Friday, November 18, 2011

The Simplest Explanation is Often the Tesh One

During a recent, lengthy conversation with my brother Brian, he brought up the John Tesh radio show so that we could badmouth the host’s daily contributions to the lives of his listeners. I don’t think all that badly of John Tesh, but the sentiment that my brother and I seem to share is that he takes a rather unquestioning attitude towards the information that he cites on his program, and tends to dispense, as if it is gospel, advice that needs to be context-dependent at best. Then again, sometimes it’s probably just wrong altogether.

Yesterday, I just happened to hear a bit of the John Tesh broadcast, and really got my dander up over his latest explanation of some academic study. To his credit, I’m sure that a lot of the fault lies with the researchers who are putting out this material in the first place, but again, it is Tesh’s unquestioning attitude in broadcasting the stuff that turns irresponsible reasoning from an academic footnote into a corruption of popular knowledge.

In this case, Tesh thought himself to be informing his audience that cultural and artistic activities improve people’s health. According to surveys of study participants in Norway, he says, those who reported going to museums on a regular basis or either participating in or watching things like ballet tended to be significantly healthier overall than people who didn’t take part in those activities.

And then, setting aside any possible questions as to the meaning of the data, Tesh asks what he apparently thinks is the only natural question: how does this work? He promptly answers his own question, apparently restating the opinions of the original researchers. Not knowing where to find the original reporting, I can’t say with certainty that that’s the case, but coverage of the story in the UK Daily Telegraph back in May made the same statements about a unidirectional, causal relationship between cultural activity and physical outcome, so that suggests that such statements are repetition of the claims of the researchers. Whatever their original language, Tesh puts it simply and stupidly: cultural activities engage us mentally, and that helps us to be able to deal with stress and keeps us healthier.

It is absolutely shocking to me that professional academics and paid researchers still sometimes use the most obvious kind of faulty reasoning and confuse correlation with causality. Observing that healthy people go to museums absolutely does not mean that going to museums makes people healthy. In fact, assuming that that’s the case strikes me as amazingly unimaginative and intellectually lazy. I recognize that one needs a hypothesis in order to make scientific progress, but in general I’d say that good advice for researchers would be unless you have a damn good scientific explanation for how two phenomena are linked, don’t guess. As near as I can tell, everyone who’s communicating the story of this culture-health connection, from the Nordic researchers to the staff of the Telegraph to John Tesh, is taking it for granted in exactly the same way. Do none of them consider that there might be other factors at play?

It’s not difficult to identify alternative explanations. Of course, any of them would need additional data in order to have sufficient support, just as the claim that cultural activities cause good health needs additional data as to exactly what the mechanism of that cause is. Without access to a university research staff or other such resources, I can only guess, but I’d be quite willing to bet that if you did a study of people’s social class as compared with their cultural engagement, you’d find that wealthier people participated in more activities.

Take the three data sets together, and you’ve got a picture of more affluent people who are healthier than poor people and go to museums more often. I don’t know what John Tesh or the Daily Telegraph would say, but I have a fairly clear sense of which of those is the more significant variable in determining the other two. And yet I still wouldn’t say that being rich makes you healthier, because that’s a stupid thing to say. What I would say is that being wealthy gives you greater access to a wide range of food options, and allows you to pay for health-enhancing luxuries like gym memberships and spa vacations, while still having enough left over to go to the opera. So being wealthy makes it easier to make both healthier and more culturally refined lifestyle choices. But unless someone gives me a thoroughly refined scientific explanation of newly discovered physical mechanisms, I’m fairly certain that the only things that have a direct impact on health are the things that interact with your body’s functioning, such as what you eat and how often you exercise.

Since the British newspapers covered this study, Britain’s National Health Service took it up and posted a thorough, reasonable discussion of it on their website, including the prominent image caption at the top of the page, “It’s hard to tell if culture affects health, or vice versa.” It also adds tremendously to my sense of frustration at this sort of study by pointing out that surveys of participants wasn’t only used to determine their level of cultural participation; the surveys were actually the gauges of participant health. Their actual health, as determined by medical indicators, remains completely unknown.

