The Science of Science Communication Is Focus of National Academies Colloquium “You can’t persuade someone you don’t respect”. That attention-grabbing statement was only one of many uttered by Kathleen Hall Jamieson, Professor of Communication and Director of the Annenberg Public Policy Center at the University of Pennsylvania, speaking at a colloquium held at the National Academy of Sciences in September in Washington DC. According to the Science Academies, the colloquium was organized because topics critical to the welfare of society are suffering
from ineffective communication. Keynote Talk Social, behavioral, and decision scientists presented on “The Science of Science Communication” to help attendees better understand the complexities of successful science communication. The keynote address entitled“ Responding to the Attack on the Best Available Evidence” was -Science continued on pg 2
Epidemiology and Public Health Heavily Criticized By Essayists Is public health a disease? This is the assertion of the headline writers at the online British magazine Spike. The magazine is publishing a provocative set of essays examining paternalism and attacking epidemiology and public health for the role they are playing in helping government to intervene in what is considered the private lives of citizens. Useful Glimpse Given the libertarian leanings of the magazine as expressed in their profile,
it’s not surprising that the articles would seek to make the case for individual freedom and for a lighthand of government in regulating human affairs. That said, the articles by Sean Collins, a US based writer, taglined “Today’s nudging elites pose a threat to our everyday freedoms”, and by Christopher Snowdon, a British book author, taglined “We are in the midst of an epidemic of lifestyle moralism” give a useful glimpse into the thinking of -Criticized continues on page 4
In This Issue: -3Talk Nerdy To Me -5Initiative to Bridge Health Divide -7Asbestos Activist Alleges a Failure of Ethics -9Research Focused on Etiology -11Jobs
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October 2013 Volume Thirty Four Number Ten
-Science continued from pg 1 “The audience has to invest meaning for the communication to work,”
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given by Jamieson who tried to help her audience understand how scientists can communicate with the public in situations where trust has been lost, scientists are accused of not being impartial, and the public itself has come to see the facts through a partisan lens.
explain the difficult concept to grasp that because of global warming, the number and severity of weather events will increase, though not all such events will be caused by global warming. Not an easy concept to get across without an effective or “lockdown” metaphor, according to Jamieson. More Prescription
Topics such as communicating uncertainty, belief and attitude formation about science topics, and social networks were also discussed. On the third day, participants had the option to attend concurrent workshops on climate change, evolution, obesity/nutrition, and nanotechnology.
Her prescription also includes speaking with a respectful voice, using impartial rhetoric, and envisioning the audience as an intelligent one worthy of engaging. This is the section of her talk where she stated “you can’t persuade someone you do not respect”.
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Common Premise Prescription Jamieson’s prescription for improved communication involves efforts to breakdown the partisan filters that prevent persons from being able to see evidence more objectively. Techniques useful for this purpose include the use of evocative narratives and the use of clarifying metaphors. The “Lock-Down” Metaphor Jamieson’s example of such a “lockdown” metaphor is likening global warming to a driver in a car in the habit of traveling slightly above the speed limit. It does not mean that the speed itself will be the cause of a future accident, but it suggests that speeding makes it more likely that something else encountered such as an oil spot on the road will cause an accident. And if so, the accident will be more calamitous. This helps
She noted the importance of finding common ground with the audience, finding a common premise on which to build communication. Without this common premise she said, effective communication is not possible. “The audience has to invest meaning for the communication to work,” said Jamieson. By way of summary, Jamieson repeated that effective communication requires establishing that scientific consensus exists on an issue, establishing the credibility of experts based on past successes, and countering the partisan filter. This latter achievement requires explaining what we know and how we know it, employing evocative narrative, and using clarifying metaphors. Succeeding in -Science continues on page 4
“Talk Nerdy To Me” Has Tips For Science Communication If you listened carefully, attendees at the Science of Science Communication Colloquim held recently at the National Academies of Science learned of a website entitled “Talk Nerdy to Me”. A contributor to that site is Melissa Marshall, a faculty member of the Department of Communication Arts and Sciences at Penn State. According to her biography, Marshall aims to teach great communication skills to scientists and engineers so that they can effectively share their work. She offers her advice on communication in a short TED talk available online (see below). What is striking are the similarities between the concepts presented by the keynote speaker Kathleen Hall Jamieson at the Colloquim and the tips shared by Melissa Marshall, in particular, the importance of respecting the audience to get them on your side as a speaker. Her short hand equation for success is: Science minus (Jargon + Bullets) divided by Audience Relevance multiplied by Speaker Passion equals Understanding by the audience. Here is some of her advice as presented in the TED talk 1.
