The National Post recently had an interesting article on “disease mongering,” an article I largely agreed with. The major point was that fostering a fear of “germs,” promoting the idea that following medical advice, especially advice involving “taking your pills,” and the very definition of who is diseased and who is not has a suspiciously commercial aspect.
Consider the marketing of hand sanitizers, a subject of interest to the flu obsessed:
The slogan of Purell — a hand sanitizer manufactured by Pfizer — is “Imagine a Touchable World.” It’s hard to miss the implication that the world in its current state is untouchable, a message underscored on Purell’s Web site, which includes a handy list of “99 Places Where Germs Are Likely To Lurk — 99 Reasons to Use Purell Instant Hand Sanitizer.” Number 6: subway seats and poles. Number 18: calculator keypads. Number 58: thermostats. Number 67: shopping cart handles. Number 83: library books. While there is solid evidence that the reasonable use of hand sanitizers in settings such as classrooms and daycares is beneficial, Pfizer portrays virtually any object touched by humans as a potential threat and any contact with any such object as a crisis that calls for a squirt of Purell. Welcome to the world of Howard Hughes. (Dan Gardner, National Post [Canada])
Gardner does not mention, although it is consistent with his theme, that data indicates the long residence time on inanimate surfaces for influenza virus still capable of infecting host cells is not matched by their survivability on human hands, which may be only on the order of minutes. This may seem counterintuitive, but human skin is a highly active biological tissue with its own complement of host defenses. Still, washing hands isn’t a bad thing. Some of his other examples are considerably more egregious:
A television ad for Brita, the German manufacturer of water-filtration systems, starts with a close-up of a glass of water on a kitchen table. The sound of a flushing toilet is heard. A woman opens a door, enters the kitchen, sits at the table and drinks the water. The water in your toilet and the water in your faucet “come from the same source,” the commercial concludes. Sharp-eyed viewers will also see a disclaimer at the start of the ad printed in tiny, white letters: “Municipal water is treated for consumption.” This is effectively an admission that the shared origin of the water in the glass and the toilet is irrelevant and so the commercial makes no sense — at least not on a rational level.
From these specific examples Gardner moves on to a more global perspective, this time targeting Big Pharma:
It is not in the economic interests of a corporation selling pills to unhealthy people for people to actually be healthy, or rather — to be more precise — for them to perceive themselves to be healthy. Their actual physical state is irrelevant. What matters is whether someone believes there is something wrong that can be cured with a pill. If so, the corporation has a potential customer. If not, no sale. It doesn’t take an MBA to figure out what pharmaceutical companies need to do to expand their markets and boost sales.
This is much bigger than advertising. It is about nothing less than shifting the line between healthy and diseased, both in consumers’ perceptions and in medical practice itself.
Steven Woloshin and Lisa Schwartz, doctors and researchers at the Dartmouth Medical School, were among the first to analyze this process. In 1999, they published a paper examining proposals by various professional associations to change the thresholds for diagnosis of high blood pressure, diabetes, high cholesterol and obesity. In every case, the new thresholds made it easier for people to be qualified as having these conditions. They then calculated that if all the new standards were put in place, 87.5 million otherwise healthy Americans would suddenly be deemed to have at least one chronic condition– and three-quarters of all Americans would be considered “diseased.”
As I said, I tend to agree with the overall thrust of this very long piece (I’ve only pulled quotes from a portion. There’s a lot more interesting material there. Follow the link.) It is wise to remember, though, that as the old cliche observes, even paranoids have enemies. We continue to learn our modern world has many dangers it would be prudent to take measures to avoid. We should be suspicious of easy fixes, whether they are a magic pill to lower cholesterol or a magic foot pad to remove toxins from our bodies. There is rarely an easy technological fix for problems that are themselves caused by technology, other than banning or avoiding the technology. If a radiation source is a danger, we are better of eliminating the source than taking a radiation resistance pill.
We should also become more sensitive to the many ways corporations and people use to market their products. That’s why it was somewhat disconcerting to read at the end of this long and interesting article the following acknowledgment:
From Risk: The Science and Politics of Fear by Dan Gardner. In stores Saturday, April 19. Published by McClelland & Stewart Ltd. Reprinted by permission.