Posts Tagged ‘public health’

“Despised lifestyles are now identified as noncontagious epidemics”

Pierre Lemieux in Cato’s Regulation magazine on the tendency of “public health” to pursue prescriptive moral reform in the guise of regulating health risks:

“In many respects,” writes [Bernard] Turnock, “it is more reasonable to view public health as a movement than as a profession.” “Public health,” the Encyclopedia of Philosophy tells us, “is focused on regulation and public policy.” Public health experts claim a jurisdiction that covers anything related to welfare, little of which consists of genuine public goods. The basic thrust of public health is to remove decisions from the domain of individual choice. For example, public health experts believe that driving is a privilege, not a right, and probably extend this characterization to any activity that they don’t like or for which they think they would easily qualify (like parenting rights).

Slippery slopes mar the whole history of public health…if one wishes softer examples, from the treatment of the insane to Prohibition, to the current harassment of smokers, and to the partial nationalization of “public” places. Despite some reversals, the slope is as slippery as it ever was.

Related, cruel but predictable: HUD plans nationwide ban on letting public housing tenants smoke in their own units [Washington Post]

Medical roundup

  • Surprised this story of interstate lawsuit exposure hasn’t had national coverage: “Texas docs threaten to stop seeing New Mexico patients” [Hobbs, N.M., News]
  • More on the Daraprim episode and the fiasco of FDA generic-drug regulation [Watchdog, earlier here and here] More: Ira Stoll/N.Y. Sun;
  • Warrants, HIPAA be damned: Drug Enforcement Administration agents pose as Texas medical board to get at patient records [Jon Cassidy/Watchdog, Tim Cushing/TechDirt via Radley Balko]
  • Litigation finance and champerty: the reaction is under way [MathBabe, earlier on pelvic and transvaginal mesh surgery speculation]
  • No longer alas a surprise to see JAMA Pediatrics running lame, politicized content on topics like “youth gun carrying” [Jacob Sullum]
  • “Shame, blame, and defame”: in alcohol regulation as in other public health fields, government-funded research can look a lot like advocacy [Edward Peter Stringham, The Hill]
  • More adventures in public health: study finds dry counties in Kentucky have bigger problems with methamphetamine [Christopher Ingraham, Washington Post “WonkBlog”]

Whole milk not so bad for you, it seems

It’s looking now as if decades of health alarmism about whole milk was misguided: in one survey, “contrary to the government advice, people who consumed more milk fat had lower incidence of heart disease.” More from me at Cato at Liberty (“Government on Nutrition: Often Wrong, Seldom in Doubt”) and from David Boaz on how the embarrassment to officialdom contrasts with “the humility that is an essential part of the libertarian worldview.”

I have no criticism of scientists’ efforts to find evidence about good nutrition and to report what they (think they) have learned. My concern is that we not use government coercion to tip the scales either in research or in actual bans and mandates and Official Science. Let scientists conduct research, let other scientists examine it, let journalists report it, let doctors give us advice. But let’s keep nutrition – and much else – in the realm of persuasion, not force. First, because it’s wrong to use force against peaceful people, and second, because we might be wrong.

On a lighter note, regarding government’s bad advice on eggs and cholesterol, from the comedy/documentary film “Fat Head”:

Trans fats banned! Now make way for palm and coconut oil, GMOs…

Pushed by a lawsuit, the Food and Drug Administration has followed through and banned the use of trans fats in processed food: producers have three years to phase out the substance. I’ve got a new piece at Cato making a few basic points: the move is sheer paternalism, it’s setting a precedent (against voluntary consumer assumption of even small risks) that activists are eager to roll out against other ingredients like salt and sugar, it’s not popular with the public (this poll finds a plurality, not majority, going along, while this one finds majorities opposed). And voluntary consumer adjustments (trans fat consumption is down by an estimated 85 percent) have already cut Americans’ average daily intake to half of what the American Heart Association recommends.

Then there’s the sadly ironic history of the whole subject: trans fats were avidly promoted at the time by the same sorts of public health activists and government nutritionists who now push for a ban. CNN:

Dr. Steven Nissen, the chair of cardiovascular medicine at the Cleveland Clinic, praised the FDA for its “bold courage” and said it “deserves a lot of credit” for taking this “enormously important” move.

“In many ways, trans fat is a real tragic story for the American diet,” Nissen said. “In the 1950s and ’60s, we mistakenly told Americans that butter and eggs were bad for them and pushed people to margarine, which is basically trans fat. What we’ve learned now is that saturated fat is relatively neutral — it is the trans fat that is really harmful and we had made the dietary situation worse.”

