Annapolis Dispatch: Science as the Foundation for Strong Policy

By Rebecca Rehr, Public Health Advocacy Coordinator

Greetings from the throes of another ambitious legislative session in Annapolis. As an advocate for the Maryland Environmental Health Network, I have testified on several important bills including: the Styrofoam ban, the Forest Conservation Act, and bills addressing food deserts, preventing the overuse of antibiotics in agriculture, and the fracking ban.

To prepare our testimony, I examine the weight of the evidence and the public health consequences of an action. I am honored to ensure the accurate representation of public health research because it is essential to sound protections. Unfortunately, this session has often focused on defending the science on these issues and more generally, the scientific method. Lawmakers can be confused or misled when science is oversimplified or misrepresented. Marylanders trust lawmakers to protect them through sound policies and lawmakers violate the democratic process when they make decisions based on misinformation.

As an example, let’s consider the debate around fracking in Maryland. Since our inception in 2012, the Maryland Environmental Health Network has tracked the health studies and stories. Within the last 2 years alone, studies on adverse birth outcomes; migraines, sinusitis, and nosebleeds; and asthma document an increase risk living near heavily fracked sites, plus the information now available on the erosion of communities’ social fabric and residents’ sense of place.

In fact, the Physicians for Social Responsibility and Concerned Health Professionals of New York’s most recent compendium details more than 900 studies that are available on the environmental, socioeconomic, and public health impacts of shale and tight gas development.

Despite all this data on harms related to fracking, a puzzled legislator still asked during the committee hearing on a fracking ban, “Of these 900 studies, none of them can conclude fracking causes any of these negative health outcomes, right?” The question itself is flawed. It drastically oversimplifies scientific methodologies and undermines important findings of increased risk and of association.  Most concerning, it propels the myth that “causation” is the appropriate standard for interpreting science.

One of the health outcomes of concern from fracking is pre-term birth.  In a legislative hearing, everyone gets 2 minutes to speak, and we cannot exaggerate results and say unequivocally that fracking will always cause pre-term birth. We know that a Hopkins study showed women living near heavily fracked sites had a 40% increased risk of pre-term births compared to women living near less fracked sites.  The study’s authors attributed this increased risk to both the increased air pollution and the stress of living near sites –well-documented factors in influencing birth outcomes.  Despite our best efforts, scientific results are not often that clear cut.  These complex explanations could be made for all the research on fracking, as well, but legislative hearings simply are not set up for this with less than 2 minutes to testify.

As I considered making the most of my 2 minutes, I recalled the teachings of Sir Austin Bradford-Hill, who wrote the standards for determining causation.  In the Proceedings of the Royal Society of Medicine in 1965, he says the following:

The “cause” of illness may be immediate and direct, it may be remote and indirect underlying the observed association.  But with the aims of occupational, and almost synonymously preventive, medicine in mind the decisive question is whether the frequency of the undesirable event B will be influenced by a change in the environmental feature A.  How such a change exerts that influence may call for a great deal of research.  However, before deducing “causation” and taking action we shall not invariably have to sit around awaiting the results of that research.

I referenced this 62-year-old statement to refute the misinformed legislator. In this statement, Dr. Hill explains that effective policy-making should be driven by what we call the weight of the evidence, or a judgment in the scientific community that
most studies to date confirm a conclusion. If he were in the hearing room, he would have said, “The weight of the evidence is clear: fracking has negative health impacts on nearby residents.  Don’t frack Maryland.”

When we know enough to act, we should. Over and over, we see science questioned and politicized. This must stop.

The Maryland Environmental Health Network and Maryland Pesticide Education Network have published a short checklist to help decision-makers interpret the science they hear during bill testimony and in their deliberations. We hope you share this piece with others and help build the strong support for science-based policy.

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