be taboo in presenting to lay audiences. 3. Do not dumb down the material This is also part of the respect for the audience. Marshall quotes Einstein to remind speakers to keep things as simple as possible but no simpler. 4. Use stories and analogies This is another form of respect because by analogies, the speaker is building on something the audience already knows. This reminds us of the importance of the “lock-down” metaphor which was highlighted by Jamieson in her talk at the Colloquim. 5. Drop bullet points This seems counterintuitive since bullet points help to avoid lengthy text on a slide. However, Marshall is quoted as saying that bullets kill, and they will kill your presentation. To listen to the short entertaining talk on video, visit: http://tinyurl.com/9392l27 ■
Explain the relevance
The first task of a speaker is to answer the so what question by making clear to the audience why the material being presented is relevant to them. 2. Beware of jargon
“The first task of a speaker is to answer the so what question"
“bullets kill, and they will kill your presentation ”
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As is obvious from its place in her equation, Marshall considers jargon to
-Science continued from page 2 communication, according to Jamieson, means we as a society will be more likely to lead the kind of lives that are compatible with good science.
“we as a society will be more likely to lead the kind of lives that are compatible with good science.”
“this was a fuzzy area”
Scientists and Policy World During the question and answer period, Jamieson was asked if scientists should become more conversant with values so as to be more effective in disputes about evidence. She made a distinction between scientists operating in the world of science trying to describe what we know and how we know it from the world of policy where participants are debating alternatives for action. She said the expertise in these two worlds was different, and appeared to be discouraging scientists from entering the policy world because it risks the credibility of the scientists. A second questioner followed up to ask if Jamieson was really saying that making recommendations on the basis of evidence such as might occur for vaccines known to be effective was off limits for scientists. She said this was a “fuzzy area”, but said the case for vaccines should be made on the merits of evidence for safety and efficacy. Whether or not the government should mandate vaccines or pay for vaccines is another matter, she said, and appeared to call that off limits for scientists.
views since it is widely accepted that there will always be such a minority in a democracy. Jamieson answered that in a democracy we can resolve disputes or get consent by counting votes. She did not answer directly the question of what to do about minority views. She added that very often the goal may be to persuade one person with the power to decide and not 51% of any group since the power may actually reside in that president, governor, or other official. Interested readers can view videos of the first two days of presentations at: http://tinyurl.com/me49gmd The Jamieson video is at the beginning of day two events. ■
-Criticized continued from page 1 persons who do not share some of the underlying values which are at the heart of epidemiology and public health. Nudging People According to Collins, the publication in 2008 of the book “Nudge: Improving Decisions About Health, Wealth, and Happiness” has set off a concerted effort by governments both in the US and in Europe to engineer environments and structure decisions so that the average person makes the “right” choices when it comes to diet and other lifestyle matters such as carrot sticks over French fries.