Or as my colleague Scott Lincicome puts it, “Food tyranny didn’t fail. It just needed better managers”

Now make way for the most popular, and still legal, substitutes for trans fats: tropical palm and coconut oils, each with problems of its own. And an even better prospect — the next panic? –is GMO-derived high-oleic soybean oil.

My Cato piece is here. And I made the WSJ’s Notable & Quotable today on this subject, which is always nice.

The petty tyranny of the FDA’s coming trans fat ban

Don’t count on donuts, frozen pizza, coffee creamers, or canned cinnamon rolls to go on tasting the same — and don’t count on the federal government to respect your choices in the matter [Peter Suderman, earlier] And of course it was public health advocates and the federal government who helped push foodmakers into the use of trans fats in the first place. Some choices do remain to you in the realm of food, so say yes to Mark Bittman’s red lentil dal, no to his politics [Julie Kelly and Jeff Stier, Forbes]

February 19 roundup

  • Sheldon Silver’s law firm reportedly loses its special status in courts [New York Post] “Ex-congresswoman could get payout from court tied to Silver” [same; former Rep. Carolyn McCarthy]
  • “High School Teacher With Fear of Young Children Loses Disability-Bias Case” [EdWeek, h/t @aaronworthing]
  • “Worth remembering that, if they had the power in the 1980s, the public health lobby would have forced us to eat a diet they now say is bad.” [Christopher Snowdon, earlier]
  • Numbers confirm that AG Eric Holder’s forfeiture reform won’t directly affect great majority of cases [Institute for Justice via Jacob Sullum, earlier]
  • Despite curiously thin evidence that they work, bans on texting while driving roll on, including Mississippi [Steve Wilson, Watchdog, thanks for quote, earlier here, etc.] Draft Ohio bill has numerous troubling features, including broad bar on future technologies, vague distraction ban, stiffer penalties without judicial discretion, mandatory court dates for minor offenses [Maggie Thurber, Ohio Watchdog, thanks for quote]
  • Cop’s defense in sex assault of teen: he “[had] money problems and a bad guy scared [him]” [Trumbull, Ct.; Scott Greenfield, Connecticut Post]
  • “Dance like no one is watching; email like it may one day be read aloud in a deposition.” [Olivia Nuzzi]

Prohibition and the lessons of Repeal Day

Last month the Cato Institute hosted a panel celebrating Repeal Day
with me, alcohol policy expert Michelle Minton of the Competitive Enterprise Institute, Stacia Cosner of Students for Sensible Drug Policy, and Cato Digital Marketing Manager Kat Murti as moderator.

On December 5, 1933, the 21st Amendment to the Constitution was ratified, supposedly ending our nation’s failed experiment with prohibitionism. Yet, 81 years later, modern-day prohibitionists continue to deny the laws of supply and demand, attempting to control what individuals can choose to put into their own bodies….

Some links related to the discussion:

  • All the panelists quoted from Daniel Okrent’s excellent history of Prohibition, Last Call. You can find out more about the book at the author’s site.
  • I quote from a speech by the late Christopher Hitchens delivered ten years almost to the day before our panel. It is excerpted in this David Boaz post.
  • Radley Balko wrote a 2003 Cato Policy Analysis, “Back Door to Prohibition: The New War on Social Drinking“. More: The federal Centers for Disease Control, as I noted, has been an agency of choice for public health campaigners because of its legacy of scientific credibility, yet this credibility is itself put increasingly at risk as the CDC lends its name to propaganda. Jacob Sullum provides examples from the agency’s elastic application of the term “binge drinking” to the trouble it seems to have acknowledging that minor alcohol consumption does not seem to correlate with poor health outcomes;
  • As I mention, the Prohibition episode was important in eroding constitutional protections against various law-enforcement tools, especially search and seizure, the law being inherently aimed at contraband goods. The same is true of the nascent Drug War undertaken following the Harrison narcotics act of 1914. You can read about one of the resulting Supreme Court cases here.
  • The role of exorbitant cigarette taxes in contributing to New York’s giant black market in cigarettes came to wider public notice following the police custody death of Eric Garner on Staten Island; more here, here, etc. The New York Post reported that Mayor Bill de Blasio ordered the city law department to refrain from filing an intended press release over a would-be landmark suit filed over untaxed cigarettes the week of the Garner grand jury decision, because it interfered with City Hall’s efforts to downplay the role of the tobacco black market.

“Health In All Policies”

At Reason, Baylen Linnekin has a year-end survey asking “a handful of food law and policy cognoscenti” (thanks!) what they would pick as the story of the year in that area, and also the story to watch next year. (Others surveyed include Elizabeth Nolan Brown, Ron Bailey, and Jeff Stier.) As a significant story in the past year, I nominated the flare-up of social media resistance to changes to the federal school lunch program (“#ThanksMichelleObama“), noting that while purveyors of “food policy” could barely contain their disdain at the insolence of the students spreading the tag, the protest did make an impression in Washington: “of all the ways to irritate the political class, making fun of them is among their least favorite.”

