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Jewish World Review April 19, 2001 / 26 Nissan, 5761
Betsy Hart
A practicing psychiatrist and a lecturer at Yale University Medical school, Satel offers a simple but devastating critique of modern medicine, saying that a culture of victimology has begun to pervade it as it too often "puts politics before health." Satel argues that there is a dangerous tendency in the medical world to look at correlation as causation and to make diagnoses accordingly. For instance, it's true that wealthier people tend to be healthier, which led two health experts to write in the American Journal for Public Health "we must address the social inequalities that so reliably produce" these inequalities in health. But Satel notes that for a variety of non-economic reasons poorer people are more likely than their more affluent peers to be obese, to lead a sedentary lifestyle and to engage in various kinds of risky behavior. These are huge health hazards, which, to the detriment of poorer communities, are often ignored by the medical establishment in pursuit of more politically correct answers. By the same token, health differences between whites and blacks are consistently, and erroneously, laid at the door of racism, Satel says. So, for instance, the stress of living with racism has been routinely blamed for the tendency among black men to have higher blood pressure than white men. But Satel shows that the major study on which that "finding" is based is flawed. She points to less reported studies that have shown that factors such as reducing salt intake have a tremendous impact on blood pressure and that blacks tend to have more salt-sensitive hypertension than whites. When the public health establishment overlooks such sound medicine for the more politically correct position that high blood pressure is a result of racism, it's the black community, which suffers. When it comes to women's health, including funding for disease research and inclusion in clinical trials, the standard understanding is that women are ignored or face discrimination. Satel shows that's just wrong. (In fact the National Institutes of Health just retracted such a claim it had made in 1997.) For starters a recent study in the journal Controlled Clinical Trials found, by reviewing research data at five-year increments since 1985, that female subjects outnumbered males 13 to 1 across all cancer trials. And Satel notes that since 1985, breast cancer research has received more money than any other cancer. That brings us to another PC issue. Given the attention paid to breast cancer it makes sense for women to think that it is the biggest health risk they face. They would also be reasonable to concur with the PC contention that it is caused by various man-made chemicals. Satel shows that the very few studies that suggest such a conclusion fall apart under review. Careful studies showing a strong connection between obesity and breast cancer rarely receive much play. In any event, women are actually far more likely to die of cardiovascular disease than breast cancer. But cardiovascular disease is not exclusive to women, and no one has suggested that man-made environmental pollutants cause it. So it's not as politically correct as breast cancer, and unfortunately for women, it doesn't get as much attention from the public health establishment. Satel lists many other examples of PC medicine, including everything from an alarming trend toward racial and gender-based "I am a member of a victim group" psychotherapy, to an organized movement encouraging nurses to see themselves as oppressed by the "male medical establishment." Satel calls those behind these agendas "indoctrinologists." While many fine doctors and researchers are valiantly resisting these trends, the influence of the indoctrinologists is growing in key areas, particularly and most ominously in medical schools.
The evidence of politically correct medicine is growing. A second
volume from Satel may be
04/05/01: King of the wimps?
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