Quotulatiousness

January 18, 2012

First they came for the smokers, then the drinkers, and now the meat-eaters

Filed under: Britain, Government, Health, Liberty — Tags: , , , — Nicholas @ 10:52

Rob Lyons on the flimsy case for declaring that “eating meat causes cancer”, and the rising tide of buttinsky government and their nudge, hector, prod, and persecute urges:

Meat causes cancer. It’s been said so many times that you’d have to be an idiot not to believe it, right?

The latest confirmation of this apparent common sense was a report published last week in the British Journal of Cancer Research. The authors, from the Karolinska Institute in Sweden, brought together 11 studies — published between 1993 and 2011 — that assessed the risk of pancreatic cancer from eating red meat and ‘processed’ meat. From this meta-analysis, the authors found that red meat increased the risk of pancreatic cancer for men, but not for women, and that the risk of pancreatic cancer rose by 19 per cent for every 50 grams of processed meat consumed.

The simple claim that ‘processed meat causes cancer’ was widely reported after the study was published. However, it would be wrong to assume that such claims about risk are all they are cracked up to be.

[. . .]

There are so many ways in which the crude tools of epidemiology could screw up the result of studies like this that it is normal for fairly small risks — like the 19 per cent increase in this case — to be treated with a massive pinch of salt. The authors of this study even note: ‘All studies controlled for age and smoking, but only a few studies adjusted for other potential confounders such as body mass index and history of diabetes.’

[. . .]

So, to sum up: the association between processed meat and pancreatic cancer is so weak it might well be a mirage; the increased risk might not be caused by the processed meat itself; and even if it is, the risk is so low that it’s really not worth bothering about. Yet still we are advised to consider cutting down on our red meat and processed meat consumption. Life is, frankly, too short to miss out on such tasty foods on the slim chance that we might lose a few years of life in old age.

[. . .]

Now that the precedent has been set for the government to lambast those who engage in unapproved habits, it’s open season on any habit that a campaigner or columnist disapproves of. Ban it! Tax it! Make them get a prescription for it! Deny them medical care! Ellen’s article is objectionable but it only follows the remorseless logic of so many others.

There is another lesson from the meat-and-cancer story: at a time when all sorts of dubious claims are made based on junk science and dodgy statistics, only some panics get wide publicity; others just pop up and disappear again in a matter of hours. The difference is that some play to an existing political or media agenda and some do not. The idea that meat causes cancer appeals to health busybodies, politicians scrabbling around for a sense of purpose, vegetarians who can’t win a moral argument about animal rights, and environmentalists who have failed to convince us that increasing the ‘human footprint’ — by wanting to eat more meat, for example — is killing the planet.

January 17, 2012

To help kids stay healthier, don’t be a clean fanatic

Filed under: Health, Science — Tags: , , , — Nicholas @ 12:08

I’ve suspected for quite a while that the “epidemic” of food allergies and other ailments among today’s children was related to the extremely hygienic conditions of modern homes (that is, kids’ immune systems were insufficiently stressed by exposure to germs, which meant higher risk of immune system over-reaction later in life). I’m not a scientist, so my suspicion was just based on less-than-statistically valid observation of my son and his friends while they were growing up — the kids with the most sterile home environments did seem more likely to have serious allergy issues come up later.

I could have been on the right track, after all:

I do wonder, however, whether we’re all becoming a bit too paranoid about germs. I include my own family in this group. Once we left the doctors’ office, for example, my wife and I encouraged our children to use a hand sanitizer. When our kids were toddlers our house had alcohol wipes and Purell vials all over the place. But is all this washing and disinfecting really necessary? Is it proactive prevention? Or overly paranoid fear?

