Dr. Whelan presented this speech on November 10, 1992 upon her acceptance of the Calver Award presenter by the Environmental Division of the American Public Health Association.
This lecture pays tribute to Homer Calver and his crusade against premature death and disease during the first decades of this century. Calver's greatness came because of the time in which he lived.
The modern cinema often portrays the early twentieth century as the gilded age of romance and comfortable leisure. But, it also was a world with the persistent stench of raw sewage and suffocating air pollution; a world haunted by misery and early death from tuberculosis, diphtheria, influenza and diarrheal diseases; a time when medical procedure and practices were medieval Calver was more than a pioneer. He was a public health revolutionary who, with others, changed the course of medical history. He and his colleagues championed sanitation and new health technologies and helped define the role of nutrition in prolonging life. Make no mistake. To Calver, "environmental health" was a constant struggle to survive.
I ask you today whether our purpose as public health professionals is that much different than Calver's. To be sure, the advances in medical science have been wondrous. Science largely has conquered infectious disease. Our children live a quarter century longer than children born in Calver's day. As a result, "environmental health" today is more encompassing and embraces many more risks including those related to lifestyle.
But these remarkable changes should simply redefine rather than change our main goal. I come here with an urgent warning. The strength of our profession the practice of preventive medicine is being undermined by what I call "politically-correct" science or PCS which abandons the principles of epidemiology, advancing instead ideological agendas and social aims. It is dogmatic and intolerant. It threatens to push health costs upward without benefits by inverting the nation's health priorities. The need to expose and reject PCS's hidden agendas, the ones which wear the mask of public health science, is the heart of my message today.
The first order of business is to examine the causes of premature death and disease. There are no surprises here, as every public health textbook reveals. Unlike in Homer Calver's time, the primary killers today relate to lifestyle. Some two million Americans die of all causes each year. One million of these deaths are premature meaning they can be postponed.
Of those one million, about half (500,000) are directly related to cigarette smoking and other uses of tobacco. Another 100,000 can be causally linked to the abuse and misuse of alcohol, adding up to 60 percent of all premature deaths. The additional 400,000 are linked with the failure to use life-saving technologies such as seat belts and smoke detectors; the failure to screen and treat life-threatening diseases, particularly hypertension and treatable malignancies; reckless recreation; the abuse of addictive substances, including HIV-infection from intravenous drug use; promiscuous sexual practices and more.
These are the real, the documented, opportunities to make clear progress the modern-day challenges of public health professionals.
But, let's turn now to the source of my dismay: There is an insidious seepage of non-science into public health. We must ask the question: How do the scientific realities of disease causation in 1992 square with the public health advice we receive every day, the public health legislation and programs being advanced in our society? The answer: They do not square very well indeed. Our national public health policy might best be described as one dedicated to squishing ants while the elephants run wild.
Read copies of popular magazines and examine the type of "public health advice" they offer. These publications recommend reducing the risk of disease and death by avoiding: the "carcinogens" on barbecued chicken; the hazards of "potentially carcinogenic" PCBs; dioxin treated coffee filters; and the alleged dangers of useful, health-promoting food additives like sodium nitrite, BHA and BHT.
The inverted health priorities based on PCS don't stop with popular magazines. The non-science of public health has dominated federal and state legislation in the name of "environmental health."
* SuperFund legislation promises to reduce cancer by "protecting" us from chemical risks at toxic waste sites, even though there is not a shred of scientific evidence that these minute exposures play a role in the etiology of human cancer.
* Prop 65 in California, which was drafted not by scientists but by the Environmental Defense Fund and the Sierra Club and backed by those notable epidemiologists and toxicologists including Tom Hayden, Jane Fonda and Whoopie Goldberg, requires warning labels on any product with even trace levels of a chemical which causes cancer in laboratory rodents. For example, under Prop 65, Liquid Paper correction fluid was taken off the market as a carcinogen, a move totally bereft of any scientific justification. All this in a state (which like all the other 49 states), has 40 percent of cancer deaths causally linked to tobacco use. There is no scientific evidence whatsoever that trace exposures to animal carcinogens like the solvent in liquid paper play any role in the causation of human cancer.
* Big Green was the anti-pesticide referendum created and put on the California ballot in 1990 by the Natural Resources Defense Council. It focused on an alleged cancer epidemic in that state and sought to ban the use of any pesticide which causes cancer in rodents when administered in massive doses. Director Oliver Stone supported Big Green because he asserted that we were "choking to death." Jack Lemmon endorsed it because swimmers were "contracting mysterious diseases." Big Green was long on Hollywood support but short on science. As the National Cancer Institute (NCI) states, there is no evidence to "suggests that regulated and approved pesticide residues in food contribute to the toll of human cancer in the U.S."
