Science strives for objectivity, but public health, by definition, involves human preferences and is subject to political forces, sometimes quite nutty ones. Decisions about one's own health can be made in a fairly rational, individualistic manner (does this cut look bad enough to warrant a trip to the doctor's office?), but collective decisions (are enough people vaccinated to prevent a plague?) inevitably become political ones.
That means that while individual irrationality (I dreamt the cut would heal quickly, so I'm not going to the doctor) may do the rest of us little harm, there is reason to worry when millions of irrational individuals or their equally irrational leaders make decisions that affect us all (let's spend billions of tax dollars on a National Office of Dream Healing).
Here, just to keep you sufficiently worried and alert, are some examples of irrational politics leading to irrational public health positions:
Greens: As if Martha Stewart didn't have enough problems lately, she's been targeted by Greenpeace, who are urging people to contact Stewart to denounce her use of products containing vinyl (PVC). As I noted in an earlier piece the evidence for vinyl's dangers comes mainly from workers exposed to extremely high, sustained doses of the substance during manufacturing processes, and there's no reason to believe that simply handling a product with vinyl in it has any effect whatsoever on human health. But the anti-industrial activists at Greenpeace can't pass up a chance to paint a famous capitalist as a villain.
Mystics and religionists: Late in his presidency, Clinton created the White House Commission on Complementary and Alternative Medicine, ostensibly to bring hard-nosed scientific analysis to bear on the booming business of alternative medicine. One must question the objectivity of the panel, though, upon hearing that its members included people such as James Gordon. Gordon is a former follower of the Bhagwan Shri Rajneesh, a mystical cult leader who has the dubious distinction of being the first person to use biological warfare to influence American politics. As columnist Robert Park noted recently, the Bhagwan's cult poisoned residents of Antelope, Oregon using salmonella in order to give the cult an advantage in local elections (the Bhagwan was later deported). It's ironic, to say the least, that while America faces real biological warfare threats, our government is taking advice from a fan of a bio-assailant such as the Bhagwan. But then, this is the same government, as has recently been reported, that is so scrupulously politically correct and open-minded that it came close to giving Mohammed Atta a loan to start a crop-dusting business even after he had expressed an interest in chemical weapons and wondered aloud about the impact that destroying national monuments might have on the American psyche. Between religious fanaticism and muddled-headed mysticism, it's a wonder the modern world continues to function.
Communists: Russian president Vladimir Putin, as noted in a New York Times editorial by Solomon Volkov, has recently suggested that physical fitness should be a rallying ideal for his nation. Today, only about one in ten Russians exercises or play sports, and Russian longevity lags behind Western nations. Ironically, argues Volkov, this is partly a result of Stalin having placed a great emphasis on sports but directing Soviet health resources toward the promotion and training of a handful of internationally-renowned athletes while neglecting the general public. Nationalist displays took precedence over everyday health.
The campus left: In another place long plagued by Marxist thinking, perennially absurd Brown University, student columnist Morriah Horani recently summed up the emerging feminist view of science, saying science is inherently anti-female. She complains about the "sheer number of people who subscribe to [Darwin's] theory of evolution, which relies on sexist assumptions for its analytical fitness." Horani warns her fellow students to be on guard against such health-related Brown classes as Genetics, which has the audacity to term bacteria that form stiff, gene-transferring plasmids "male" and the bacteria that receive them "female." The class is "littered with gendered rhetoric that is derisive of women," warns Horani. Such attitudes, she argues, somehow explain scientists' failure to devise a male contraceptive pill (though scientists themselves claim that it's just far trickier to disrupt the male system than the female). You don't even want to know how strongly she objects to conventional descriptions of sperm-egg interaction. (Horani's discovery that there is "gendered" language in writings about reproduction resembles a recent Onion article revealing "sexism" in the animal kingdom.) Ivy-League activists of this sort are disproportionately likely to run the government and foundation bureaucracies of tomorrow, and they are beginning to add their strange, shrill , left-wing voices to the existing right-wing clamor against teaching about evolution and sex.
Institutionalized sexism: You thought I was oblivious to such things after reading the preceding paragraph, didn't you? But there are times when such lefty-sounding accusations are unavoidable, and that is the way many doctors now feel about reports that from the 1950s to 1970s about half of pediatric endocrinologists offered estrogen treatments to girls who were expected to grow to over six feet in height. That's right, they treated height (in women) like an illness. According to an Associated Press report, the use of estrogen for height-prevention tapered off as fashions changed and six-foot supermodels became a popular ideal. Before that shift, though, the eugenics-like practice of preventing tall women may have robbed us of a generation of glorious amazons.
Monarchists: Politics interacted with unscientific health claims long before the present day. Marc Bloch's 1924 book The Royal Touch recounts the seventeenth-century belief that English kings had the magical ability to heal scrofula (an infection of the skin of the neck) and other illnesses. It's a reminder of how closely related human beings' belief in authority and the supernatural are. Whether politicians are still held in high enough regard to make this scam workable today is doubtful, but I wouldn't be surprised if Hollywood celebrities were able to convince legions of adoring fans that they have miraculous healing powers (they certainly have the power to influence public health debates).
What constitutes a legitimate public health priority cannot be determined solely through scientific calculations, since our preferences determine what will be considered a problem or a benefit. Still, sorting out those preferences would be an easier and more rational process if we weren't misled by propaganda and superstition.