That, at least, is the thinking behind the “hygiene hypothesis,” a school of thought first proposed by David P. Strachan in 1989, and now experiencing a resurgence that’s probably a response to society’s mania for cleanliness. Strachan’s original study sought to explain why British kids with greater numbers of older siblings had fewer incidences of hay fever, speculating that perhaps it could be the fact kids with lots of older siblings tend to be exposed to greater numbers of germs. While it was greeted with skepticism early on, Strachan’s theory has since been confirmed. In fact, in the decades since, greater exposure to germs early in life has also been associated in epidemiological studies with lower levels of asthma, some allergies and even such autoimmune diseases as type-1 diabetes and multiple sclerosis.

[. . .]

“These data support the idea that the greater diversity of microbial exposure among children who live on farms is associated with the protection from the development of asthma,” study researchers reported, speculating that microbial exposure may encourage development of immune system cells that in turn suppress the production of the sort of immune-system cells that trigger asthmatic reactions. Researchers’ next hope to determine which microbes are most responsible for preventing asthma — and that, perhaps, may lead to new therapies, such as targeted microbe exposures, for the dreaded respiratory malady.

More broadly, the study is a reminder that humans have been living and fighting off germs for tens of thousands of years. Particularly when we’re young, germs serve an important purpose for the development of the immune system. By depriving our children of exposure to germs, we may be depriving them the benefits of a process the human body has evolved over aeons, a process that helps to create healthy and allergy-free adults.

January 15, 2012

As you’d expect, healthcare costs are not evenly distributed

Filed under: Economics, Health, USA — Tags: , , , — Nicholas @ 12:20

Jordan Weissmann in The Atlantic:

When it comes to America’s spiraling health care costs, the country’s problems begin with the 5%. In 2008 and 2009, 5% of Americans were responsible for nearly half of the country’s medical spending.

Of course, health care has its own 1% crisis. In 2009, the top 1% of patients accounted for 21.8% of expenditures.

The figures are from a new study by the Department of Health and Human Services, which examined how different U.S. demographics contributed to medical costs. It looked at the $1.26 trillion spent by civilian, non-institutionalized Americans each year on health care.

The top 5% of spenders paid an annual average of $35,829 in doctors’ bills. By comparison, the bottom half paid an average $232 and made up about 3% of total costs.

January 11, 2012

An unlikely source of healthcare innovation: Singapore

Filed under: Asia, Economics, Health — Tags: , — Nicholas @ 00:10

In a post from a few years ago, Bryan Caplan sings the praises of the very different approach to public healthcare practiced in Singapore:

In The Undercover Economist, Tim Harford highly praised the health care policies of Singapore. But it wasn’t until I read the section on health care in Ghesquiere’s Singapore’s Success that I realized how amazing the official numbers are. If the following is true, all the comparisons showing that the U.S. greatly outspends Europe without getting better health are beside the point, because Singapore makes Europe look like the U.S.:

    The Singapore government spent only 1.3 percent of GDP on healthcare in 2002, whereas the combined public and private expenditure on healthcare amounted to a low 4.3 percent of GDP. By contrast, the United States spent 14.6 percent of its GDP on healthcare that year, up from 7 percent in 1970… Yet, indicators such as infant mortality rates or years of average healthy life expectancy are slightly more favorable in Singapore than in the United States… It is true that such indicators are also related to the overall living environment and not only to healthcare spending. Nonetheless, international experts rank Singapore’s healthcare system among the most successful in the world in terms of cost-effectiveness and community health results.

How does Singapore do it? Singapore is no libertarian health care paradise, but it does self-consciously try to maintain good incentives by narrowly tailoring its departures from laissez-faire:

    The price mechanism and keen attention to incentives facing individuals are relied upon to discourage excessive consumption and to keep waste and costs in check by requiring co-payment by users.

    […]

    The state recovers 20-100 percent of its public healthcare outlay through user fees. A patient in a government hospital who chooses the open ward is subsidized by the government at 80 percent. Better-off patients choose more comfortable wards with lower or no government subsidy, in a self-administered means test.

