Ep 88: How I learned to stop worrying and follow the data (with Timothy Caulfield)
How much coffee should we drink? Is there a scientific way to have a healthy, happy life? And how do we distinguish scientific sense from nonsense?
In this episode, we talk with author and University of Alberta professor Timothy Caulfield about decision making and misinformation in the modern world. A surprising number of “common sense” decisions that people make in their daily lives are not actually backed by strong scientific evidence, and Tim strives to debunk these in his recent book, “Relax, Dammit!: A User's Guide to the Age of Anxiety”.
Among other things, we discuss with Tim how often we should check email and how risky it really is for kids to walk to school. We also talk about how science communication can be used to curb misinformation, and Tim shares his dos and don’ts for effective scicomm.
Cover photo: Keating Shahmehri
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SPEAKERS
Art Woods, Marty Martin, Tim Caulfield
Art Woods: Ah, the human brain. Capable of so much, yet led astray so easily.
Marty Martin: One of the brain’s stranger quirks is its inability to assess relative risk in meaningful and realistic ways…
Art Woods: Let’s take an example that highlights an important parental question…whether or not you should let your kids walk to school on their own.
Marty Martin: In days of yore, that’s just what kids did – and it came with many upsides: kids got more exercise and developed a critical sense of independence and agency.
Art Woods: Clearly, those days are mostly gone – now, most parents in most cities don’t let their kids walk to school but instead drive them to and from..
Marty Martin: A key reason cited by parents is ‘stranger danger,’ the fear that their kid will be abducted by some unknown person with evil intent.
Art Woods: Now clearly this does happen, and we don’t want to minimize the seriousness of these kinds of events. But it’s also important to point out that the danger is vanishingly small for most kids in most places.
Marty Martin: For example, the chance of any particular child being abducted is about 1 in 14 million, and the average kid would have to stand on a street corner for 200,000 years before they were abducted.
Art Woods: And what’s amazing here is that the real danger lies in the supposedly safer alternative of driving – turns out the odds of injury or death while driving to and from school are far higher.
Marty Martin: More driving also raises the odds that kids will get insufficient exercise, which carries with it a bunch of other health risks for common western afflictions, including obesity, diabetes, and cardiovascular disease.
Art Woods: The somewhat narrow point here is that we humans do a poor job of assessing relative risk.
Marty Martin: The broader point is that, in general, we do a bad job of assessing the data and then acting on it in ways that increase health and happiness and minimize danger, stress, and disease.
Art Woods: Today we talk about these issues with Tim Caulfield, professor of law at the University of Alberta, the research director of its Health Law Institute, and current Canada Research Chair in Health Law and Policy.
Marty Martin: Tim is well known for his documentary series, on Netflix from 2017 and 2018, called ‘A User's Guide to Cheating Death’ and for his 2020 book called in the Canadian market Relax, Dammit!: Healthy and Happy in the Age of Anxiety
Art Woods: The book goes by a few other names in other countries, including Relax: An everyday guide to health decisions with more facts and less worry AND Relax: A User’s Guide to Life in the Age of Anxiety.
Marty Martin: Geez, the multiple names are enough to make you anxious…
Marty Martin: We spend the first part of our chat with Tim talking over the book – which focuses on the small and large decisions each of us confronts nearly every day, including whether or not to let our kids walk to school.
Art Woods: Many of us make those decisions using common sense– the stuff that everyone just knows to be true…
Marty Martin: But is it true? Turns out that often the data simply don’t back up the common wisdom, or the data simply aren't there, or they are a lot more equivocal than you’d think from listening to your typical podcaster (AW: ahem…) or reading your typical wellness blog.
Art Woods: From there, we broaden our conversation to talk over misinformation more generally – where does it come from and why does it seem so pervasive right now? How does science intersect with other powerful forces shaping society, including political polarization, high levels of public anxiety, and historically low levels of trust in experts and institutions.
Marty Martin: These things of course have come together in a perfect misinformation storm surrounding covid, which we discuss briefly.
Art Woods: From there we move on to talking about the dark art of science communication – MM: scicomm – including Tim’s own experiences making his show and writing his book, and some general pointers for doing scicomm in better and worse ways.
Marty Martin: I’m Marty Martin
Art Woods: And I’m Art Woods
Marty Martin: And this is Big Biology.
[music break]
Art Woods 00:00
Well, Tim, thanks so much for joining us on the show. It’s super great to get a chance to talk over information, science, misinformation, and things we can do to promote sort of better use of scientific approaches to everyday decisions. We're going to cover a whole range of topics on the show today, but we want to start with your relatively recent book called Relax, which has subtitles that differ by country. A User's Guide to Life in the Age of Anxiety, for example, is one. We just read the book, thought it was awesome. And just for the listener, what Tim does is he takes a sort of typical day, and he runs through all of the different kinds of decisions that one has to make: what time to get up, what to eat for breakfast, how much coffee to drink, you know, when to go to work, and what to do when you get there; and talks about a lot of the received wisdom about these events, and then proceeds often to debunk it. And to bring in science and say “no, this is not what you what you thought it was.” So super great approach. Really entertaining. I guess, I guess let's just start by talking about a couple of examples from that book. Let's jump into it by talking about coffee. I'm an avid coffee drinker. I'm trying to cut back. But I understand from your book, maybe that's not the best thing. Maybe it is the best thing. How much, how much coffee should I drink? How much coffee should anybody drink?
Tim Caulfield 01:20
First of all, don't cut back! You’re going the wrong direction.
Art Woods 01:24
Perfect!
Tim Caulfield 01:26
I love the coffee topic because, first of all, there are so many headlines about coffee and research, am I right? It's just a great example of a topic that has gotten a ton of attention, and the pendulum has swung back and forth. Right? So, you know, when I first started writing about the wellness, woowoo culture and health in pop culture, it was bad for you, you know, you weren't supposed to drink it, right? You know? It’s adrenal fatigue you were going to get which is not a real thing, by the way. Or, you know, it will cause, it was going to cause cancer, because it had all these chemicals in it the way it was processed. And so everyone was trying…
Art Woods 02:06
You’ll be dehydrated!
