A Force for Greatness: Science Policy Links for the Week of April 16-22, 2017

Given how much the past few months have been largely about “eating the seed” corn by threatening to pillage the nation’s scientific capabilities, this week was comparably more uplifted. Having reached a tipping point with the rhetoric of the current president, scientists and science advocacy organizations started planning a “March for Science” back in late January. It started small, but absorbed many organizations who signed on over time and yesterday it was revealed as a world-wide force for educating a world where the rise of ignorance has never seemed more breakneck. This week’s science policy news links are a mix of the uplifting (scenes from the many “Marches for Science” across the globe) and the cautionary (fake science organizations still abound).

  • PHOTOS: Scientists Take To Washington To Stress A Nonpartisan Agenda“. Meredith Rizzo. National Public Radio.  Comments: a few scenes from a very geographically diverse effort to highlight the importance of science to humanity. These appear to be only from the march in Washington D.C.
  • Remarks“. James Beacham. March for Science, Geneva. Comments: My colleague’s, James Beacham’s, opening remarks to participants at the Geneva March for Science (recorded by my student, Matthew Feickert). A good look into why one scientist chose to march. James was an organizer of this satellite march.
  • The Universe in a Box“. Claire Lee. TEDxKlagenfurt. Comments: Claire is a colleague of mine and at yesterday’s “March for Science – Geneva” in Switzerland she gave a short version of this lovely talk on what we know about the universe, how we represent it with creative aids, and how that relates to all we do not know. I link the original TEDx talk because I don’t have video of the one from yesterday’s march.
  • Intelligent Design Advocates Are Angry They’re Not “Partners” in the March For Science“. By Hermant Mehta. Patheos Blog. April 21, 2017. Comments: A leading fake science organization, The Discovery Institute (DI), laments being excluded from having a prominent role in the “March for Science.” But the reason is simple. Science is not a democracy – it’s the tyranny of facts and evidence. And the facts and evidence have been clear for over a century: biological diversity in the natural world is the result of evolution by means of natural selection. The DI actively works to undermine that evidence, not by conducting research (what scholarship they have on record is poor, and mostly just criticism, commentary, poor math, and historical misrepresentation), but by using the US legal system to try to inject their specific conservative Christian-based creationist ideology into science classrooms. Shame on them for lamenting they were excluded from organizing a March for Science when they themselves are a force that actively undermines science; cheers to the actual organizers for standing firm against this nonsense. I applaud mature and reasoned religious organizations that accept the scientific evidence about the natural world without seeing it as a threat to their beliefs. The DI is, sadly, not one of those. Science is a shield against dangerous nonsense, and the DI is institutional dangerous nonsense that seeks to undermine the very foundation of modern medicine.
  • Victory in Texas“. Glenn Branch. National Center for Science Education. Comments: This past week, the Texas State Board of Education, which notoriously either ignores expertise for science education recommendations, toys with including religious or watered-down guidance for public school science teachers, or even admits anti-science into the discussion of science standards, took a positive step forward this week. After considering changes to the science education standards, they adopted a slate of changes that removed language from the standards that had opened the door to using religious arguments to counter scientific ones in the science classroom. This is a big step for Texas. While there are no guarantees the next SBOE won’t undo some of this good, it was heartening in this era to see a group of elected representatives walk back from the educational abyss.

A big thing is coming up in the week ahead looms large over science in the United States:

  • The current federal spending legislation for FY17 expires at midnight on April 28. If the Congress fails to act to extend the legislation, the government shuts down. This means any active program that relies on federal funding also shuts down, such as operations in Antarctica or the national laboratories that are crown jewels in the treasure chest of U.S. science. Write your Congressperson(s) and ask them to act to support science while keeping the country operating through the rest of the year. 

Bad science reporting on Mayo Clinic Proceedings “Prescription Drug Use” paper

CBS demonstrates the inability to even read the abstract of a scientific paper when reporting on prescription drug use.
CBS demonstrates the inability to even read the abstract of a scientific paper when reporting on prescription drug use.

I saw on Facebook today some repeats of a CBS article from Atlanta entitled “Study: 70 Percent Of Americans On Prescription Drugs” [1]. The news article cites this actual scientific article from the Mayo Clinic’s “Mayo Clinic Proceedings,” entitled “Age and Sex Patterns of Drug Prescribing in a Defined American Population” [2].

