experts doing science or sociology?

work with public health experts from time to time, or I should say I interact with them, and find many of them reasonably level-headed.

But public health is a soft science. Its principal tool is the question­naire, where subjects are asked whether they're under stress, whether they got vaxxed, or whatever, and the researchers look for correlations. The answers are mostly subjective and strongly affected by how the questions are phrased. My efforts to convince my colleagues to measure things objectively, such as BP and cortisol as indicators of stress (instead of just asking subjects if they feel stress), so far have been unsuccessful.

With so little empirical grounding, the field is drifting away from science and adopting the ideology of critical race theory. A while back we woke up to discover that the CDC, the government bureaucracy tasked with providing us with accurate information on diseases, thinks racism is “a serious public health threat,” as CDC director Rochelle P. Walensky put it. Don't get me wrong—racism is certainly a form of not-niceness, which is why it's so hard to understand why left-wing activists keep trying to create more of it—but insofar as it still exists it is a social problem, not a public health problem, and any connection to disease will remain speculative until somebody provides convincing evidence that it can be measured with any degree of accuracy and demonstrates, using a placebo-controlled clinical trial, how it could induce a disease.

Just claiming that it induces stress doesn't count. As psychologists discovered long ago, asking subjects is only useful in learning what subjects will say when asked a particular question.

The same is true of “climate justice,” whatever that is. Yet the CDC is now asserting, in a highly embarrassing statement, that global warming too is now the business of public health officials.

This isn't just bureaucratic creep. Much of the field has become entranced by woke ideology. They need to ditch the politics and at least pretend to do science before actual scientists kidnap them and force them, under torture if necessary, to admit that they're not adding to the world's storehouse of knowledge at all, but only doing sociology.

Confused academics

Here's an example. An article in last month's Public Relations Review^[1] made the amazing discovery that conservatives had a lower opinion of the CDC than liberals.

The paper starts out by stating that “an organization's public reputation is one of the most influential situational factors for determining both the stance of and stance toward the organization.” The authors then dive into a discussion of psychological differences between liberals and conservatives in the USA, saying that conservatives are more authoritarian and averse to threat and more likely to believe government is important in enforcing the principles of civic life, whereas liberals believe in freedom.

Based on this premise, which has to be the most thoroughly discredited claim of all time, the authors hypothesize that conservatives would be more supportive of the CDC than liberals. They are thus totally baffled to discover the opposite is true: negative opinions of the credibility of the CDC correlated with self-reported conserv­atism. Respondents who thought COVID-19 was a bigger threat were more accommodating of the CDC while those did not think so gave the CDC low credibility.

So, did the authors discard their hypothesis? Just because it conflicted with the evidence? Don't be silly! They speculated that some unknown person (who remains nameless in the article) was undermining the CDC's efforts to build and maintain a solid and credible organization by intentionally creating discord for partisan gain. They proposed that the role of emotions such as fear, which they think is higher in conservatives, should be studied as a possible explanation.

It's a good illustration of a basic principle of logic: accepting a false premise allows you to argue to any conclusion. And there's no better source of false premises than ideology.

Health inequity

Another paper from a place called the Center for the Study of Racism, Social Justice & Health at UCLA ^[2] complains that current databases don't collect enough data on racism as a factor on the “co-occurrence of racism and COVID inequities.” Equity means to make the results the same regardless of what causes it. It's a bit scary to see it applied to diseases, but we could be charitable and assume they're not just trying to blame one race for the susceptibility to disease of another, but just want to reduce disease.

Unfortunately, that interpretation doesn't fly. Another paper ^[3] asserts that “a long history of structural racism” leads to adverse health outcomes, as highlighted by inequities in COVID-19 infections. What they want to say is that racism is killing people.

A typical example purporting to demonstrate this is an article in Maternal and Child Health Journal from the Center for Antiracism Research for Health Equity, Division of Health Policy Management at the University of Minnesota, which says ^[4]:

In the United States Black [sic] women are nearly 4 times more likely to experience a pregnancy-related death. Recent evidence points to racism as a fundamental cause of this inequity.^[7] . . .

They have four goals they want the CDC to implement:

1. To create a product that was inclusive of all forms of racism and discrimination experienced by birthing people [sic].
2. An acknowledgement of the legacy of racism in the U.S. and the norms in health care delivery that perpetuate racist ideology.
3. An acknowledgement of the racist narratives surrounding the issue of maternal mortality and morbidity that often leads to victim blaming.
4. The product would be user friendly for MMRCs [Maternal Mortality Review Committees].

Another paper ^[5] goes so far off the deep end they enter here-be-dragons territory:

White supremacy is a system in which those who benefit from whiteness maintain power and privilege through the oppression and exploitation of those who are not included in the definition of whiteness, with Black and Indigenous People of Color (BIPOC). This includes perfectionism, worship of the written word, sense of urgency, defensiveness, quantity over quality, only one right way, paternalism, either/or thinking, power hoarding, fear of open conflict, individualism, progress is bigger/more, objectivity, and right to comfort.
. . .
Within the lineage of Derrida and Foucault, [Achille] Mbmbe's conceptualization of biopower and biopolitics depart from the Eurocentric view to include a framework of power with a critical lens of colonialism, post-coloniality, and conceptualizations of aliveness within a framework of the 'living dead' whose bodily sovereignty are controlled by racialized state politic.

It's hard to express just how weird this stuff looks in a journal dedicated to promoting health. Frontiers in Public Health, where this was published, is not some campus paper with the hammer and sickle and a picture of Karl Marx on its masthead edited by pimple-faced students with Che posters in their dorm. It is a real scientific journal listed on PubMed, with an impact score a moderately respectable 3.02. That makes it all the more surprising to find its pages filled with poststructuralist drivel and unscientific rubbish.

The evidence

What evidence were the authors in these three papers referring to? It turns out that it is now accepted dogma that unequal outcomes are proof of ‘structural racism’. As of this writing, there are 14,113 papers using the term ‘health inequity’ or its plural. Those three papers are by no means unique: many other papers equate health inequity to racism. Here^[6] is a typical example, published by authors from the American Heart Association.

There are reports that some groups are more susceptible to COVID than others. But the idea that racism is behind it is not something one can just assume. There are massive differences in lifestyle, vaccination rates, and risk factors among different groups, not to mention genetic factors. Any first-year biochemistry student can rattle off half a dozen diseases and disorders that are specific to one ethnic or racial group: Tay-Sachs, sickle-cell anemia, hereditary hemochromatosis to name just three. In fact, genetic disorders (of which over 6000 are known) are by definition specific to people of common descent.

The activists ^[7] typically define "structural racism" to be the ratio of black to white population in educational attainment, employment, and incarceration. This is a form of circular reasoning: all ‘inequity’, these activists claim, is racism by definition. The authors then write as if they have proved something when in fact their conclusion is ideological, tendentious, and unfalsifiable.

You might think that redefining ‘racism’ to mean ‘any difference’ would just render the term meaningless, but the goal actually seems to be to convince themselves that structural racism is real and that medical professionals are committing mass murder. Why anyone would want to make such a bizarre claim is not clear: the only likely effect will be to discredit public health as a respectable occupation.

This is not science. It is poison to science. The field of public health is rapidly becoming useless as a source of knowledge, with the CDC leading the way. Public health experts have an important role to play in our society. They can't fulfill that role if they lose our respect.

apr 28 2022, 6:17 am. last updated may 04 2022 5:53 am