Understanding Heath Information-Health

The first and perhaps most difficult challenge for consumers is to make sense out of the health information explosion. Many popular magazines regularly print health articles, newspapers often devote entire sections to medicine, the publications of health newsletters abound, television programs feature numerous health stories, and a plethora of scientific health-related studies are published daily. There are an estimated 20,000 scientific, technical, and medical articles published each year worldwide and this does not include the larger number of nontechnical articles. Interest in health information appears to have reached an all-time high.

The availability of so much health information has drawbacks; the major drawback is that so much of the information is confusing, sometimes even contradictory . Even medical experts have trouble separating fact from fiction. It is not unusual to see some new finding headlined one day and completely refuted the next. It has been speculated that as much as 50% of the medical advice we follow today will be considered obsolete, or at least will undergo major modification, during the next 5 years. For some people the ubiquity of refutations and contradictions leads to an attitude sometimes referred to as health fatalism, which maintains that nothing can be believed. People with a fatalistic view disregard health information because they believe that new findings will inevitably disagree with facts previously accepted as true.

Several examples illustrate this point. Sodium has long been associated with cardiovascular disease. In 1995, however, researchers found that men and women who consumed less sodium had more heart attacks. This finding made headlines in the popular press. Reactions were swift and strong. Hypertension patients who agonized over bland, low-salt diets for years threw up their hands in disbelief and despair. Reducing sodium intake was no longer a good idea, to the contrary it increased the risk of early death. It should be of little surprise therefore that countless numbers of people felt deceived and misled. The resultant fatalistic view toward health care and medical advice was understandable. What the headlines didn't say is that the people adversely affected by low sodium intake were hypertension patients taking drugs to lower blood pressure. In other words the results were based on a very specific population group that didn't represent the population at large or even mainstream hypertension patients. Also it was undetermined whether the study population engaged in other behaviors (cigarette smoking, sedentary lifestyles, etc.) that might be more responsible than sodium for heart disease.

Hot dogs are another good example. Researchers found that children who eat more than a dozen hot dogs a month had nine times the normal risk of childhood leukemia. This was the featured headline in a nationwide television news show broadcast during prime time. Public reaction bordered on the hysterical. Scared parents overreacted partly because of irresponsible practices in television journalism and partly because they didn't demand all the facts. They believed the story was completely true simply because it was reported in the news. In the big picture of leukemia research, this was just one very preliminary study that had some serious shortcomings. For instance, the results were based on crude dietary histories. Also, researchers could not determine whether it was the hot dogs or something else that hot dog eaters do or eat that might increase the risk of leukemia. If there is a cause-and-effect relationship between hot dogs and leukemia, it will take larger, more sophisticated studies to prove it.

The point of these examples is that an appropriate approach to health information is to adopt a skeptical and suspicious attitude, especially toward extreme and sensational health claims. The First Amendment to the US Constitution, which guarantees freedom of the press, also guarantees Americans the right to publish health-related hogwash. The more you read, generally the more conflicts and contradictions you will uncover. This should not make you feel uncomfortable but, to the contrary, make you realize that medicine is still as much art as science.

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