Tim Caulfield 02:07
Dehydrated which is another myth! I still hear that one. And so it was all these headlines about how it's bad for you. But it's kind of swung the other way now, right? Where we have these big observational studies that say, you know, it's good for you. And it's good, you know, cardiovascular risk for dementia and helps your exercise. But the reality is, and you guys know this, you guys are scientifically literate, you know, it, these are big observational studies, it's really hard to get powerful causative data about the role of coffee in our lives. And, and so the truth is boring, but probably in the middle: that it's probably not bad for you and maybe good for you. But I think it's a really, really good example of all these nutrition studies that we see, you know, chocolate wine that they love to roll out. And they're almost always observational studies that don't have good causative data to back them up. It's a good reminder that people should take those things with a grain of salt. And the other reason I love this topic, and it's a theme in the book is, you know, there's no magic food out there. There's no magical food. I wish there was a magical food, you know, coffee’s close.
Marty Martin 03:22
So, Tim, I mean, the thing with, many of us drink coffee for, obviously, the caffeine. I do happen to like the taste, lots of people like the taste. But there's, what about the research in terms of how much caffeine or the timing of caffeine intake personally, anecdotally, and it's, you know, not much better than correlation. It's an N equals one. But my day, my night is profoundly changed by having coffee later in the day. So what, what about the particular caffeine component of coffee?
Tim Caulfield 03:49
Yeah, and I think that that's a really important point, because when I, you know, here, I was half joking there. I love coffee. Drink up. Yeah, they're like my older brother. He can't drink very much. The drink makes him jittery. And a lot of my family members, they stop at noon, for the exact reasons that you're talking about. They're worried about the impact it's going to have on your sleep. So you absolutely have to get a sense of the impact that coffee has on yourself. But one of the things I think is really funny, and I talked about it in the book, is you have these studies that are done that look really scientific and they lead to other side headlines about how to optimize your coffee drinking, right? The exact timing of your…There was one that was done by the military, right, where they're trying to optimize exact, you know, this navy seals, I can't remember what it was or, you know, Army Rangers or something, you know, their, their their tactical gear drinking coffee.
Art Woods 04:37
The bad-assness of the Navy SEALs.
Marty Martin 04:39
Okay, so another one of the elements of a major academics diet, and I guess, office culture in general, no matter what the particular thing is email. What is the appropriate way to handle the ever-present, never-ending weekend-killing email?
Tim Caulfield 04:39
Yeah, once again, I think there's a lot of nutrition hype around that, and you've really got to figure out how coffee works for you. Right? And, you know, if you're drinking, you know, 20 cups a day, it's probably, it's probably not the best idea. But you probably know that. You guys have probably seen some of these studies and look, I'm making fun of observational studies that’s real research, can be absolutely valuable. Look, we learned about smoking and cancer, right? Through observational studies, so I'm not trying to say that there, it's totally useless. But a lot of the studies have looked at quite a bit of coffee intake, somewhere between four or five cups a day and still found no, no real harm associated with it. So I think you've got to figure out, you know, the role of coffee in your life. And is it impacting sleep? Is it impacting your anxiety? You know, and all those kinds of things. Oh, my gosh! I'm sure you guys agree with this one. Email is one of the worst parts of my life. You know, when you're an academic, you know, did you know you were signing up to be an email answerer? That was your job.
Marty Martin 05:55
I don't remember that class. No.
Tim Caulfield 05:57
I joke in the book that, and there's a lot of research on this, as you can imagine. I joke in the book that if you're in a major city, and you're looking at a crowd, you're probably looking at a crowd of email answerers, right? I mean, this is how dominant it is in our life, you know? Really has become a huge part of our life. It's our do-list, and, you know, there's some studies that talk about how a third of the workday is consumed answering emails. And some people even higher, put it higher than that. And of all the chapters in the book, this is the one that maybe had the biggest impact on my own personal, you know, life. So you've probably, there are a lot of like the business gurus, business optimization, kind of gurus have long talks about this idea of caching your emails, you know? Just answering it twice a day, or just ignoring them to the end of the day. And there have been studies on this. Not a lot. Again, hard to study this well. But that's also probably not a good idea because I actually have tried this. I don't know if you guys have tried this, but you think about it all day long. Think about the explosion, that's going to happen when you...
Art Woods 07:02
Oh shit.
Marty Martin 07:04
It's there.
Tim Caulfield 07:05
It's there. It's just waiting to blow up. It's like this bomb in my on my computer.
Art Woods 07:09
So I mean, I've swung between the polls of like, you know, tried to check just once a day and do everything in one fell swoop. And you know, you run into the occasional person who checks just a couple times a week and you think like, weirdo, you know? And then the other poll is like checking it all the time. Basically just having email open and answering things as they come in. In some ways, I think that works better for me because it feels like those conversations are sort of more ongoing, but then you hear things about like switching costs, right? And how disturbing it is to, like, answer an email and how long it takes you to get back to fully engaging with whatever task you were doing before. I don't know. I feel like I can switch pretty fast, but maybe I'm just deluding myself. And you know, I'm never working at full capacity because I'm always distracted. No comment. No comment.
Marty Martin 07:53
You probably are. I'm going to say you probably are deluding yourself.
Art Woods 07:58
Okay, great.
Tim Caulfield 08:00
So this, absolutely the switching costs. This ties into the multi-tasking literature that's out there. Right? And I think this is sort of like the coffee thing. And I think this research on this is pretty good. You know, I always had this huge caveat, hard to study this, well, you know, hardly, you can't really build a clinical trial really robustly here. But the datas points to the idea of trying to find times in the day where you're not switching, right? When you're avoiding that email. And that's sort of what I try to do. So like, and I'm a writer, right? I'll block for 45 minutes, and that feels like a long time. Isn't that terrible? Like, but 45 minutes, an hour, where you're not going to look at your email. But the problem, and this goes to your switching comment, so much of our of our lives is online. So I'll say I'm going to do that, and then I go: Oh, I've got to research that or I got to look at the data on that. So then you get off your manuscript, and you move to the internet. And then all of a sudden you're on your email, and then also you're on your Twitter feed. So it is, it is very, very hard to avoid that switching, but the data seems to indicate to try to find a pace. You're optimizing your, your sort of, your cognitive load, if you can find those blocks of time where you can be creative and actually get things done. Now, the other interesting thing, it's an excuse to talk about one of our cognitive biases, you know, this illusion of superiority, and I'm not saying you have that delusion.
