Three years ago, I was invited to testify before the New York City Board of Health about a proposed law to cap the portion size of sugary drinks served in restaurants. This request didn’t come as a surprise. After all, I had published several well-cited articles linking these beverages to childhood obesity. What did catch me off guard was my reaction: I was horrified at the thought of taking a public position for or against. I was reminded of that reaction when I read Andrew J. Hoffman’s recent essay on how academics need to communicate with the public on a wide range of public-policy issues.
In my field, public health and nutrition, as in many other fields of science, presentations tend to be rich with data and discussions of limitations and caveats, almost always closing with the phrase \”more research is needed.\” Testifying before the board of health, I would have no such options. Rather I would have five minutes to stake out a clear position. Yes, I believed, as did virtually all of my colleagues, that sugary drinks threatened people’s health, but was my belief sufficient to justify this policy action? Were a handful of longitudinal studies and two randomized control trials enough evidence?
To the layman, such concerns may seem laughable, but for me they were very real, part and parcel of the culture of academic research. We researchers aspire to be truth-finders, both objective and neutral. We often wrestle with what I call the \”high degree of proof\” syndrome, the belief that anything less than rock-solid evidence (which, for many, means nothing less than many large randomized control trials all producing the same results) is insufficient to justify public action.
And, perhaps most important, we fear being wrong. When company reps, government officials, or hired lobbyists issue statements on behalf of their constituencies, what matters is their capacity to get their position across. Their primary goal is not to expand the world’s store of knowledge and speak to the state of science.
To be sure, being wrong is no small thing, as history shows. To name just two examples, nutrition scientists used to recommend margarine over butter in the 1970s, and hormone replacement therapy was routinely prescribed to postmenopausal women in the 1990s, reflecting a belief that a gain in reducing the risk of hip fracture and heart disease outweighed the risks of the therapy itself. Scientists deliberated on the best available evidence at the time to make these recommendations, but newer, more definitive studies reversed the state of science—and the standard practice—decades later.
Unfortunately, these recommendations may have resulted in more heart attacks, strokes, and occurrences of breast cancer (in the case of hormone replacement) among those who followed these guidelines. And the perceptions among the public often linger long after the science has been updated.
Should researchers have remained silent on these issues? Should they have publicly opposed recommendations not supported by perfect evidence? Here’s the problem with answering yes: If we wait for perfect evidence, we will wait forever. Perfect evidence is Santa Claus: (spoiler alert) It does not exist.
What we do often have is good-enough evidence—evidence that, if shared, stands a strong chance of making a positive difference. When we absent ourselves from the public stage, we too often cede the conversation to those with the loudest voices or deepest pockets. For example, the beverage industry spent more than $10-million to persuade voters in Berkeley and San Francisco to vote against a tax on sugary drinks last November.
In staying silent, we also pave the way for more celebrities like Jenny McCarthy, people with megaphones to spread sensational misinformation that may have deadly consequences—consequences that are now all too apparent in the recent outbreak of measles, a disease believed to be eradicated as recently as 2000. We pave the way for a world where, in the words of Yeats, \”the best lack all conviction, while the worst are full of passionate intensity.\”
Yes, speaking out carries risks, but staying silent in the public discourse may be even riskier. It was with this in mind that I took a deep breath and decided to step out of my comfort zone and voice my support for the proposed portion-size limitations on soda. I didn’t say this was the silver bullet that would solve the obesity epidemic for us, because it isn’t, but I believed this was one step in the right direction.
And you know what? It wasn’t nearly as daunting as I’d feared it would be. I also found myself in good company with several other academic types there, citing relevant data to voice their support or push back. Nobody focused on the gaps in my statement—they were focused on what I did say.
To step into the spotlight and make a case for or against a public policy takes courage and deep reflection as a scientist, but we can’t simply opt out. We won’t always be successful (indeed, the law I went to bat for was ultimately struck down, not because of the scientific evidence but for legal reasons), but we can do our part. When we withhold our perspectives, we risk depriving the public of the best available information. Speaking out is not only our right, it is also our responsibility.
Author Bio: Y. Claire Wang is an associate professor and co-director of the Obesity Prevention Initiative in the Mailman School of Public Health at Columbia University.