* The U.S. Environmental Protection Agency designates a chemical a "probable human carcinogen" no matter what the level of human exposure if it causes cancer in any animal species at any dose. It was this type of EPA designation that led to the great-Alar-apple scare of 1989 when terrified consumers nationwide discarded their apple products. This may be PCS but, again, there was and is no scientific reason to believe that apples or Alar ever contributed to the risk of cancer or any other disease in children or adults. The NCI has equated the risk of eating an Alar-treated apple with that of eating half a peanut butter sandwich.
Inverted health priorities, I regret to say, are also visible in resolutions proposed by the American Public Health Association.
* APHA will this week consider a referendum entitled "Encouraging Prevention in Environmental Programs" prepared by Dr. Richard Ginsburg. It begins by stating that "environmental pollution" and "toxic substances" make a "major contribution to critical public health problems... like cancer." This charge is without scientific justification. The referendum claims that there are "significant and widespread health effects in... humans" due to "exposure to toxic substances in the environment." This statement is in stark contrast to public health realities. The referendum calls for a reduction in the use and disposal of all toxic substances no matter what the exposure, cost of implementation or loss of benefit to society.
If as a public health professional I had to make a list of the top 100 risk factors for premature disease and death in our country in 1992, exposure to trace levels of "toxic chemicals in the environment" would not even make the list.
These above mentioned programs and proposals all purport to protect public health, but they are not grounded on public health science. Why do we have public health policies which are so far afield from science? Why are we engaged in the trivial pursuit of the hypothetical which would so horrify real public health professionals like Homer N. Calver?
This is a very complex question. I will only highlight my thoughts here:
First, the manufacturers of the leading cause of death cigarette companies dominate the print media in this country and exert a tremendous influence on government regulatory processes. The Industry spends nearly $4 billion advertising and promoting their products. Clearly, this buys silence in the media and special attention in legislative chambers. Nothing could make the cigarette merchants of death happier than to see consumer cancer prevention efforts focused on "killer apples" and to have the word "carcinogen" used so frequently that it loses all meaning.
Second, it is human nature to avoid blaming oneself for ill health. Better to blame others particularly "industry" than look to our own lifestyles.
But let's move beyond these two obvious explanations for our nation's inverted priorities and suggest a third factor: That ideology has crept into public health and environmental policy; an ideology which is anti-capitalistic and anti-free enterprise; an ideology that sees Man, industry and technology as the enemy of nature; an ideology which has abandoned science, reason and rationality in favor of intuition, inconsistency and a commitment to a goal or goals other than improved public health. Those practicing PCS never address real, documented public health threats. Nature, always benign, is the new god and environmentalism and consumerism are the new religions to worship and protect.
Some practicing PCS think owls are more important than the livelihood of families. They pressure EPA to ban useful pesticides, such as EDB, when alternatives pose a greater health risk. There is no room for thought or perspective just advocacy. Just listen to what politically correct scientists and activists say when expressing their contempt for science; their belief in the inherent benevolence of nature versus the perversity of man-made chemicals; and their rejection of risk-benefit analysis. Indeed, they grant low priority to human welfare in the general scheme of things.
* The Natural Resources Defense Council argues that: "Allowing the EPA to condone continued use of a chemical whenever the benefits outweigh the risks is absolutely anathema to the environmental community."
Leaving no room for thought or perspective, such advocacy is frightening enough from the environmentalist with an agenda. It is even more frightening when journalists abandon reason regarding environmental matters as happened in 1989 when Charles Alexander stated publicly. "As the science editor at Time, I would freely admit that on this issue (the environment) we have crossed the boundary from news to advocacy."
* Earth First!'s Rick Bailey was candid when he said, citing lack of facts, "I pretty much feel... that the biological and ecological foundation of this planet is under siege." (emphasis added)
* Stephen Schneider, a climatologist and leading proponent of global warming theory states, "To capture the public imagination... we have to offer up some scary scenarios, make simplified dramatic statements and little mention of any doubts we might have."
* Dr. Charles Wurster, an outspoken anti-DDT spokesman in the 1960s, when asked if he thought a ban on DDT might encourage the use of a more dangerous chemical, responded, "Probably... so what? People are the causes of all the problems; we have too many of them; we need to get rid of some of them; and this is as good a way as any." Wurster and his supporters expressed no concern about the ban on DDT and subsequent resurgence of malaria in Ceylon (now Sri Lanka).
