My snarky comments in my last post about scientific studies came back to me this afternoon, as I perused my iPhone at the park.
A week ago I read (and I bet a lot of you did too) an article in the New York Times, entitled
If no one contests the fact, why is it controversial?
You don’t follow politics much, do you?
Here is what lots of scientists are saying to argue that the obvious advice that arises from this fact should not be given:
“The bottom line is there has not been a single study done on moderate alcohol consumption and mortality outcomes that is a ‘gold standard’ kind of study — the kind of randomized controlled clinical trial that we would be required to have in order to approve a new pharmaceutical agent in this country,” said Dr. Tim Naimi, an epidemiologist with the Centers for Disease Control and Prevention.
This a completely valid scientific point, but also a terrible basis for debate. How’s it both? Well, the central assertion that correlation is not causation is critical to good science. And that critical rule is the most often ignored best practice in science, by both lay people and scientists themselves. So it certainly is reasonable to say that you should not take this statistical fact alone as advising moderate drinking.
But there are numerous other studies that show more direct causation between alcohol consumption and a variety of specific health benefits and risks. How do we balance them? Dr. Naimi’s suggestion that we employ a process similar to the FDA’s approval process for new drugs is flawed for various reasons. First, as the article notes, the only sponsor for such a test that might allow the results to be trusted by both sides would be the Feds. And they won’t pay for such a process because whichever side comes out behind will hate them. Further, I would suggest that using a process that would reject Aspirin or Penicillin as possessing too many risk factors to be allowed, would certainly find against alcohol. Which is more an indictment of the government’s process of approving drugs than it is of alcohol. The fact is, like everything else on Earth, alcohol has benefits and risks. If we want to know how those sides tend to balance, I’d suggest that we have a study already done, to the goldest of standards, about how those risks tend to balance. The sample size is humanity….
To be fair, the argument Dr. Naimi and some others (don’t you just love when reporters use the phrase
some scientists say…?) make against my last point is this:
…the two groups are so different that they simply cannot be compared. Moderate drinkers are healthier, wealthier and more educated, and they get better health care, even though they are more likely to smoke. They are even more likely to have all of their teeth, a marker of well-being.
The problem I see with this distinction is that the scientists seem determined to believe that these sociological differences could have no causative relationship with alcohol consumption. This is of course ridiculous. No one claims that alcohol use can and does change people’s life circumstances, at least in the case of heavy use or abuse. Why should we reject out of hand the notion that moderate alcohol use might actually promote some of those
social advantages the researchers say distinguish moderate drinkers?
I’m not saying this is certain, but I contend that the differences they are discussing can’t legitimately be used as control factors since income and education may also be affected by alcohol use. In fact, a Forbes article by Arthur Brooks cites a study that purports to show such a relationship.
Moderate drinkers are richer than teetotalers, too. In 2001 the University of Michigan’s Panel Study of Income Dynamics found that light drinkers (one to two drinks a day) had a mean income of $49,000, versus $36,000 among teetotalers. This is a nuanced statistic; drinking may be associated with other variables (like education) that influence income. So the researchers did their best to strip these other causes out. If two adults were identical with respect to education, age, family status, race and religion, except that the first had one or two drinks each night after work while the second was a teetotaler, the drinker would tend to enjoy a “drinker’s bonus” of about 10% higher income.
Is this correlation or causation? Again, who knows? Especially since in this area we are leaving medical science and entering sociology. And sociology ain’t science, guys. Sorry, but it isn’t.
Finally, another article in Forbes (the one I was reading in the park while my kids played on the swings) makes a logical argument that in many ways trumps the entire debate. The article, by Jeff Stier is entitled
bikini waxing is found in the subtitle is not why I was reading it. Stier’s article is a general condemnation of how we are becoming increasingly, riskily, adverse to… well… risk.
Most of his article is devoted to the fish pedicures, video games, and the aforementioned bikini waxing, but he ends with linking the Brooks article and saying this about the correlation/causation question.
I believe that moderate drinkers have the ability to accept risk (unlike teetotalers) and manage it (as opposed to alcoholics). This is a discipline that they can deploy both at the bar and at the office. The ability to engage judiciously with risk in all facets of life may be a predictor of success–whether it’s part of a career, daily routine or society in general.
So let’s wrap up this rambling post. It is a fact that moderate drinkers happen to live longer than those who drink more or less. There are specific, well established health benefits from alcohol consumption, with more being found all the time. The are specific risks associated with alcohol use as well. In addition to living longer, moderate drinkers make more money, are healthier, and are better educated. Moderate drinking is a skill, employing talents that are valuable for success in all walks of life. And I’ll add that drinking is enjoyable and can improve our quality of life.
I’ll close with a famous quote by Benjamin Franklin that apparently was not quite what is usually reported:
Behold the rain which descends from heaven upon our vineyards; there it enters the roots of the vines, to be changed into wine; a constant proof that God loves us, and loves to see us happy.