Words matter. Even more in public health policies

Policy facts

The editorial entitled Dangerous words published on The Lancet starts stating that “Medicine is underpinned by both art and science. Art that relies upon strong therapeutic relationships with patients and populations. And science that brings statistical rigour to clinical and public health practice”. This statement introduces the decision of Trump administration to ban words like health equity, vulnerable, entitlement, diversity, transgender, fetus, evidence-based, and science-based from government documents for the US$7 billion budget discussions about the Centers for Disease Control and Prevention (CDC).

Reactions

A Health and Human Services’ spokesperson stated that “science should always drive the narrative […] recent media reports appear to be based on confusion that arose when employees misconstrued guidelines”. Moreover, the US National Academies of Sciences, Engineering, and Medicine observed that “such a directive would be unprecedented and contrary to the spirit of scientific integrity”. One Twitter user tweeted on January 6, 2018: "Dangerous words to be banned from US government documents" - The absurdity of this initiative is just overboard. How can truth and progress be discussed without these words?”

Food for thought

The editorial continues saying that “The disenfranchisement of people and perversion of science undermines trust in government and places the health of Americans at risk”. It also claims that a collaborative response is needed from within the USA, as well as “from health leaders around the globe, particularly from WHO, whose constitution specifies a government's responsibility for the health of its people, recognizes the importance of research, and calls for all necessary action to attain the objective of the organisation”.

From ASSET

ASSET experts performed a semantic analysis in order to understand to what extent ethical issues are dealt within the national pandemic preparedness plans. This study detected the lack of Science-in-Society issues, such as ethics, gender and participatory governance that, as it has been proved according to the project experience, are of great relevance in case of epidemics and pandemics. Conversely, based on the concerns expressed in the Lancet article mentioned above, it is arguable that if words matter in defining policies in general, they are even more significant to express specific concepts in public health programs. Going further into such reasoning and applying it to the relationship between science and politics, that perspective is easily retrievable in most public health actions, or at least it should be the main driver. Since 80’s, for example, the CDC Behavioural Risk Factors Surveillance System (BRFSS) monitors both the temporal and the geographical trends for several health-related behaviours in the population with the final aim of “turning information into actions”. Moreover, science communication (in its widest spectrum) is in charge of becoming the joining link in a chain that goes from science and research to public health policies.