Art Woods 09:21
I'm sure I do.
Tim Caulfield 09:22
But everyone thinks they're good at multitasking. I think there's been studies that have shown about 70, 70%, or 80% of people think they're good at multitasking, but everyone else is bad at multitasking. Right? And there has been again, some research on this and about 97.5% of people are terrible at multitasking. You're one of the 2%. I can see just by looking at you.
Art Woods 09:44
Right! Great! Kids walking to school. So Marty and I both have high school-aged kids and like mine walk, live pretty close to their high school in Missoula, Montana, and they could walk all the time. They often don't. I think Marty's kids maybe are the same way. Talk about why kids don't walk to school anymore, and how the fear of bad things happening has sort of put a crimp in us, in our, in our culture, and the way people think about that.
Tim Caulfield 10:14
Yeah, this is one of my, again, glad you brought up. This is one of my favorite chapters in the book. And as you know, in the book, I tackle sort of fun, frivolous stuff, and also things a little bit more serious. And I put this in that camp. And it also is a wonderful, you could have written an entire book on this, right? Because there's so many interesting social forces at play here, and I think it's a really good proxy topic for a lot of, of what, of our decision making right now, right now, which is so informed by by fear. So, so you're absolutely right. You know, if you look at the cultural shift, over the last couple of decades, parents are starting to drive their kids to school. And this is happening not only in North America, but all over the world, mostly in North America, and in particular, the United States, but it's happening all over, all over the world. And that decision to drive your kids to school, obviously, it's complex law. A lot going on there. Some parents just might be convenient for them because they're off to work or something like that. So I gotta be careful not to over-generalize, but that decision is largely informed by fear, right? Largely informed by fear because some studies have found that distance isn't even a variable that is that significant in this decision. And the fear, the dominant fear, than then holds quantitative and qualitative work on this is stranger danger. You know the white van is going to pull up, and there's going to be abduction. Or for older kids, it's going to be some kind of violence on the way to school. And if you look at the actual stats, right? You look at the chance of something like that happening to your kid, it's almost zero, right? It is so fantastically rare that you can put it in the category of not going to happen. Look, I've got four kids. Our kids walk to school, it is very, it was close. So I totally get this fear. I totally get it. But it's a very good example of how this, this fear mongering has caused this decision shift. And a lot of it has to do with what's called the availability bias, right? Because all it takes is one abduction, one murder happening on planet Earth, let alone in your county.
Art Woods 12:13
And we hear about it.
Marty Martin 12:14
Yeah. Yeah, Yeah.
Tim Caulfield 12:14
The headline is there. And that's what you remember. That's what you, that impacts your decision making. Not the fact that there's a one in a million chance that it's ever going to happen to your kid. The other, of course, a big factor there is, there is a little bit of peer pressure. We've experienced that, right? So all the other parents are driving their kids to school. If I don't drive my kid to school, I'm being, I'm being negligent. Right? So and again, a little bit of evidence to back that up, also. And then of course, you have to think of what's being lost here. Right? The kids' experience of being independent for just a few moments walking to school, the exercise, talking with friends, or maybe it's just a moment to daydream. All that's lost, right? When you drive your kid to school. And then of course, you also create a traffic issue. So you almost create a problem that didn't exist that necessitates you driving your kids to school. It's absolutely crazy. So we are starting to see a push back. We are starting to see a little bit of a shift. You're starting to see some places say you can't, you know, even build these zones where you're not allowed to drop your kids off. So I totally get it. But it's a really unfortunate cultural shift.
Art Woods 13:29
Yeah, it's a strange psychological thing. So like, so I grew up in Oklahoma, in a town that was detached from Oklahoma City at the time. It's now kind of been swallowed up by Oklahoma City, and it was it was pretty rural. I mean, I really grew up in the sticks. And I had a really unsupervised childhood in the sense that I could just, you know, run around after school in the woods behind the house with with all my friends, and we were just ran amok, and it was great. And I think it's actually really formative for me. And, you know, I can recognize that. I can see it clearly. And yet, I did not give my kids that same freedom here in Missoula, and like, why why not? You know, I mean, I think it's probably just as safe here, if not safer, and yet, somehow, it just did not feel right. And trying to piece together the origins of that feeling is really difficult.
Tim Caulfield 14:16
And it's, I think you make a really important point, because when you talk to people and as you guys know, there's actually a lot of research on this. People think crime is worse now, right? That is a dominant, dominant perception. And look, you know, when I wrote the book, it was easy. I could say this even more forcefully because as you guys know, the crime rates have ticked up a little bit, but still the crime right now, I don't know I'm not going to guess your ages. I think we're probably all in the same Venn diagram. We're kind of close.
Art Woods 14:45
Close enough.
Tim Caulfield 14:46
Yeah, the crime right now is way less than when we were growing up. Like the risk to you, when you were growing up, for some event to occur, which was still rare, right? Still in phenomenon, way less right? Way less now, than in the past, but the studies in United States in particular have shown that 70, 80% of people think that crime is worse now. They think drug use is worse now. Not true. They think, you know, all of these things are worse now than in the past, and it's simply not true. And part of it is the way it's covered. Part of it there, of course, is political messaging that people want. The other interesting thing, and I'm fascinated with, because you guys know I'm really interested in pop culture, is the way pop culture portrays crime. So you know, I have one of my secret passions is bad network, procedural, crime procedurals, you kno: CSI, Criminal Minds, Bones, I've watched them all. And if you believe those shows, there is a criminal on every corner ready to abduct your kids. And the crimes that are portrayed in those shows almost never happen, right? They just don't exist. But it does impact. There's this cultural obsession with those kinds of crimes, even though they don't reflect reality.
Marty Martin 15:55
Yeah. All right, one, one more little debunking, and then we'll switch gears a little bit. But I want to do this for one of my children. I'm not going to name names given the particular topic, but their siblings will definitely know who we're referring to. Your perspective, your take on dental hygiene, whether it was flossing, or the timing and brushing and fluoride in the water. I mean, what are we to think about these kinds of things?