Another provocative question was asked about when it was appropriate or acceptable to ignore minority
Collins in his essay is upset about the covert nature of these activities even -Criticized continues on page 6
Europeans Launch Initiative To Bridge Health Divide Social Injustice Killing People On A Grand Scale, Says Report A panel of experts representing 53 countries has published a final report entitled “Review of Social Determinants and the Health Divide in the WHO European Region”. It finds a range of difference in life expectancy in countries of 17 years for men and 12 years for women, with the lowest life expectancies occurring the in the eastern part of the region. The new review was commissioned to help inform planning for Health 2020, a health policy framework. Headed by Michael Marmot, director of the Institute of Health Equity in the UK, the review was intended to provide practical guidance on what interventions countries could use to act on the social determinants of health. It provides guidance or “best buy” priorities in 12 policy areas. Public Health Emergency A key concern for the authors of the report is the financial crisis that has occurred since 2008. “The financial crisis threatens a public health emergency, and inaction will lead to a worsening of social, economic, and health burdens,” according to WHO. For Marmot, “unemployment, particularly the high persistent levels of youth unemployment, is a public health time bomb waiting to explode…I would say to any government that cares about the health of its population: look at the impact of their policies on the lives people are able to lead and, more importantly, at the impact on inequality. Health inequality kills. It is socially unjust,
unnecessary, and avoidable, and it offends against the human right to health.” Excerpts Other important observations from the report include the following:
“a public health time bomb waiting to explode”
“We now know that what makes societies flourish and sustainable also makes people healthy.” “A central argument of this review is that social policies can by judged by their likely impact on health equity.” Countries in the region should have two aims: “improving average health and reducing health inequities by striving to bring the health of less-advantaged people up to the level of the most advantaged. Improving the levels and equitable distribution of the social determinants should achieve both aims.” “Central to this approach is empowerment—putting in place effective mechanisms that give those affected a real say in decisions that affect their lives and by recognizing their fundamental human rights, including the right to health.
"Health inequality kills"
“There is a vibrant debate on what is sometimes portrayed as a tension between action on social determinants and individual freedoms. This review calls for -Injustice continued on page 10
-Criticized continued from page 4
“a change from government working for us to government working on us ”
though they do not actually force people to make certain choices. The driver of paternalism according to the article is the concept that individuals consistently fail to do what is best for them and therefore the intervention of government to make the right choice easier is justified. Collins views these interventions as a change from government working for us to government working on us, and “is an assault on the idea of people as rational subjects.”
private behavior or private property. Many problems today such as climate change are now presented as a “public health issue”. This phrase has been applied to bullying, unemployment, and other public concerns recently. According to Snowdon, this is a slippery slope and he says “the endlessly accommodating field of ‘public health’ is a magnet for unelectable social scientists and moral entrepreneurs.” He labels ‘public health’ as “lifestyle regulation” Problem Magnitude
epidemiology. Good Decisions Hard To Make
“He labels ‘public health’ as “lifestyle regulation”
Poor decision making is a major point of contention since behind the nudge movement are new findings which reveal that people have inherent biases and other natural flaws in making decisions and cannot be counted on to do the “right thing” for a variety of reasons. Collins continues to believe in the capacity of individuals to overcome these tendencies . In his view, the elites of today are simply too pessimistic about people in general. The fear is that once government intervention proceeds along these lines for health reasons, it will not take long for these authoritarian tendencies to extend to other aspects of life besides health. Attack on Public Health
The arguments made by Snowdon are of a different sort and more directly target public health. According to Snowdon, the meaning of public health has gradually expanded over the years from protection against contagion to become increasingly concerned with
Snowdon attacks the practice used by epidemiologists of identifying low level risks and multiplying them by population figures to estimate the magnitude of problems. He calls this a “sleight of hand” and states “issues which are of minimal concern to individuals cannot magically become pressing concerns for society by multiplication.” In even more strident terms, Snowdon says the general public “puts little faith in epidemiological trash. They know that chocolate will be said to cause cancer today and will be said to cure cancer tomorrow.” Who Decides Risk/Benefit? Snowdon resists societal judgments about risk. For example, he asks “Is a greater mortality risk a price worth paying for a lifetime’s smoking? Who is to draw the line? Adds Snowdon, “The mandarins of ‘public health’ would draw it as near to zero as is politically feasible, but in an -Criticized continues on page 10
Asbestos Activist Alleges A Failure of Ethics In Conducting and Using Research At McGill “Scientists and academics have a role to play to speak up against this ongoing corruption of public health policy which causes unnecessary disease and deaths.” That’s how Kathleen Ruff, an activist and founder of Rights on Canada has characterized at a recent one day conference in Montreal some of the research carried out at McGill University and the internal investigation of this alleged corruption of policy by the University. The conference (Asbestos: Dialogue for the Future) was called by the Faculty of Medicine to engage in a baseline discussion about what asbestos is, how it has been used historically and its impact on human health, and to participate in a dialogue for the future with respect to research policy, ethics, and the broader context,” according to the University.