So far as a sleeper issue to look for in 2015, my nomination was:

Have you heard of “Health in All Policies”? It’s a buzz-phrase for inserting public health dogma into everything from land use to taxation. Imagine if sticking up for your taste in milkshakes and margaritas meant you had to attend zoning meetings. It might come to that.

At “The Pulse”, a series on health based at Philadelphia’s public radio station WHYY, reporter Taunya English describes “Health in All Policies” at more length and quotes me providing a voice of skepticism about the idea.

Westminster, Mass., and the well-tended grass roots of tobacco bans

Townspeople came out loudly and in force to oppose the proposed Westminster, Mass. ban on all tobacco sales, and that has thrown advocates back a bit [New York Times, MassLive, earlier]:

“They’re just taking away everyday freedoms, little by little,” said Nate Johnson, 32, an egg farmer who also works in an auto body shop, as he stood outside the store last week. “This isn’t about tobacco, it’s about control,” he said.

Right he is. And despite the Times reporter’s lifted eyebrow at the notion that “outside groups” are encouraging town officials to go forward with the ban, it’s worth asking how Westminster, Mass., population 7,400, came to have its very own “tobacco control officer.” Do you imagine the townspeople decided to create such a position with local tax funds? If so, read on.

WestminsterSealFor well over a decade the Massachusetts Municipal Association has run something called the Tobacco Control Technical Assistance Program, assisted by grant money from the state Department of Public Health. It does things like campaign for town-by-town hikes in the tobacco purchase age to 21, and town-by-town bans on tobacco sales in drug stores. It will surprise few that it has been in the thick of the Westminster situation.

This article, written for a friendly audience of public health advocates, frankly describes how the MMA project, with assistance from nonprofit and university groups as well as the state of Massachusetts, worked to break down the reluctance of town health boards to venture into restrictions on tobacco sales (scroll to “Roles of the Massachusetts Tobacco Control Program, Local Boards of Health, and Tobacco Control Advocates”);

Local boards were enticed into hiring tobacco control staff by the DPH’s tobacco control grants. As a participant in the process explained, “[L]ocal boards of health looked at it as ‘oh, it’s a grant. Let’s apply for this grant. So now, what do we have to do, now that we’ve got it?’” … The grants dictated that local boards use those community members they had hired as their staff to assist them in enacting and enforcing tobacco control regulations…

The staff paid for with money from outside the town seem to have seen their job as, in part, lobbying the local officials: “We’ve had to work on each individual board [of health] member to get them to come around,” said one.

The account continues with many revealing details of how the outside advisers managed to orchestrate public hearings to minimize critics’ voice, deflect challenges with “we’ll take that under advisement” rather than actual answers, and in the case of particularly intense opposition, “back off for a couple of months” before returning. “Grant-funded regulatory advocates were able to counter all of [opponents’] arguments and tactics.”

In other words, an extra reason for the townspeople of Westminster to be angry is that they have been paying to lobby themselves. And it’s worth knowing exactly how the game plan works, because similar ones have been rolled out to localities in various states not only on “tobacco control” but on “food policy,” environmental bans and other topics. Grass roots? If so, most carefully cultivated in high places.

Update Nov. 21: board drops plan in face of overwhelming public opposition.

Needed: a post-Frieden CDC


Bloomberg’s nanny-in-chief was never the right choice to lead the Centers for Disease Control, much less with an actual epidemic in sight, argues the New York Sun:

…it was the former mayor of New York City who gave the nation Thomas Frieden, who is one dangerous doctor and is the middle of the catastrophe. … Because of the government’s blunders in the Ebola emergency, people are starting to look a harder look at Bloombergism.

… the CDC budget has soared more than 200% since 2000 to $7 billion. The Centers, moreover, are squandering this lucre (which was seized from the American public via taxes) on regulating motorcycle helmets, video games, and playground equipment, as if any of that has anything to do with diseases. No wonder that when Ebola hits, the CDC seems to be staggering….

Mr. Bloomberg is enormously invested in this through the school of public health at Johns Hopkins. Do Americans want a cabal of left-wing, government doctors in Atlanta engineering our playgrounds, motorcycle helmets, and video games? No one plays a video game or rides a motorcycle for his health….

It is important that the Ebola emergency is starting to get people thinking about the first principles of the Centers for Disease Control.

Read the whole thing. Related: Heather Mac Donald and Steve Malanga, City Journal; Jacob Sullum.

While we’re at it: I’ve got a new post at Cato about the international aspects, including the U.N.’s World Health Organization and Prof. Lawrence Gostin’s article “Healthy Living Needs Global Governance.”