I’ve heard a lot of smart people warn that co-payments are penny-wise but pound-foolish, because people cut back on high-benefit preventive care. Unless someone is willing to dispute Singapore’s budgetary and health data, it looks like we’ve got strong counter-evidence to this view: Either Singaporeans don’t skimp on preventive care when you raise the price, or preventive care isn’t all it’s cracked up to be.

August 17, 2011

Maclean’s on transgendered teens

Filed under: Cancon, Health — Tags: , , , , — Nicholas @ 12:19

Maclean’s covers a controversial topic:

Treatment of GID is highly controversial. Some experts believe that the best way to help children and teens is to convince them to accept their bodies and not undergo the therapies that will cause dramatic physical changes. Cormac, however, lives in Vancouver, where pediatric endocrinologist Dr. Daniel Metzger and the B.C. Transgender Care Group are based. The loosely organized group, of which Metzger is a member, is the sole provider of care for transgender youth in B.C. and offers the most extensive suite of medical services for GID adolescents in Canada. Metzger believes that the best course of treatment for teenagers diagnosed with GID is hormone therapy: either blockers to stop puberty or, if post-pubescent, hormones that physically alter the body in a way that reflects their chosen gender. For some teens like Cormac, who are confident, psychologically stable and have family support, this transformation can be complemented further with cosmetic surgery.

Without treatment, Metzger argues, the path to adulthood for GID teens can be torturous, as evidenced by shockingly high suicide rates: 45 per cent for those aged 18-44, in comparison to the national average of 1.6 per cent, according to the U.S. 2010 National Transgender Discrimination Survey Report on Health and Health Care. Cormac carefully considers what life would be like today if he were still Amber. He pauses for a few seconds then gravely announces, “I think that would push me to be suicidal.” He is much more calm now, he says, free from his obsession with wanting to be a boy. “Before I transitioned I thought about it a lot, like, every minute. Now, I feel like I have so much extra brain space,” says Cormac, who is an honour roll student.

June 3, 2011

QotD: New York City, the capital city of Nanny State

Filed under: Bureaucracy, Food, Government, Quotations, USA — Tags: , , , , — Nicholas @ 11:49

The lowest blow in City Hall’s war on wicked food is its recurring efforts to ban the buying of fizzy pop with food stamps. In an initiative that could easily be titled ‘No Coke for poor black folk’, the Bloombergers have sought federal permission to prevent welfare recipients from using government cash to purchase fizzy drinks. The killjoyism of this campaign, the Scrooge-infused miserabilism of it, is astounding. City Hall has launched an advertising campaign demonising sugary drinks as one of the great evils of our time, and its internal email correspondence about the campaign, which was leaked to the New York Times, shines a rather harsh light on the evidence-lite nastiness of the modern-day nudge-and-nanny industry. Scientific advisers emailed Thomas Farley, Bloomberg’s overactive health adviser, to say that the ad’s claim that drinking pop can make you gain 10 or 15 pounds is ‘simplistic’ and ‘exaggerated’. Overriding them, Farley responded: ‘I think what people fear is getting fat, so we need some statement about what is bad about consuming so many calories.’ Who needs evidence when you have fear? The ad shows human fat gurgling from the top of a can of soda. One City Hall employee could barely conceal his excitement: it is ‘deliciously disgusting’, he said in one of the emails that was leaked.

‘Deliciously disgusting’ — that just about sums up how New York’s new rulers view the huddled masses of this extravagant city. In a complete reversal of the traditional democratic relationship, Bloomberg and co don’t consider it their duty to mirror the desires and outlook of those who elected them. They want to remake New Yorkers as models of what they consider to be healthy citizenship. Much of this stuff comes from Thomas Farley, who is championed by both Bloomberg and the liberal media as an admirably thin jogging aficionado who believes in the power of the nudge to remould the citizenry. He is a ‘superman’, the New York Times recently gushed, who has ‘grasshopper-like legs’ (eurgh), a result of the fact that ‘he exercises seven days a week, loves his vegetables and has never smoked a cigarette’ (boring). This fanboy fluff piece was illustrated with a picture of Farley leading a workout of not-so-thin black New Yorkers, his grasshopper-like legs just as sure a sign of his superiority as his white skin would have been 100 years ago.

