Why can’t we create health research that works?

Dr. Scott Atlas is an epidemiologist, physician, and founding director of the Institute of Global Health and Society at New York University Langone Health. He has published 28 books.

I think science has become politicized and we have gone through a sort of hyper-politicization of science. There has been a very sharp increase over the last 15 to 20 years in political support for climate change science and, during the Trump administration, there is a clear dividing line here. I think we are moving towards an impasse that is potentially damaging for the quality of research that is done in this country.

What we are doing is moving beyond a consensus around a reality that is far more scientifically clear than what we have even today. This recent news of the very unusual likelihood of our warming climate coming true is one of these “wow, this is going to be a big deal” moments that very quickly makes us think of our impact on the environment and our impact on our health.

By increasing our use of energy, we are changing the world around us. But it also affects our health. So we can’t help but become activists to show that the public can help drive our own policy in light of a clear evidence base about this global health issue.

Human research is not always driven by interest in human health and public health but by interest in innovation and technology and some justification for doing research. There are some people who do the scientific research for its own sake and then apply it to the benefit of the society, but my belief is that the scientific research undertaken in this country should be motivated in a very different way than just doing it to find a new bionic arm. We need to focus on what actually works and the scientific literature is telling us that antibiotics are ineffective and should not be given to treat chronic infectious illnesses like pneumonia. The literature is clear that obesity is linked to cardiovascular disease and stroke and not only are we very far from the entire weight-loss diet study, we are not even close to understanding how to treat obesity beyond just following its suggestions. And this is a prime example of a health question that needs an effective medicine, but the best medicine probably is not getting there.

To shift to a new paradigm, we need to involve citizens in contributing to scientific research and policy development, making science as transparent as possible, with clinicians and scientists as partners with patients in designing policies. The medical society should have a very clear policy making function and helping people to understand their risk of diseases and and help them understand their treatment choices. At the end of the day, the medical scientist needs to have the basic information to treat the patient and tell the patient what the intervention is and how it will work.

Do we still see medical research at its core as applying only to the benefit of the public or do we see that as more a lot of evidence and medicine is changing?

I think the medical social science is evolving toward a public health social science. So we are finding a growing number of scientists who are conducting research that focuses on prevention of chronic diseases and improving health outcomes while reducing costs. So, yes, I think the medical social science is evolving to addressing public health issues. I think it is very important. Some of the very basic knowledge we don’t have the expertise on yet and therefore need to be developed, but there are many people in medical social science who are able to talk about the research that has already been done, and take all of this research, put it into a policy analysis and do it in a way that really addresses public health.

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