In the NHS’s conclusion, it reiterates that the direction of causality is difficult to determine, and adds:

For example, just as participating in cultural activities might cause people to report better physical and mental health, it is just as plausible that people who feel healthier were more likely to engage in cultural activities.

No kidding. All a person should have to do to come up with this alternative explanation for the data is to think for just one minute about their own experience. Surely even John Tesh has felt down in the dumps at one or two points in his life. I’d be surprised if he reported that he was especially well-traveled among his local cultural institutions during those periods.

For that matter, the curve for this study would be absolutely shattered by interviewing just a few people who are genuinely sick. The researchers did adjust for things like chronic disease, but presumably not for recent, persistent disease. If, say, you’ve gotten the flu in each season of this year and have been laid up in bed for weeks at a time, of course you’re not going to the symphony. But if the poll was worded with sufficient vagueness, anyone who was reviewing the data blind would just see that participant x reported being in somewhat poor health and was highly unlikely to go to the cinema, theater, or gallery. Such a researcher might easily conclude that participant x’s cultural disinterest was contributing negatively to his health, if that researcher didn’t think very hard about the different ways to interpret what he was reading.

The study also analyzed reports of satisfaction with life, anxiety, and depression, and found that particular activities, depending on the gender of the participant, were correlated to differing levels of each. I take it that the essential conclusion from this part of the research is “Doing stuff makes you feel better.” You don’t say! And yet here also, to claim a unidirectional relationship is to draw an illogical, indefensible, and irresponsible conclusion, because feeling better makes you do stuff, too.

It’s the irresponsibility of this kind of reporting that really drives me crazy and prompts me to write 1,500 word rants on the topic. And that is also why I focus my umbrage on John Tesh, because it’s his sort of highly digested, exceptionally simplistic, and frequently repeated iterations of this kind of terrible academic research that are especially poisonous. One-dimensional interpretations of correlation between behaviors and conditions send a clear message of blame to people experiencing the less favorable conditions.

I imagine John Tesh rhetorically asking his audience “worried about your health?” and then cheerfully explaining to them that “if you think the problem is that you don’t have insurance or you can’t afford anything but empty calories at the grocery store, you’re wrong! It turns out that you, listener, just fucked up by not attending enough literature readings.”

Sadly, I’m sure that John Tesh genuinely feels as though he’s helping out his audience by telling them about the little aspects of their day-to-day lives that can contribute to their lasting health. But the thing is that for those of them who really have to struggle with these issues, he’s just making it worse. Considering that that Nordic research group included anxiety as a factor in its calculations, you’d think that someone would have given some thought to the likely future effect of believing that your health is tied to the number of lectures you attend this year. If people of distinctly low socioeconomic class listen to Tesh on this one and come to believe that frequent participation in cultural activities is key to their physical and mental health, the actual effect may turn out to be the opposite of what Tesh intends. I say that based on experience; I know what severe anxiety can come of trying to be culturally engaged while knowing all along that you cannot actually afford it.

If this possible ill effect was the consequence of just some one-off comment from John Tesh, I could give him a pass, but from what I’ve heard of his show, this is part and parcel of his daily broadcast. The list of recent topics on his website at this moment includes “Loneliness is bad for your health,” and “Volunteering boosts your health.” Bullshit claims, both. There is almost no conceivable way that in either of those cases the two factors being linked aren’t just simultaneous effects of other causes. Yet somehow Tesh doesn’t know that. Tragically, the researchers who produced the original claims may not. And certainly, much of Tesh’s listenership doesn’t realize that, and will take the voice on the radio at its word.

And what will come of these claims? Well, sure, certain frequent volunteers will feel more confident that their next check-up is going to go just fine. But also, some people who don’t have the time to volunteer because they’re working three jobs and still can’t afford health insurance will have found a new source of stress, anxiety, and depression, while some of those who have the best health care money can buy will attribute its effects to that Thanksgiving they spent working at the soup kitchen downtown. And at the same time, John Tesh is telling his sick and lonely listeners that if they’re worried about their health they’d better make sure they aren’t lonely, and if they’re worried about their loneliness, they damn well should be because it’s going to keep them in poor health. That information is rather less than helpful unless you’re neither lonely nor afflicted.

But the simpler the explanations of everyone’s problems, the better it is for everyone who doesn’t suffer them.

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