Brendan O’Neill, “The men who killed New York”, The Spectator, 2011-06-04

March 15, 2011

“Obesity crusaders” use “inherently flawed instruments, such as BMI and apple-body shapes, to misinform the public”

Filed under: Government, Health, Media — Tags: , , , — Nicholas @ 12:50

Patrick Basham and John Luik address the manifest failings of the public health crusade against obesity:

Since the anti-obesity campaign is allegedly motivated by scientific findings, it would seem reasonable and prudent to make doubly sure that those claims are factual and trustworthy. Yet, we continue to find that the case against obesity is significantly flawed. Not only are the claims of an obesity epidemic often wildly exaggerated, but the science linking weight to unfavourable mortality outcomes is also frequently nonexistent or distorted.

[. . .]

As Danesh suggests, other researchers have suggested concentrating on a measurement of the waist alone, while many cling to BMI, which calculates obesity based upon a weight-to-height ratio. Because of its easy applicability, BMI is universally used in officially defining obesity, despite its manifest shortcomings. The BMI is wholly arbitrary and has no scientifically valid connection with mortality.

“Obesity crusaders” are what we call the individuals who manufactured the obesity-epidemic story in the first place and continue, through application of inherently flawed instruments, such as BMI and apple-body shapes, to misinform the public. They are a relatively small group of public-health officials in the US, the UK, the EU, and the World Health Organisation, assorted academics (very many with close ties to the weight-loss and pharmaceutical industry), the International Obesity Task Force, and a collection of so-called public-interest science groups.

How are these obesity crusaders reacting to the unambiguously good news published in The Lancet? Surely, they rejoice at the fact there is one less thing for a health-conscious population to fret over? No, they are not in celebratory mood. Quite the contrary. The obesity crusaders did not waste any time on the New Good News; after all, the Old-Time Religion continues to serve them so well.

It gets worse for the “fat=early death” meme:

There is little credible scientific evidence that supports the claims that being overweight or obese leads to an early death. For example, Katherine Flegal of the Centers for Disease Control and Prevention found that in the US population there were more premature deaths among those who are normal weight than those who are overweight. Indeed, in this study, Americans who were overweight were those most likely to live the longest.

In the American Journal of Public Health, Jerome Gronniger found that men in the “normal” weight category exhibited a mortality rate as high as that of men in the moderately obese category; men in the “overweight” category clearly had the lowest mortality risk.

January 29, 2011

Bad news for US small businesses

Filed under: Bureaucracy, Government, Law, USA — Tags: , , — Nicholas @ 11:32

A very small item in the recent US Obamacare legislation will mean a huge increase in tax compliance paperwork:

Section 9006 of the health care bill — just a few lines buried in the 2,409-page document — mandates that beginning in 2012 all companies will have to issue 1099 tax forms not just to contract workers but to any individual or corporation from which they buy more than $600 in goods or services in a tax year.

[. . .]

But under the new rules, if a freelance designer buys a new iMac from the Apple Store, they’ll have to send Apple a 1099. A laundromat that buys soap each week from a local distributor will have to send the supplier a 1099 at the end of the year tallying up their purchases.

The bill makes two key changes to how 1099s are used. First, it expands their scope by using them to track payments not only for services but also for tangible goods. Plus, it requires that 1099s be issued not just to individuals, but also to corporations.

Taken together, the two seemingly small changes will require millions of additional forms to be sent out.

“It’s a pretty heavy administrative burden,” particularly for small businesses without large in-house accounting staffs, says Bill Rys, tax counsel for the National Federation of Independent Businesses.