Tim Caulfield 16:21
Oh, no, it's a tough topic. Of all the topics in the book, this is the one I kind of try to skate around. So prepare for some skating. So globally, globally, and I had the opportunity to talk to, you know, dental academics around the world, which is one of the great things about writing a book like this, I love these conversations, right? I love being able to talk to someone who's going to really dig, dug into the topic. So the reality is globally, the data on a lot of the dental care is pretty bad. It's pretty bad. Even around something like flossing, which it has become a truism. That you're supposed to do it. The impact of flossing, a lot of dental outcome, but I want to be careful here, right? This is part of, is not, it's pretty ambiguous. So you could argue in some academic, dental academics do, that it's because we haven't run the good clinical trials. Others say, look, even the clinical trials that have been done, you know, where people are flossing, you know, you get an expert flosser in there, it's not that impressive the impact it has on cavities. When you're talking about gum disease, it's a little bit, I think the data is a little bit more robust, but still not spectacular, you guys. The biggest impact on your teeth is brushing your teeth as a fluoride delivery mechanism. Right? So yeah, there are a whole bunch of other reasons to do it. We all have coffee. So there's the breath issue. But brushing is largely a fluoride delivery mechanism. So you have, you know, this, have to remember, it's a massive industry. So special brushes, you know? Special dental floss. All of that, there's a market out there. I'm not saying that dental care is not important. I'm not saying that. I think it is, obviously, very, very important, and there's really fundamental things that we need to do to take care of our teeth. But there's a lot of less than robust data informing our decision making.
Marty Martin 18:10
Yeah, so one thing that intrigued me about those chapters, among many things, especially hygienic advice to one of my kids, I've been interested in this concept of evolutionary medicine for a long time. And we want to move into sort of the evolutionary components of some of your points in the book. We'll get to that in just a second. But I've always been surprised, and it could just be my ignorance or lack of effort to look in the literature. I haven't seen a giant take on evolutionary dentistry. You know, it's always been bizarre to me why we go and get rid of these biofilms on our teeth when those biofilms presumably evolved with us for millennia. And I mean, the default position should probably be like most microbes: some of those guys are good, some of those guys are bad. And just absolutely blasting everything away. Does that make sense? I've tried to engage my dentist on these topics. He looked at me funny and left the room. He loves it when you come in. He's like... "OH THIS GUY AGAIN! HERE WE GO!" Yeah, but it's, I mean, is there any... Have you stumbled on anything evolutionary in the dentistry world?
Tim Caulfield 19:10
Oh, yeah. So I totally agree with you. I think it's absolutely fascinating. You know, because we had, we went through this era that lasted pretty long time where we destroyed everything, right? You know, it's a microbe, we got to get rid of it. So I'm actually involved in a big interdisciplinary microbiome project right now, where we're looking at microbiome hype that we.. I work with this, you know, scientific team that's actually doing research on the microbiome and the role of the microbiome and things like allergy and asthma, which is fascinating. But I think one of the the takeaways over the last, you know, say decade of microbiome research is that it's way more complex than we've often stated. And there's good and bad. Most of it's good. You know, the vast majority of microbes are either totally benign or probably good. And this small fraction are bad. So I think you're right. So there's been interesting commentary on mouthwash, for example, is that screwing up your your microbiome in your mouth? Yeah. I think it's an open question. Right? And so yeah, I absolutely agree with you. A nd you've probably seen this data to where they talked about your dental health might be proxy for more general health. Right? And, and that's why you see that correlation between socio economics and poor dental health, etc, etc. So I think the bottom line is a lot more complex than it's often been portrayed. And there's a lot of shaming around, you know? Like, think about your dental cleaning. Like you almost feel guilty if you don't go in and get your dental cleaning. And the reality is the data is like, you know...meehhh.
Art Woods 20:35
Yeah. That feeling of guilt is, it's funny you say it that way because, like, I've gotten the message from the dentists like: "Oh, you're six months overdue for your dental cleaning." You think "shit six months!" like, you know, "what a slacker I am!" Like, maybe it just doesn't matter. Let's move to a sort of recent and ongoing source of misinformation and strife. And that's just all of the sort of misinformation and outrage about COVID. So obviously, this last couple of years has been really trying for everyone. Huge global pandemic and lots and lots of misinformation. So why, like what happened to create that, that misinformation explosion associated with COVID?
Tim Caulfield 21:18
Yeah, it's been an unbelievable couple, a couple of years. So I've studied misinformation and conspiracy theories. You can imagine what my last couple years are like. It was... This is going to sound like hyperbole, but it's not, you know? The misinformation killed. Probably killed millions. Like I know that sounds like hyperbole but certainly hundreds of thousands of people.
Art Woods 21:35
Yeah, that's shocking.
Tim Caulfield 21:37
Yeah, died as a result of misinformation. Right? And and I don't think, I don't think that gets sent enough. You know, the new FDA head said, I think it was in March or April, that, you know, misinformation is having an impact on the life expectancy in the United States. You know, that's how, you know, measurable the impact of misinformation. And that's largely in the context of public health topics, but we had a couple of big grants on study misinformation. And so we've been in the context of COVID, we've been following it really, really closely. I've done some of our own, own work on it. And even our team was surprised how bad it got. You know, at the beginning we put these grants in in like February of 2020. And even though we went in, you know, our eyes open, we study this area, we were surprised how bad it got. And I think one of the things I was most surprised about, and this was naive of me, I should have anticipated it probably, but how political it became. How quickly this became about ideology. I'm sure you guys have seen these studies that in the United States, and there have been a number of medical health... I think it's fair to say there's a body of evidence on this now. About the correlation between whether you voted Republican or Democratic and the health outcomes in the context of COVID. Whether you voted Republican or Democratic predicts whether you'll take ivermectin, right? Are, you believe hydroxy? I mean, that's where we are. Right? Which is absolutely... And the other thing I think, is really, really important to emphasize, you know, when people like myself, and you know, other people talk about misinformation in the context of, of COVID, a lot of people are saying: "Oh, you're trying to silence debate", or "You're trying to...it's cancel culture. You're trying to erode freedom of expression". No! This stuff is clearly misinformation. We're not talking about the marginal stuff, you know, how much immunity do you get from Omicron? Or, you know, when's the best time to get a booster? We're talking about stuff that is clearly, clearly misinformation. That's what's really, you know? That's the trigger for a lot of these topics. But unfortunately, those on the other side, pushing the misinformation have done a really good job of, of clouding the discussion and trying to say, it's about cancel culture and everyone has different opinions. And unfortunately, then we resulted in a lot of false balance. I didn't answer your question because I was.. You, you really pushed a few buttons there for me.