The CBS article claims right in the first paragraph of their story that

“Researchers find that nearly 70 percent of Americans are on at least one prescription drug, and more than half receive at least two prescriptions.” [1]

This is demonstrably a false statement, as reading the abstract of the paper will tell you:

“Objective: To describe the age and sex patterns of drug prescribing in Olmsted County, Minnesota.” [2]

So, the authors say NOTHING of how many generic Americans are taking at least 1 prescription drug. Later on, at the very end of the paper they note that

“In general, drug-prescribing patterns in this population are consistent with those in previous population-based studies in the United States . . . Our findings cannot be compared directly with findings from these previous studies because of differences in methods (weekly or monthly use vs annual use and data derived from drug prescriptions vs self-reports, pharmacy records, or insurance claims).” [2]

but that is about the grandest statement they make. They don’t note that the data is anomalous with expectations based on drugs prescribed to certain age classes, etc. They report this as data-gathering to help inform healthcare system studies, but they don’t consider these numbers representative of “abuse.”

The CBS article also makes the outcomes of the study sound horrible by using the weasel word, “prescription drug,” but when you read the data breakdown in the paper the numbers actually make a lot of sense and, if anything, reflect the current trend toward obesity in the United States (in other words, then negative connotations of the paper are more aligned with a known underlying health problem in the U.S. whose symptoms can be treated with a range of prescription drugs).

Taking all age groups together:

  • 26% are taking an antibiotic or erythromycin of some kind – not a surprise, since bacterial infections are common and this is how they are treated.
  • 11% are taking vaccines of some kind. That’s great news!
  • 10% are taking anti-asthmatics – again, not a surprise, since asthma affects an estimated 7% of the U.S. population and anti-asthmatics can be used to treat other related diseases [3]. So these numbers are in-line with the affected population.
  • 9% are taking anti-infective/anti-inflammatory drugs – that’s good. Preventing inflammation and infection are not bad things, and thank goodness we have drugs to help control these issues.
  • 6% are taking drugs (throat and nasal agents) that would be used to treat symptoms or complications associated with nose, chest, or throat infections (e.g. flu, severe cold, etc.). No surprise there. For instance, the percentage of people that get the flu each year varies between 6-20% [4].
  • 14% are taking drugs for digestive reasons (laxative, etc.).
  • 7% are taking diuretics, which are used in the treatment of heart, kidney, and other problems – the most heavily using sub-population of these was people over 50 . . . so not a surprise, because that’s when heart, liver, and kidney problems begin to crop up.

A few other categories had 5% or fewer usage, but they are all explainable for a variety of diseases that are common in sub-populations.

The ones to watch out for are the fraction on medications intended to treat blood pressure or heart issues, or depression:

  • 11% take anti-lipemic agents, chemicals designed to lower cholesterol
  • 7% take beta-blockers and 7% take ACE inhibitors, which help treat heart and blood pressure issues
  • 13% take anti-depressents
  • 12% take opioid analgesics, which can be habit-forming (which is why they are given on prescription, of course)

Let’s consider the 11% who take anti-cholesterol drugs and the 14% that take a drug intended to treat the heart in some way. About 1/3 of the U.S. adult population is obese [5], and obesity raises your risk factors for heart and cholesterol-related problems (I myself have struggled with high blood pressure, which is very well-controlled by keeping my BMI below 30 . . . but that is just me, and should not be mistaken for the actual copious medical evidence that obesity increases significantly all the risks to your heart and lungs). So it’s not a huge surprise that a non-trivial fraction of the population takes drugs to control problems associated with one of the largest health issues facing our nation. If anything, it’s worth focusing on the obesity issue and less on the drugs issue, which is more a symptom than a cause.

The other concerning issue is the number of people taking anti-depressents, but . . . again . . . taking anti-depressants is a response to the underlying cause:

An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. [6]

We’ve gotten better at identifying how behaviors are related to the chemistry of the mind, and especially to depression and related classes of mental state. Right now, effective treatments for many people involve drugs. Perhaps, in the future, we’ll find other ways to control depression, but the reality is that now we have classes of drugs that can have positive effects on people fighting with depression.

All of the numbers simply reflect the fact that we know how to treat a lot of disease classes using drugs, and so drugs get prescribed. Keep in mind, again, that CBS blew their reporting on this article in the first line of their story, when they said it applied to all Americans. Wrong. Just wrong.

[1] http://atlanta.cbslocal.com/2013/06/19/study-70-percent-of-americans-on-prescription-drugs-one-fifth-take-5-or-more/

[2] http://www.mayoclinicproceedings.org/webfiles/images/journals/jmcp/jmcp_ft88_7_2.pdf

[3] Fanta CH (March 2009). “Asthma”. New England Journal of Medicine 360 (10): 1002–14. doi:10.1056/NEJMra0804579PMID 19264689

[4] http://www.webmd.com/cold-and-flu/flu-statistics

[5] http://www.cdc.gov/obesity/data/adult.html

[6] http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml#Intro