industry was funding the research. Asbestos Problem The presentation by Ruff is important because asbestos continues to be exported around the world and for the past 20 years asbestos sales have stayed at around 2 million tons per year despite overwhelming scientific evidence of the harm caused by asbestos. The asbestos industry says that chrysotile asbestos in virtually harmless and should continue to be used. The evidence on asbestos was the subject of a recent extensive review of the literature by a consortium of professional epidemiologic associations in 2012 which issued a statement that asbestos is harmful in all forms and should not be used.
“For the past 20 years asbestos sales have stayed at around 2 million tons per year ”
Allegations Review In a presentation entitled “A Failure of Ethics by McGill University”, Ruff used her presentation to allege that the research carried out by Prof JC McDonald, a former head of the Department of Epidemiology and the use of that research improperly served the interests of the asbestos industry and undermined public health policy. Among the allegations she makes are that there were improprieties in the research itself, that the research minimized the threat to health posed by chrysotile asbestos (calling it “essentially innocuous”), that there had been improper asbestos industry influence, and that McDonald had at times denied that the asbestos
McGill carried out a review of the allegations and dismissed them. Ruff and others at the conference believe the process followed by McGill to investigate the allegations was biased, lacked independence, lacked transparency, and the report issued was inaccurate and contained misleading information.
“Asbestos is harmful in all forms and should not be used”
In concluding her paper, Ruff stated “a vast imbalance of power exists between the asbestos industry -Asbestos continues on page 8
-Asbestos continued from page 7
“It is critical that McGill’s broken ethical review system be repaired”
and people overseas to whom the industry continues to ship 2 million additional tons of asbestos every year. Ethics means protecting the right to health of the powerless. Consequently, it is critical that McGill’s broken ethical review system be repaired. According to Ruff, McDonald’s research is still of concern because the asbestos industry continues to use his research to promote the sale of asbestos, and chrysotile asbestos represents 100% of the global trade. McGill Response
“All professors in the university are expected to observe the highest ethical standards in their work ”
In correspondence between McGill’s David Eidelman, Dean of the Faculty of Medicine and Ruff, McGill has provided its ethical guidelines and the specific sections which deal with conflict of interest. According to the Dean, “…all professors in the university are expected to observe the highest ethical standards in their work.” In response to a question of whether or not it is unethical for a faculty member to falsely deny any connection to the industry funding his or her research, the Dean agreed that IF such a situation occurred, it would not be in compliance with McGill’s current regulations. So What? One can ask why it is important to get further clarity about the issues raised by Ruff. If the allegations were proven to be correct, this would serve to discredit the previous work she describes at McGill and could lessen the influence that work has in the global policy arena.
Asbestos related diseases are still a major issue. The WHO has estimated that worldwide 90,000 people die each year from mesothelioma, lung cancer and asbestosis. Although worldwide consumption of asbestos has decreased, consumption is increasing in many developing countries. The limited data available suggests that exposures may also be high in developing countries. Mesothelioma continues to increase in most European countries and in Japan, but has peaked in the U.S. and Sweden. Although the epidemic of asbestos related disease has or is expected to plateau in most of the developed world, little is known about the epidemic in developing countries. It is obvious that an increase in use by these countries will result in an increase in asbestos related diseases in the future Looking Forward Regardless of the outcome of the allegations made by Ruff, it seems clear that improvements are needed in the procedures and practices that govern the oversight of conflict of interest. In his correspondence with Ruff, McGill’s dean pointed out a suggestion from the McGill conference to implement postapproval compliance monitoring to help insure that investigators are actually following the guidance given by Institutional Review Boards, and doing a better job of raising awareness about ethics regulations among students and faculty. ■
Research In Epidemiology Overly Focused On Etiology At The Expense Of Improving Health Outcomes Can Epidemiologists Pivot To Become More Consequentialist? “…this interest in identifying causes has, during the past quarter century , increasingly come at the expense of a more rigorous engagement with the second part of our vision for ourselves---the intent for us to intervene ---and this approach threatens to result in an imbalance in our vision that takes the field far away from relevance and into obsolescence.” So writes Sandro Galea in an October 15, 2013 commentary in the American Journal of Epidemiology entitled “An Argument for a Consequentialist Epidemiology”. His concerns are echoed by Ward Cates writing in the same issue of the AJE and revisiting a topic he first addressed at an SER meeting as far back as 1994.