Art Woods 24:02
That's great.
Tim Caulfield 24:04
You know, I think that there was fear. It was ideology. It was on the other side, you know, on the science, we could have done a better job with scientific uncertainty. I think we, especially early days in the pandemic, I think we were too dogmatic in our language and that had an impact on trust. And of course, of course, of course, and again, a body of evidence on this: Social media. Huge role. Just an absolutely huge... I know it's become a truism to say that now, but I don't think we should forget that social media really changed the nature and the quality and the magnitude of misinformation out there.
Marty Martin 24:38
Yeah, yeah. So um, what would you say? I mean, I guess the the other weird piece of this, that I never really know how to talk about because it forces me to look like I'm in a camp that I'm not necessarily in. And Art and I try really hard not to take stance. This is a science podcast. We try very, very hard not to get political, but ...
Art Woods 24:56
We're taking a stance for science. Come on!
Marty Martin 24:58
Taking a stand for science. Thank you. That's the platform that I'll stick with. There was a time. I mean, there had been examples. And Art and I talked about this offline before we started chatting with you. There have been times when, like the standard bearers for Science in the country did some really weird things in the US initially, you know. We weren't supposed to wear masks until we were all supposed to wear masks. How do, where do we stand right now with not necessarily the masks, but with the public trusting the best science because, you know, the people, they're supposed to be conveying that aren't telling us everything we need to know. And in that vein, I'm wondering what the literature now says about the biggest risk factors for morbidity and mortality with COVID? Because one of the ones that seems to be out there and doesn't get as much attention as I would think that it should is obesity. I mean, where do where do we stand right now? And how do we think about, as members of the public, trusting the scientific authorities when we're told different versions of the story? Yeah.
Tim Caulfield 25:56
This goes back to what I said earlier about, we did not handle scientific uncertainty very well. Right? And let's start with the data on trust. I mean, there's been a lot of research that has told us that trust has eroded with our, with health care providers, with the scientific community and for sure, with public health officials. Which is just tragic, right? It's just tragic. There was a study that came out very recently, I'm going to say, you know, week before last, that suggested that a growing portion of the population thinks it's okay to harass public health officials. Like it was just a stunning kind of data, right? And a little bit, a little bit across the ideological divide too. It was, yes, more with Republicans, but we're seeing that shift also with Democrats. And I just think that shows the frustration that people have with how science was communicated. I think the mass debate is great. And that goes back, back to what I said about we were too dogmatic in our language. As you know, you guys know this well. You know, in January of 2020, if you looked at the literature on the the utility of masks in this situation, it, you know, whose position, World Health Organization, the CDC, the Public Health Agency of Canada, the National Health Service in the UK, all had a very similar position on masks, right? And the idea was, and this was just sort of informed speculation at the beginning of a pandemic, was that they weren't going to have that much utility, people weren't going to wear them properly, they might be touching their faces more, and there might be a behavioral compensation that was hurtful. So in other words, people will have their masks on and think they're protected, and it's going to cause them to be closer to individuals, not washing their hands. So this was sort of like informed speculation that led to this dogmatic recommendation early in the pandemic, butI think it's often forgotten. They pivoted quickly, right, once the data started to merge on the effectiveness and utility of masks, and the messaging got better. But the damage was done. I still get people bringing up masks, you know, antivaxxers, and "why should I believe you?" So I think the lesson there, of course, is we've got to get better about talking about scientific uncertainty in a way that keeps people, people's trust. And that feasts, so that's the beginning of the pandemic. Let's go to the question that you had now. At the end...we're hopefully near the end of the pandemic.
Marty Martin 28:15
Pandemic, maybe.
Tim Caulfield 28:16
It's even more complicated. I, you know, this ragged ending, you know, to the pandemic. It wasn't like we're marching in the streets, you know, with victory signs, where.. It's questions about boosters, questions about, are we ever going to get under 100,000 deaths in the US a year? Right? You know, is this what the, is this what the future looks like? Questions about when we should be wearing masks? It's this very ragged ending, right? And questions about who's at risk and how we should target our public health efforts and messaging, right? So I think that it's going to be very, very challenging going forward, and then layer on top of that, all of the things that we just talked about have been politicized. Right? And it makes it near impossible that if I could, I'm going on too long, I apologize. But I think it's a really important question. The other thing that's happening is this revisionist history about the pandemic, and I'm actually thinking of writing a piece on this, unfortunately, this revisionist history is is landing, and particularly on the political right and we have to be careful people believe misinformation across the political spectrum. I don't want to sound like I'm picking on the political right. But we know in this context, this is where it's landing. The idea that vaccines didn't work. The vaccine saved 10s of millions of lives, right? You know that I'm sure you saw this study. I think it was like 20 million and the vaccines were a spectacular scientific achievement, number one, number two. They talked about how the lockdowns didn't work, right? And they're unnecessary, did more harm. Like the lockdowns varied across the country. I hate, I don't even like the phrase lock downs because every jurisdiction was trying to balance public health measures with, with freedoms. Every jurisdiction was doing that, and they did in different ways. And we know data tells us again that these lock downs, let's call them public health measures, were effective. They were effective. We were talking about slowing the spread, reducing hospitalization, you know, reducing deaths. They were effective, including mask views. Yes, going forward, I think we have to be more targeted, we're going to learn, but but that kind of revision is history. And the idea that the ivermectin, hydroxychloroquine, any other kind of reuse drugs are somehow, are effective, and were effective, just simply not true. But those three messages and forth, unfortunately, are landing. And they're causing us to be more angry about the pandemic, and I think probably worse, may have an adverse impact on future public health measures and how we tackle the way in which is going to come. It's just a matter of time. So yeah, it's a very, very interesting, tough time. And again, a long rambling response to a great question.