Eliminating the goods exemption could launch an avalanche of paperwork, he says: “If you cater a lunch for other businesses every Wednesday, say, that’s a lot of information to keep track of throughout the year.”

For a one-person business, this change could double or triple the tax-related paperwork right there. Given that a lot of people have started new businesses in the last couple of years — partly because big businesses downsized and haven’t been hiring again — this will be a significant discouragement to self-employment.

H/T to Virginia Postrel for the link.

Update: It may not stand: there’s a bi-partisan coalition in the Senate to repeal that provision.

January 7, 2011

How not to handle public health issues like influenza

Filed under: Bureaucracy, Health, Media — Tags: , , , , , — Nicholas @ 09:38

I was astonished to hear a radio reporter yesterday admit that much of the reason for the drop in people getting flu shots is the massively overblown oh-my-god-we’re-all-going-to-die media panic last year over Swine flu H1N1. In case you somehow managed to miss out on it last year, every news broadcast seemed to feature yet another doctor or public health official telling us that we faced a worldwide pandemic of H1N1 which was the invincible, all-conquering Überflu to top all plagues we’d ever faced before. Death tolls in the millions were confidently predicted. Every individual who died seemed to be mentioned personally . . . because there were so relatively few compared to those poor folks who died of “ordinary” seasonal flu.

Lorne Gunter gives a bit of credit where it’s due:

Give Allison McGeer credit for being frank about what’s behind this winter’s flu outbreak in Ontario: unnecessary panic over last year’s swine flu “pandemic.” Dr. McGeer, head of infection control at Toronto’s Mount Sinai Hospital, says flu cases are way up this season because vaccinations are way down; and vaccinations are way down, likely, because too much was made of the swine flu by media and officialdom last winter.

It is a medical case of the doctors who cried wolf, in other words.

[. . .]

There is a fine line between erring on the side of caution and crying wolf. And last year, the UN’s World Health Organization (WHO) blew through that barrier with abandon.

Just as it had on SARS and bird flu and the Ebola virus, the WHO overreacted to swine flu, issuing cautions that were out of all proportion to the risk the disease posed to the public. (Remember in 2003 when the WHO recommended people from around the world stay away from Toronto because the city was host to a few hundred SARS infections?)

But unlike those earlier panics, the WHO pulled out every stop on swine flu. It was as if the UN agency had been surprised that its earlier scares had failed to grow into full-blown pandemics; and so they figured that, finally, swine flu was due to become a worldwide infection requiring a dramatic response from international health officials.

As I wrote last year in May, when even the most panic-stricken media outlets were no longer playing the JuggernautOfDoom theme:

This would have been a good opportunity for de-escalating the panic mongering (and perhaps even attempting to rein-in the media, who were equally to blame for the tone of the information getting to the public). They chose, instead, to actively hide the fact that H1N1 cases were running below the level of ordinary seasonal flu cases (total H1N1 deaths: approximately 18,000 — typical annual death toll from seasonal flu: 250,000-500,000).

The biggest problem isn’t that they over-reacted this time, it’s that it has reduced their credibility the next time they start issuing health warnings. And that’s a bad thing. Unless they pull the same stunt next time, too. In which case, we may start hearing talk about setting up competing organizations to do the job the current entities appear to have given up on.

July 31, 2010

QotD: Take experts’ advice with a pinch of salt

Filed under: Bureaucracy, Food, Health, Media, Quotations — Tags: , , , , — Nicholas @ 11:41