heed these calls for paying more attention to public health? Part of the problem is the system of incentives currently in place for academic researchers. When the funding source for research at the National Institutes of Health rewards etiologic research over more applied public health research, it is not surprising this type of research is what is submitted. Also, salaries and promotions are based on publications of this type of research. As stated by Galea, these factors are determinants of how epidemiologists behave, and he calls for changing these determinants once and for all.
“an imbalance in our vision that takes the field far away from relevance and into obsolescence.”
Accountable Health Advocates Speaking at the recent SER meeting and now in the AJE, Galea is seeking to provoke epidemiologists into a rethinking of their priorities. His goal is to shift the current focus from one heavily devoted to etiologic research to one devoted more consciously to improving health outcomes. Otherwise, he fears that epidemiology, whose relevance is already being questioned, will fade in importance. Familiar Refrain This is not a new topic for epidemiologists since calls for researchers to become more consequential were issued years ago by Milton Terris at APHA in Atlantic City in the 1970s and William Foege in the 1980’s even before Cates’ address at SER. Why the failure to
This topic was the subject of an article in Epidemiology last year by David Dowdy and Madhukar Pai who made a case for creating “Accountable Health Advocates”, a new subspecialty of epidemiologists which would focus more intentionally on the translation or use of epidemiologic findings to improve public health.
"he calls for changing these determinants once and for all“
According to Dowdy and Pai, support for this work would come from a reallocation of resources or creation of new rewards and incentives for epidemiologists who choose this career path. At present, the authors say there are many -Consequentialist continues on page 11
“…individual freedoms and responsibilities feature strongly in the approach taken”
“It is time to ‘denormalize the demagogues of ‘public health’”
-Injustice continued from page 5
-Criticized continues from page 6
social action—but individual freedoms and responsibilities feature strongly in the approach taken…The wider influences of society on the social determinants of health are of fundamental importance in enabling people to achieve the capabilities that lead to good health. An individual’s resources and capabilities for health are influenced by social and economic arrangements, by collective resources provided by the communities of which they are part, and by welfare state institutions…
enlightened society the judgment can only be made by the one person who bears all the risk and enjoys all the benefits: the individual.” He ends by saying it is time to “denormalise the demagogues of ‘public health’”
“A key action area is to develop new instruments and mechanisms—and strengthen those that exist—to empower people and ensure that the opinions and perspectives that are heard in decision making processes include a better reflection of equity arguments. Empowering people includes promoting civil society, enabling unions to be formed, and developing political and non-political organizations freely.”