Art Woods 30:47
Yeah, no, that's great. Let me run one other idea by you which is something Marty and I were talking about offline. And I agree with you that part of this is just bad messaging and inconsistent application of ideas. But I think there's another thing at play here, which is that, you know, the science is developing in real time. And so people are making left turns and right turns not not politically, but just like in, you know, what they think is going to work and what they think is not based on new scientific studies that are coming out. And I think, maybe to us as scientists, that feels normal. That's part of the normal scientific process, but I think many people are uncomfortable with that because they see, you know, so called experts changing their mind. And to them, that's a sign of, you know, manipulation or some sort of darker thing going on rather than just like following the science as it emerges. What do you think about that?
Tim Caulfield 31:37
I totally agree with this and a really, really important point. And I also, I get so much hate mail. I'm sure you guys get some hate mail, too, but I just get tons and tons of hate mail. And this is always part of the content. By the way, quick aside, I always find it incredibly ironic because the tone of science doesn't work, you know, they're emailing me.
Marty Martin 31:58
Not a note on a pigeons leg.
Tim Caulfield 32:03
It doesn't work. But I think you're right. I think that there is, this goes to scientific literacy and how we have been taught to think about science. Science is not a list of facts, right? Sciences, it's really, really hard. It's messy. It's incremental. There's retractions. That's normal. There is outlier studies that get more attention than they should get. And I think that I'm hoping that one of the legacies of how science was communicated with throughout the pandemic is exactly this, that we learn to teach about scientific uncertainty, the scientific process, the importance of a body, the body of evidence, the importance of having open academic debate in a way that is constructive. All of, I'm hoping I'm naive because it's not going to happen, but I absolutely think this fueled. And one of the, one of the problems, of course, is on the other side that's pushing misinformation. They've weaponized this, right? They've weaponized the scientific uncertainty in a way to try to create the exact kind of impression you're talking about: that somehow science doesn't work, that it's being, something's being withheld, that we can't trust you because you disagree, which of course, is not the case at all. That's science playing out in real time in front of you, you know, we're seeing the sausages being made. We don't like what we see. Right? But that's the scientific, that's the scientific reality.
Marty Martin 33:21
Yeah, yeah. So did I understand you to say that, I mean, whereas the solution must lie in education, the solutions not going to come from education. Is that, is that right? That seems scary.
Tim Caulfield 33:36
You know, my answer, again, is entirely predictable. But I still think, it's really important to emphasize, you know, the solution, it's going to be multipronged. Like, this is an incredibly complex problem. That's going to require multiple solutions, right? So it's going to require teaching more critical thinking in education. The reason I'm cynical about that was, you know, how politicize education is, right? Less so in Canada and a lot of other jurisdictions, but certainly in the United States. But we have to teach critical thinking skills. We have to teach teach media literacy. We absolutely need to get the social media platforms involved. That's a topic for an entire podcast. We need to have the regulator's do more FTC, FDA, the the licensing bodies, physicians, the nurses, the physiotherapists. They need to do more. And we absolutely need to debunk, you know? Battling misinformation does work, you know, these kinds of conversations can have an impact. So we need to do more of that, and we've got to do it in a creative manner. We have to do all of those things, and much more of that, you know? That's not a comprehensive list, and we can make a difference. And I actually think this has become, you know, one of the defining issues of our time, so this is not, this is something that we all need to take very seriously. And the good news is, you're starting to see that happen, you know? The World Health Organization, the UN, the federal government's the state governments, you know, the universities, everyone's taking this topic much more seriously. And you're starting to see more scientists and clinicians get on Tik Tok on Facebook, on Instagram, and do a great job of of science communication.
Marty Martin 35:08
Right. Right. So one of the things that we do. I think we want to turn to sci comm. You know, you've just been an incredibly good advocate for that kind of a position, and we want to pick your brain a little bit about, you know, your sort of timeline through that, your experiences and such. But as a transitional point from this topic, as scientist, I know that my family doesn't really understand that when I publish a paper, I don't get a $500 check from the journal. Right? And then when I get a grant, I don't immediately get, you know, 50% of that million dollars or something like that. When in your position, you know, as you write these books, trying to do the good job of digging through all of the different science and distilling down, "what's the best message?" I mean, at the end of the day to be the cynic. You're, You're profiting off of this. Right? So you are writing a book. I mean, maybe profiting is too strong of a word.
Art Woods 36:00
At least some coffee.
Marty Martin 36:01
Art and I have published some books so really nice coffee occasionally, I guess, maybe your outcome here. But how do you navigate that? I mean, how do you? How do you think about portraying yourself as an honest broker? And then really more on the meta site: how do you do this? Like, how do you decide, with the mountains of literature that are out there, what the sort of status quo is, or the best way of understanding a particular topic is at the given time?
Tim Caulfield 36:24
Yeah, to the first question, it is a challenge. And there's actually kind of layers to that question because, and I have a lot of colleagues. The wonderful thing is now there's this community that you can discuss these issues with. So I have I have colleagues that, you know, kind of have walked the same path as me, you know, people like Jen Gunter, and, you know, others. We talk about these things a lot. And I think what I mean by layers is, you know, opportunities emerge, and you have to ask yourself, "should I do that? What impact is that going to have on a future messaging?" So, you know, do you go Dr. Oz?
Marty Martin 36:58
Right?
Tim Caulfield 36:59
Not that, not that that opportunity is coming, and I think I know what my answer would be. But you know what I mean. So I think this is a really, really important question. So for me, the way I negotiate it, and it might change in the future as I'm getting older, is I try to.. This is going to sound really boring, but I try to maintain a balanced portfolio. So in other words, I try to make sure that I'm still doing the academic work. That I'm getting the public research grants. That I'm engaging in a transparent way with the scientific community, with the public health community, with the policymakers. So you keep that kind of balanced portfolio. And then you're also doing, you know, writing to the popular press, and you're doing these books, and you're doing the media work. So that's the way I've, I've tried to negotiate it. And I think the other thing is to be really, really transparent. And I do think sometimes you have to make.. I won't say they're tough calls because you're.. It's getting tougher, and I'll come back to that in a moment. But who you do the work for? So who are you going to give a talk for and and to be sure that you're transparent about it? Do you work with the pharmaceutical industry? Right? Do you work with thi..I hate to use the word Monsanto because I think sometimes that's rolled out too often as the as an example of..But you ask yourself those questions and, and, I think you near always have to be reflecting
Marty Martin 38:18
Yeah. Okay, that's fair.