More and more, the history of dietary guidelines that our public-health authorities promulgate resembles the Woody Allen comedy Sleeper, in which the main character, awaking from a centuries-long slumber, learns that every food we once thought bad for us is actually good, starting with steak and chocolate. But you wouldn’t know that from government experts’ increasing efforts to nudge us into their approved diets. In 2006, New York City passed the nation’s first ban on the use of trans fats by restaurants, and other cities followed suit, though trans fats constitute just 2 percent of Americans’ caloric intake. Now the Bloomberg administration is trying to push food manufacturers nationwide to reduce their use of salt — and the nutrition panel advising the FDA on the new guidelines similarly recommends reducing salt intake to a maximum of 1,500 milligrams daily (down from 2,300 a day previously). Yet Dr. Michael Alderman, a hypertension specialist at Albert Einstein College of Medicine, observed in the New York Times that because sodium is an essential component of our diets, the city’s effort amounts to a giant uncontrolled experiment with the public’s health that could have unintended consequences. And in 2006, Harvard Medical School professor Norman Hollenberg concluded that while some people benefit from reduced salt intake, the evidence “is too inconsistent and generally too small to mandate policy decisions at the community level.”

Steven Malanga, “Egg on Their Faces: Government dietary advice often proves disastrous”, City Journal, 2010-07

May 26, 2010

The pandemic juggernaut of doom . . . that failed to materialize

Filed under: Bureaucracy, Cancon, Health, Media — Tags: , , , , — Nicholas @ 17:07

Lorne Gunter has a good wrap-up of the bone-headed approach of public health officals in Canada to the Swine H1N1 flu “pandemic”:

Good on ordinary Torontonians. Despite all the H1N1/swine flu hype this past winter, just 28.2% of that city’s residents bothered to get vaccinated against the “pandemic;” that’s less than the 35% who usually get shots each year against the seasonal flu.

Even Toronto health care workers couldn’t be stampeded into getting the shots. Only 60% of them bothered.

[. . .]

Even from the start, the World Health Organization and other experts where told this strain of flu was weak and easily defeated. Infection rates never came remotely close to forecasts and death tolls were thankfully much, much lower than for typical seasonal infections.

The trouble, I think, was that so many public health officials have predicted so many pandemics for so long — SARS, bird flu, swine flu — that they simply got caught up in their own warnings and projections. They wouldn’t listen to contrary evidence.

The relevant public health authorities would have served the public interest (and their own credibility for the future) if they’d been much more forthcoming as the early stages of the pandemic showed H1N1 not to be the second coming of the Black Death. Instead, they doubled-down and raised the propaganda bar even higher.

October 27, 2009: Given that regular seasonal flu causes thousands of deaths annually, you’d think it would be good statistical discipline to count the cases of H1N1 separately, both the gauge the severity of the disease and to chart the effectiveness of the vaccination program. Lumping seasonal flu and “flu-like symptoms” together with H1N1 seems a big step backward from normal public health practice.

This would have been a good opportunity for de-escalating the panic mongering (and perhaps even attempting to rein-in the media, who were equally to blame for the tone of the information getting to the public). They chose, instead, to actively hide the fact that H1N1 cases were running below the level of ordinary seasonal flu cases (total H1N1 deaths: approximately 18,000 — typical annual death toll from seasonal flu: 250,000-500,000).

The biggest problem isn’t that they over-reacted this time, it’s that it has reduced their credibility the next time they start issuing health warnings. And that’s a bad thing. Unless they pull the same stunt next time, too. In which case, we may start hearing talk about setting up competing organizations to do the job the current entities appear to have given up on.

February 9, 2010

This week’s silly health panic: third-hand smoke.

Filed under: Environment, Health — Tags: , , , — Nicholas @ 12:48

Don’t worry, anti-smoking campaigners! Even though the evil smoking empire is in retreat, and smokers get worse press than child molesters and people who talk at the theatre, there’s a new moral front opening up: third-hand smoke! The war isn’t over yet:

Lingering residue from tobacco smoke which clings to upholstery, clothing and the skin releases cancer-causing agents, work in PNAS journal shows.

Berkeley scientists in the US ran lab tests and found “substantial levels” of toxins on smoke-exposed material.

They say while banishing smokers to outdoors cuts second-hand smoke, residues will follow them back inside and this “third-hand smoke” may harm.

