By Dr. Paul Ehrlich
Close readers of my blogs for this website will be aware that I am annoyed at the way research reaches the public. Let’s see. Cities are supposed to be worse for asthma than the country, except that that there is also a rural asthma epidemic that has been revealed by better technology. Amish farms protect children and especially the women who work with cows from asthma, but Hutterite women, who don’t work in the barns, have a higher incidence of asthma than the men. Earlier this year I wrote about a study in Pediatrics showing that African-American children are sensitized to foods at much higher rates than other kids, which was followed shortly by another associating food-allergies with children from highly educated families.
Now we have another study by an Air Force researcher that associates peanut allergies with families that have more money. The shallow speculation that accompanies popular reporting of these studies usually mentions the “hygiene hypothesis,” which usually doesn’t go much past glib assertions that rich people may use more hand sanitizer and do their laundry more often than poor people. I must point out for a start that asthma was once thought to be a disease of the affluent. Now we know that poor people and all other income groups get it, too.
As a practicing allergist, I have to cope with the fallout from this kind of reporting. Parents come to my office after reading about one study or another despairing that their child’s severe asthma or food allergies are somehow their fault. I try to reassure them that broad observations about the causes of the allergy epidemic are useful in the aggregate, but there are exceptions to every sweeping rule. Besides, headline-worthy conclusions are often arrived at through deficient sampling. I am the first to admit that the absence of food allergy among the severely asthmatic children I saw at New York inner-city schools doesn’t mean there isn’t a hidden epidemic.
Should we as a society, as doctors, public health professionals, and even parents ignore individual data points? Of course not. The fact that the larger forces are to blame doesn’t mean we should do nothing collectively or individually. Our air should be cleaner. We should use antibiotics aggressively when warranted, but not routinely for minor infections, especially viral ones for which they do no good. We should keep our homes free of cockroaches and mice. We should reserve Caesarian deliveries only for medical necessities and not schedule them for the convenience of doctors and patients.
But when confronted with the reality of a severely allergic child no one should ever look at the menu of causative factors as described in the press and despair. Take the best medical advice you can find and do the best you can to make the life of your little patient better.
Photo by freepokercoach.com