Art Woods 38:20
Let's let's stay on the sci com thread here just for a little while. So if you just had to provide any advice to aspiring sci comm people, and we know lots of younger scientists who are interested in in sci comm. In fact, I think it's maybe been more popular than ever. What, What's your advice on how to do it effectively? Like what, what's the best way forward to being effective and getting your message out?
Tim Caulfield 38:41
Yeah, I think first of all, please do it. We need more.
Art Woods 38:45
Just, just do it.
Tim Caulfield 38:45
Yeah, the more voices out there, I think, I think the better. I mean that. I know like if people, some people don't agree with that. They say you are just adding to the noise, and you need to have full, you know. I really think we need to have those voices out there countering the misinformation. And so for people that want to get involved, you know, take that step, one recommendation I often make is find something that you're really passionate about. That you can tackle in a creative way, and that isn't going to feel overwhelming to you, right? So one of my favorite examples of that, there's a couple. One is that there's a Twitter account called Just Say in Mice. Do you know that one?
Art Woods 39:22
No.
Tim Caulfield 39:23
So all they do, all they do is they highlight articles in the popular press that are about some kind of health benefit when the reality was it was done in mice. You know, this is a mouse study. That's all they do. And I think if you find it, it's I think they have 100,000 followers. Right? And that's all they do. And holy cow, is that ever valuable? And I think that that Twitter feed has had an impact. I think that it causes the popular press to pause. Is this a mouse? You know, should I put this line in here, that this is just a mouse study. So find something like that. Maybe it's about the microbiome. There's another one on quantum physics, you know, how the wellness-woo people love to say everything, you know? Reiki is quantum physics. Homeopathy is quantum physics. You know? Mindfulness is quantum physics. You know? So all they do is say, "it's not quantum physics". So find something like that, and you can feel comfortable getting in and you can get a little bit of traction. And then you can kind of expand as you feel, feel more comfortable. The other thing you can do, I always like to highlight, is creativity wins, you know? Shareable content, shareable content. You know, during the ivermectin debate, the FDA put out a tweet that said, "Seriously, y'all. You're not a cow. You're not a horse. Just stop." Right? Which I love it. Right? The FDA did that. Right? So think about something that's scientifically accurate but still creative and fun. And, look, this advice has been taken. There's so much great content out there right now. And we of course, have this entity called hashtag Science Up First, hashtag Science Up First. We're on Twitter. We're on Instagram. We're on Facebook. We're on Tik Tok. And we just try to create great content with diverse voices. We co create with different communities incredibly shareable content. Now I'm just an advisor, I was one of the cofounders of Stepback. We have this fantastic, creative, young, vibrant team that's handling it all. Scientific experts. I invite people to take a look at hashtag Science Up First because I think the team, not me, the team has done a fantastic job of all the things I've just described.
Marty Martin 39:42
Wow.
Art Woods 39:42
Wow.
Marty Martin 41:25
There, you know, the niche that we try to fill to be indulgent, the niche that we try to fill, is to sort of tackle some of those really complicated and yet super cool topics that just don't get treatments by, you know, the Attenborough's when they show the beautiful mannequins and the you know? He just cheats because he gets to go to tropical forest and show charismatic things, and it's just aren't my voices. It's not, not quite the same thing at all. But one of the one of the topics that you've pitched in a paper way, way back in ancient 2009 with Tania Bubela, was this sort of misconception of the deficit model, right?That the public can't, you know, understand complicated sort of things. So we're wholly sold on the idea that yes, in fact, the public can, but how do you navigate these really complicated things? And let me give you one that we would love your input on because it's something I think you've also written about and definitely thought about a lot. It's the sort of veil genetic determinism. The pervasive GWAS study that there's the gene for obesity or the gene for this and the gene for that, and Art and I just sort of scream from the mountaintops all the time. It's like, no, there's this thing called phenotypic plasticity, this other thing called epistasis. All these other big words that are so incredibly consequential, right? And yet, the media just continues to do this simplistic way of what genes are doing. How have you navigated this area, or that particular topic?
Tim Caulfield 42:44
I love that topic, and I'm so glad you brought it up because in my total academic hat on, this is actually a topic I've done probably the most research on. No one ever brings it up, so thank you very much. It's so true. You know, I used to start my class, I teach a science policy class. Every day, I start the class with items in the news. And I used to start every day with "The Gene for" news headlines. Every day there seemed like there was ten headlines, right? The gene for obesity. The genes for drinking coffee. The gene for and on and on and on. And it never plays out. I mean, it's almost like diets, right? You would think that after, you know, a thousand bad diets, people would realize there's no magical diet. You would think that after.. I've been collecting these headlines, and I should send you guys my slides, since 1993. And I have the yellowed, you know, the grey, you know? Actually I clipped.. I used to clip them out and make a collage out of them. Yeah, they never, ever, ever play out. And I think what happened was, You know, we had the BRCA one, BRCA two in the 90s, mid 90s. And we all thought, you know, we all thought we were going to have a million of these, right? They're going.. It just didn't happen, right? So I think that it's a very seductive, there's a lot going on here, right? It's a very seductive message. Right? And, and it feels sciency. And, of course, the other thing is, there's a big geno-hype industry behind it. You know, there are these huge grants right from the Human Genome Project through this great desire for this, this to play out. We've seen it with precision medicine take off. And, you know, you have all these direct to consumer genetic testing companies. And I think that was all fed this, this narrative. And I think it's harmful because it takes away from the basic things that we can do as humans to live a healthy lifestyle, right? Because it all becomes, oh, I have this gene and I'm supposed to be, you know, the reality you guys know this. The reality is there's like five or six or seven things that every human needs to do to live a healthy lifestyle. And I’m not talking about rare diseases, and of course, there's socio economics and all those things are hugely important, but there's six or seven things that we can all do and then everything else is fiddling at the margins. And these, this gene language that plays out in pop culture is really trying to target that fiddling at the margins and make it sound like it's bigger than it really is. But you guys know. You don't smoke. Look, if you smoke, nothing else matters. You don't smoke, you exercise and that's really whatever you love. You know, you eat well, no magic there. We all know what that looks like. You try to maintain a healthy weight. That's really tough. We all can be healthy in different shapes and sizes. You sleep. You take basic public health measures: wear seatbelts, you know, get vaccinated, and you surround yourself with people you love. That's about it. Am I, did I miss anything?
