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Tuesday Dec 19, 2017

Words Matter: Support Science, Evidence

Evidence-based.
Science-based.
Diversity.
Entitlement.
Fetus.
Transgender.
Vulnerable.

When that news broke this past weekend, it shocked doctors, scientists and champions of public health. The CDC is supposed to be a nonpartisan agency that is centered on saving lives through evidence-based health promotion.

Following public outcry, HHS has tried to downplay the list, which some insiders are characterizing not as a "ban" but rather a recommendation intended to make it easier for the agency to win budget approval in a Republican-controlled Congress.(www.nytimes.com)  

However, the message to CDC officials is that the agency's $7 billion discretionary budget is at risk. The administration has already threatened to make dramatic cuts to the agency's budget; this suggested self-censorship will likely lead to intimidation surrounding the aforementioned topics when the CDC makes future budget appeals.

Dismissing the seven selected words is shortsighted, and it reveals deep-rooted biases against vulnerable populations, programs such as Medicare and Medicaid, and people who are transgender. The move could put many important CDC efforts under siege. For example, the CDC has been working to prevent targeted violence, suicide and HIV infections in transgender communities.(www.cdc.gov)

The agency also has highlighted a range of health disparities among low-income, minority and diverse populations, and made recommendations to prevent diabetes(www.cdc.gov) and cancer(www.cdc.gov) and to curb tobacco use(www.cdc.gov) in these populations.

Furthermore, the CDC has been instrumental in preventing the spread of Zika to pregnant women and their fetuses.(www.cdc.gov) How will the agency tackle future maternal health initiatives if it is prevented from using medically accurate terminology?

Finally, the ban -- or recommendation -- is indicative of the ongoing War on Science.(www.ucsusa.org) Rather than using the terms "science-based" or "evidence-based," officials reportedly have been directed to say the "CDC bases its recommendations on science in consideration with community standards and wishes."

No. We can't craft prudent public health guidelines based on wishes.

This shift away from evidence-based public health policy is a threat to all Americans. The anti-vaccine movement is getting louder.(www.chicagotribune.com) The homeopathy industry is growing and making billions.(www.vox.com) Alternative treatments for cancer are increasing patients' risk of death.(www.cancer.gov) Climate change deniers are influencing public policy.(www.huffingtonpost.com)  

There are hucksters and charlatans around every corner, preying on patients. Our best weapons against this are evidence, science and the truth, but this administration has made repeated attempts to convolute evidence and muddy the scientific waters, leading to confusion among the public.

So, what can we do? Physicians need to continue to be clear and objective. We should use our platform and position to educate the public. We should encourage our professional organizations to support evidence-based guidelines. And we should tell this administration to stop politicizing science.

Natasha Bhuyan, M.D., is a board-certified physician in Phoenix. You can follow her on Twitter @NatashaBhuyan.(twitter.com)  

Posted at 02:52PM Dec 19, 2017 by Natasha Bhuyan, M.D.

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