* David M. Graber, a self proclaimed environmentalist for the National Park Service has opined that, "Human happiness, and certainly human fecundity, are not as important as a wild and healthy planet... we have become a plague upon ourselves and upon the Earth... Until such time as Homo sapiens should decide to rejoin nature, some of us can only hope for the right virus to come along."
* Leading Prop 65 proponent Jane Fonda was clear when she pledged "We've got to establish a socialistic economic structure that will limit private, profit-oriented businesses... Ultimately we must concern ourselves with pulling out by its roots the decadence that controls our culture, the profit motive that controls our culture." Also, supporting Prop 65, campaign spokesman Bob Mulholland gave his assessment of science's role, "In a political debate, science doesn't matter much. It's really how you feel about the issue." (emphasis added)
Prop 65, interestingly, banned the discharge into water of chemicals which allegedly caused cancer or "reproductive toxicity" in laboratory animals. But the legislation only banned the discharge of these into private water supplies. Municipalities, which supply most of the water Californians drink, were exempted.
How strange, if one truly wants to prevent cancer and thinks that trace levels of animal carcinogens are the cause, why distinguish between private and municipal supplies? Prop 65 author David Roe explained it this way, "Government is not affected. The initiative applies only to business in other words, only to people or companies seeking to make a profit." When my group, the American Council on Science and Health, asked Los Angeles Mayor Bradley about this alleged discrepancy, he responded similarly, "Government agencies were left out because they were not profiting from the manufacture or use of toxic chemicals."
Is it not fair here to pose this question to advocates of PCS, "Is it not profits, rather than carcinogens, to which you object?"
It is time that we return to peer reviewed, mainstream science and reject once and for all what is perhaps the darkest side of PCS the antiquated, destructive view that a growing industrial economy is the enemy of a clean environment and a healthier people.
We know that Americans will not tolerate a government that offers less economic opportunity for their children than they had for themselves. The recent Presidential election is a reaffirmation of this truth. However, it's my firm belief that the continued march of PCS undermines our ability to achieve both economic and public health goals. Common sense tells us to stop PCS before it's too late.
Ecologist William Clark reminds us of what happened when common sense and rationality was rejected in the sixteenth and seventeenth century and a half a million people, ostensibly witches, were burned at the stake. That was a time riddled with doubt and unexplained illnesses. No cause could be found. Society had to blame someone the witches.
We are in our own unscientific, witch hunt when we abandon facts and pursue the hypothetical, when we're motivated not out of reason but out of fear, uncertainty and a commitment to goals other than public health. Now is the time for reason and rationality, a time for public health professionals to reclaim their profession to take it back from Hollywood and the political activists.
Now is the time for public health professionals to return to the spirit that brought Homer Calver to greatness and acknowledge that we all want to protect the earth, human health and our high standard of living. Science and technology are the solution, not the causes of our ills.
Finally, it is time to embrace sound, scientific, preventive medicine as the way to reduce the upward spiral of health care costs. You may argue that there are few public health professionals who would join ranks with the likes of Jane Fonda and Meryl Streep, but silence is assent. Where are the professional environmental scientists protecting the distortion of their profession when laws based on pseudoscience are proposed?
Francis Bacon once said, "The... goal of the sciences is the endowment of human life with new innovations and riches." His noble words ring true today. At the close of the Rio Summit this past spring, 425 members of the scientific and intellectual community formally objected to the politically correct agenda of those who dominated the conference. They rejected the theme that Man was the enemy, that industry, technology and profits posed a world-wide hazard.
These scientists signed what is known as the Heidelberg Appeal. As of this moment, nearly two thousand scientists from around the world have signed this appeal you can too. I want to conclude by summarizing what these scientists, without a political agenda have to say:.
* We want to make our full contribution to the preservation of the Earth.
* We are worried at the emergence, at the dawn of the twenty-first century, of an irrational ideology which is opposed to scientific and industrial progress.
* We stress that many essential human activities are carried out... by manipulating hazardous substances... and that progress and development have always involved increasing control over hostile forces to the benefit of mankind.
* The greatest evils which stalk our Earth are ignorance and oppression, not Science, Technology and Industry
I urge every member of American Public Health Association today to sign the Heidelberg Appeal. Be true to the honored tradition of Homer Calver and reject politically correct science. Take a step toward a better today and a better tomorrow.
(From Priorities, Vol. 5, No. 1)