Marty Martin 45:34
No, that makes sense.
Art Woods 45:35
Such a lovely simple message. Like we all know this stuff, right?
Tim Caulfield 45:40
But you can't sell any gene tests on that one.
Marty Martin 45:43
23andMe will not fare well with that kind of perspective.
Art Woods 45:45
Life style coaches maybe. Let me ask one just sort of a counter question here at the very end, and I think we'll wrap: are there, are there counterproductive kinds of sci comm? Are there, are there approaches to sci comm that you think just don't work?
Tim Caulfield 46:00
Yes, for sure. You know, I think that one of the things we've learned is, you know, you can't be... You do need to figure a way to be creative. And this plays into our conversation about uncertainty. I think if you lean too heavily on the uncertainty, that's going to be weaponized. So I do believe you can be honest about what the science says and still respect the uncertainty. So I think, you know, the other thing is, I think being, you know, being too negative, playing to the fear. You can probably hear the hesitancy in my voice. The hesitancy is we know that that messaging does work. In other words, it is powerful. There's a negativity bias, you know, negative headlines outperform positive ones. But I think, in the long term, it's not an effective strategy. So I think we need to figure out how we can be constructive and positive and still have engaging content. But the other thing I will say is, there's this all, this concern about the backfire effect, right, that, you know, we shouldn't tackle misinformatio because we're just going to spread it. It's just going to cause people to be more entrenched in their views. Most of the literature actually doesn't support that concern. Most of the literature, especially post-2010 when we first started hearing about the backfire effect, tells us there's either no backfire effect, or it's much more complex and context specific than we realize. Yes, I think it's still there and more research needs to happen, but we shouldn't let it scare us away from battling misinformation. So you can use pop culture moments of which is what I tried to do. Like some celebrity will say something ridiculous, and I'll, I'll try to use that in order to talk about the good science, and not worry about the backfire effect. But the last thing, I think, is really important: shaming and blaming, it almost never works, right? So if there's someone out there who wants, who's striving to find something effective that's going to help them with their disease or with their life circumstances or their mental health, and they've got pulled into the misinformation void or the alternative, it doesn't do any good to shame and blame them, you know? Tackle the the source of the misinformation not the individual that's looking for answers.
Marty Martin 47:56
Okay. So, one last question, Tim. Is there some biological or health topic that you think needs more attention than it gets right now? Sort of it is mired in this sort of misunderstanding and needs a big spotlight.
Tim Caulfield 48:11
I think that the misinformation on the microbiome, I think, is and I think that's going to happen, I think we're going to see, see more of that. The other thing that I think doesn't get enough attention is the way in which science is twisted within the scientific community. So what do I mean by that? Predatory journals, science hype, retractions, that still circulate, you know, those zombie papers? I think all of that sort of all of those forces that happen kind of behind the veil. I think they need more attention. I think I you know, in my next book, I'm going to talk about this, but I think people should be marching in the street, about predatory journals, the hundreds of millions of dollars that a public funds that are wasted on this that is making the scientific enterprise worse, not better. Right? So that's just one example. So I would like to see more attention on on that as a source of misinformation and spin. And we're starting to see that, obviously, I've read a couple great pieces on that. But I really think that needs more attention. And it's not a, you guys know this, it's not going to be easy to fix because it really ties into the incentive structures in academia. All of those things, but I think it's a big complex problem. And if we want public to trust science, we need to fix science.
Marty Martin 49:28
Yeah, agreed. I mean, at the same time, we have to stick right out there in front and center all the problems, and they're already the impression of what problems there are. In fact, there are these two, so yeah, makes our job that much more difficult.
Art Woods 49:39
Well, fantastic. We've covered a lot of ground, but we always like to end by just giving our guests a chance to say anything that we haven't asked: Is there anything else you'd like to say?
Tim Caulfield 49:47
Well, first of all, I'd like to thank you for the opportunity to talk about this. I think it's such an important topic. And I think that, you know, I'm hopeful. I know we've talked about a lot of bad things. But I'm a glass half full kind of person. You know, I'm excited about all the good research that's going on now in the battling of misinformation. You know, I'm very involved in this community and in the literature and I'm really excited about the nuance that we're starting to see in in in the academic discussions, but also the policy discussions on how to tackle this. I think it's going to be ugly for a while, but I'm hopeful.
Art Woods 50:21
Well, that's great. Yeah, I remain optimistic too. I don't know, it seems irrational a lot of the time, but that's just how I feel. I think it maybe it's a personality quirk.
Marty Martin 50:27
Yeah. It's a good thing. You'll continue to do good work as long as…
Tim Caulfield 50:31
It’s everything that you guys do. I love these kinds of conversations. And I love that this platform exists.
Art Woods 50:36
Well, thanks so much for coming on the show.
Marty Martin 50:37
Yeah. Thanks for coming on, Tim.
Art Woods 50:38
It was a pleasure to talk to you.
Tim Caulfield 50:39
Thanks so much, guys.
[music break]
Marty Martin: Thanks for listening to this episode! If you like what you hear, let us know via Twitter, Facebook, Instagram, or leave a review wherever you get your podcasts. And if you don’t, well we’d love to know that too. All feedback is good feedback!
Art Woods: Thanks to Steve Lane, who manages the website, and Ruth Demree and Brad van Paridon for producing the episode.
Marty Martin: Thanks also to interns Dayna De La Cruz, Daniela Garcia Almeida, Kailey McCain, and Kyle Smith for helping produce this episode. Keating Shahmehri produces our awesome cover art.
Art Woods: Thanks to the College of Public Health at the University of South Florida, the College of Humanities and Sciences at the University of Montana, and the National Science Foundation for support.
Marty Martin: Music on the episode is from Podington Bear and Tieren Costello.