The report is available for download at:
The articles have drawn several comments by the magazine readers. To access the Collins article, visit: http://tinyurl.com/mc9dpe5 To read the Snowdon article, visit:
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-Consequentialist continued from page 9 disincentives for epidemiologists to advocate for the utilization of established evidence, including “professional fallout” from a perceived lack of objectivity and difficulty of publishing such work in scientific journals. Epi Marketing In an accompanying commentary, Ward Cates revisits his remarks at SER some20 years ago and concludes that
although epidemiology as the science of causality is still alive and well, it can do so much more. He agrees with Galea that “the key will be our ability to market our epidemiologic skills in a way that is seen by society as making a difference. And the advent of the Affordable Care Act provides epidemiologists with an opportunity to prove that relevance “…not only by clarifying etiologies but also by planning public health actions and evaluating interventions. " ■
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University of Pennsylvania Clinician Educator in Epidemiology and Biostatistics The Division of Infectious Diseases in the Department of Medicine at the Perelman School of Medicine at the University of Pennsylvania seeks candidates for an Assistant Professor position in the non-tenure clinician-educator track. Applicants must have an M.D or M.D./Ph.D. degree and have demonstrated excellent qualifications in education, research, and clinical care. Advanced training in epidemiologic research methods is also highly desirable. Board Certified or Board Eligible is requirement for the position. We expect the candidate to have skills in clinical epidemiology and biostatistics and to spend approximately 20% time providing patient care and teaching and 80% time performing patient-oriented research. We anticipate this individual will develop with independent funding, a cutting edge patient oriented research program focused on antimicrobial resistance and healthcare-acquired infections. We seek candidates who embrace and reflect diversity in the broadest sense. The University of Pennsylvania is an equal opportunity, affirmative action employer. Apply for this position online at: http://tinyurl.com/p44ode4
Open Rank Professor â€“ Public Health Location: Georgia State University, School of Public Health, Atlanta, Georgia Position: Tenure Track, Associate/Full Professor, Available August 2014, or sooner. Georgia State University seeks an outstanding epidemiology scholar to join the faculty of its new and fast-growing School of Public Health. The ideal candidate will be a social epidemiologist with the proven ability to build and lead collaborative, interdisciplinary research projects as part of Georgia Stateâ€™s Second Century Initiative (2CI), which supports emerging fields of study. Qualifications: An earned doctorate in Epidemiology/Public Health with advanced analytic skills, and a focus on social epidemiology, epidemiologic methods, prevention science and other fields that have general bearing on Public Health. For persons in related fields, advanced training in epidemiology is required. Candidates must have demonstrated potential for excellence in teaching and developing an independent research program in the area of expertise, as well as the ability to contribute to the University and profession through service activities. Deadline: Application materials should be submitted as soon as possible.
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The University of Alabama at Birmingham (UAB), Department of Epidemiology in the School of Public Health is inviting applications from outstanding candidates for tenure track positions in cancer epidemiology, including population-based epidemiology, molecular epidemiology and/or genetic epidemiology at the level of Assistant Professor, Associate Professor, or Professor (12- month tenured or tenure-earning positions with salary, rank and tenure status commensurate with qualifications). UAB is home to one of the original eight NCIdesignated comprehensive cancer centers (CCC). It has been continuously funded for over 40 years and currently holds >$140 M in extramural research funding. The UAB-CCC is comprised of 6 major research programs, 15 shared facilities, and 4 SPORES. UAB is a thriving urban university/medical center with research funding exceeding $433 M that houses among others, a Center for Clinical and Translational Science and a Nutrition and Obesity Research Center. We are seeking candidates with a PhD or an equivalent degree in epidemiology or related fields with additional training or experience in cancer epidemiology; a track record and/or strong promise of obtaining peer-reviewed external funding and publications in the above areas; commitment to excellence in teaching and advising undergraduate and graduate students; excellent written and oral communication skills; and demonstration of highly collaborative research. Though not a requirement, applicants with a background in the study of energy balance and cancer are strongly encouraged to apply. The successful candidate will interact with key researchers throughout the University and the CCC, and have opportunities to collaborate with a broad range of senior investigators conducting research in areas such as nutrition, immunology, chemoprevention, basic research and medicine. UAB offers outstanding opportunities for multidisciplinary population, molecular and genetic epidemiology research in cancer by providing access to unique populations and state-of-the-art genomics, metabolomics, proteomics, microbiomics and other core facilities and related biostatistical/bioinformatics support, and clinical biospecimen repositories. UAB is an Equal Opportunity/Affirmative Action Employer committed to fostering a diverse, equitable, family-friendly environment in which all personnel can excel and achieve work/life balance irrespective of ethnicity, gender, faith, gender identity and expression or sexual orientation. UAB also encourages applications from individuals with disabilities and veterans. A pre-employment background investigation is performed on candidates selected for employment. Interested applicants should submit a cover letter, current curriculum vitae, and three references to: Search Committee Chair Christine Skibola, Ph.D. c/o Joanna Carson 1720 2ND Avenue South, 1665 University Boulevard, RPHB 220B Birmingham, AL 35294-0022 email: email@example.com
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Published on Nov 5, 2013
The Epidemiology Monitor presents its October 2013 issue focusing on topics of interest to epidemiologists, bio statisticians, public health...