More than half the residents of Marin County, a suburb of San Francisco, hold at least a bachelor’s degree, giving the county one of the highest education attainment rates in the United States. But it’s also where, according to a 2015 study by Kaiser Permanente, roughly one in five children under the age of 36 months had not been fully vaccinated. Neighboring Sonoma County had under-immunized rates of 13 to 16 percent. The latest data from the CDC show unvaccinated rates among kindergarten students have risen in 11 states, largely because of parental fears about the side effects of vaccines — fears that are unsubstantiated by science.
Vaccines have become emblematic of a nationwide struggle between science and its skeptics, with each side speaking a language the other does not understand. As the above examples show, this skepticism about science, while a perspective held by only a subpopulation of people, still crosses educational, geographic, and political lines.
Science has been through this before. In 1846, Ignaz Semmelweis, a Hungarian physician, realized the importance of hand-washing in hospitals — only to be met with ridicule. Hand hygiene is now standard practice worldwide and prevents countless infections. During my own career as a surgeon and scientist, I have seen rampant denialism about the link between smoking and cancer. But as we all know, millions of people are now, in 2018, still making decisions about life and death based on rumor of the sort that Semmelweis would recognize only too clearly.
There are many opinions about how we arrived here. Global economic forces that have left people displaced and disillusioned, failing education systems, the politicization of science and medicine, growing skepticism of experts and institutions, social media’s ability to spread false stories as rapidly as true ones — all have likely played a role. It also seems that a broad appreciation of science is waning. From a survey of 14,000 people in 14 countries, a study by 3M found that two in three respondents think “a little to never” about the impact of science on their everyday lives.
I don’t pretend there are easy solutions, but there are certainly positive steps we can take. For example, we can find ways to be more innovative, efficient, and collaborative in how we research and test medical treatments and interventions. Removing the divide between fundamental discovery-based science on one side, and clinical-based science on the other, would be a start. Allowing the two to work more closely together could spur wonderful — and unexpected — translational discoveries, and may help the public better understand the value of fundamental research.
Another way is for us, as doctors, researchers, and practitioners, to continue sharing the work we’re doing and the exciting frontiers we’re pushing forward — not just in academic papers or medical journals, but across the country. We have a responsibility to educate people, especially children, about the role and value of science in our society today, and the tremendous advances that have been achieved — advances that are too often taken for granted.
When the 20th century ended, men and women in the U.S. were, on average, living close to 30 years longer than when it began. Many people outside the field of medicine today aren’t familiar with whooping cough or diphtheria — diseases that in 1920 combined to kill more than 20,000 Americans. Polio has been eliminated in the United States. HIV is no longer a death sentence.
The pace of these achievements continues to accelerate. In this past year alone, there have been promising advances in our understanding of ALS and autoimmune diseases. At Stanford Medicine, we’ve worked on a new approach to treating multiple sclerosis, and our researchers have pioneered a less expensive, faster, more reliable test for tuberculosis, a disease that still devastates developing countries and remains difficult to diagnose in places that lack electricity.
In the face of skepticism and disbelief, storytelling and engagement from the scientific community has never felt more valuable — or necessary. The conversation may not always be easy, but it is critical that we participate in it. “Mankind’s greatest achievements have come about by talking,” the late Stephen Hawking said, “and its greatest failures by not talking.”
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