Efforts are currently underway to determine if there’s a strong media response to this “new threat”. If so, funding will be sought to research the possibility of “fourth-hand smoke” and possibly even “fifth-hand smoke”.

November 11, 2009

The only surprise is that it’d only be 33%

Filed under: Cancon, Economics, Health — Tags: , , — Nicholas @ 08:22

Alison Martin summarizes a survey of Quebec workers which found (among other things) that 33% of men would show up for work even if they or a family member had H1N1:

According to a poll of Quebec workers, many employees in Quebec would still show up for work even if they had the H1N1 flu virus.

Close to one-quarter of respondents to the poll conducted in September 2009 on behalf of the Ordre des conseillers en ressources humaines agréés said that they would still go to work even if they or a member of their household had the H1N1 flu virus. This attitude is even more prevalent among men, with one in three (33%) reporting that they still intended to go to work if they or a relative caught the virus.

Close to 60 per cent of respondents said that they show up for work even when they really aren’t feeling well.

“We’ve already noted that employees in Quebec tend to show up at work even when they’re ill. They don’t seem to be sufficiently aware of the risks of such behaviour, which in the end benefits neither the employee nor the employer, and definitely should be stopped,” explained Florent Francoeur, CHRP, Ordre president and CEO.

The question was clearly worded to elicit the most newsworthy headline: it’d be an odd family if everyone stayed home if even one person in the family was ill . . . and a family with limited long-term employment prospects. Private sector employers tend not to have the same kind of generous sick time provision that public sector employees get, so employees don’t tend to take as much sick time as civil servants.

For many workers, if they don’t show up for work, they don’t get paid. This is especially true at lower income levels, where missing a few days pay can be a severe economic dislocation.

October 27, 2009

Statistical measurements are important

Filed under: Bureaucracy, Health — Tags: , — Nicholas @ 07:52

So why, especially right now, have the US government’s key players in the public health arena stopped counting swine flu cases?

Part of the mystery comes from a federal government in such a tizzy to spread its vaccine and declare “national emergencies” that it doesn’t think it’s necessary to keep counting. Via CBS News:

In late July, the CDC abruptly advised states to stop testing for H1N1 flu, and stopped counting individual cases. The rationale given for the CDC guidance to forego testing and tracking individual cases was: why waste resources testing for H1N1 flu when the government has already confirmed there’s an epidemic?

Given that regular seasonal flu causes thousands of deaths annually, you’d think it would be good statistical discipline to count the cases of H1N1 separately, both the gauge the severity of the disease and to chart the effectiveness of the vaccination program. Lumping seasonal flu and “flu-like symptoms” together with H1N1 seems a big step backward from normal public health practice.

September 8, 2009

John Snow and the start of modern epidemiology

Filed under: Britain, Health — Tags: , , — Nicholas @ 08:52

Another “on this date” entry for you: in 1854, John Snow persuaded the local authorities in a London borough to remove the handle from a water pump at the centre of a cholera outbreak. The move was successful, and the death rate dropped immediately. Randy Alfred has the story:

BroadSt_cholera_map

Physician John Snow convinces a London local council to remove the handle from a pump in Soho. A deadly cholera epidemic in the neighborhood comes to an end immediately, though perhaps serendipitously. Snow maps the outbreak to prove his point . . . and launches modern epidemiology.

The Soho neighborhood was not then filled with galleries, clubs, restaurants and other fine urban diversions. Some of it was an unsanitary slum where centuries-old cesspits sat chockablock with the wells that provided drinking water to a crowded populace.

Asiatic cholera had stricken Britain in successive waves since 1831. Snow, an obstetrician who pioneered the use of anesthesia in Britain, published On the Mode of Communication of Cholera in 1849. His hypothesis (and supporting data) held that the scourge was caused by sewage pollution in drinking water and “always commences with disturbances of the functions of the alimentary canal.”

« Newer Posts

Powered by WordPress