Bash Science with Gay AND Fat-shaming? It's like a rightwing three-fer

We recently discussed how the Origami Condom project supported under the Small Business Innovation Research Congressional mandate had quite obvious public health implications in a prior post. This was in response to the gleeful Republican bashing of NIH funding priorities in the wake of NIH Director Francis Collins' rather poorly considered claims* that Ebola research has been held back by the flatlining of the NIH budget over the past ten years.

Today we take on another one of these claims that the NIH has not been using its appropriations wisely. Fox news provides a handy example of the claim:

The National Institutes of Health (NIH) has spent more than $39 million on obese lesbians

As the wags are posting on various social media outlets, more Americans have been dumped by [insert popular entertainment personality] than have been killed by Ebola.

In striking contrast, obesity is a big killer of Americans. According to one review of the evidence:

Using data on all eligible subjects from all six studies, Allison et al. estimated that 280,184 obesity-attributable deaths occurred in the U.S. annually. When risk ratios calculated for nonsmokers and never-smokers were applied to the entire population (assuming these ratios to produce the best estimate for all subjects, regardless of smoking status, i.e., that obesity would exert the same deleterious effects across all smoking categories), the mean estimate for deaths due to obesity was 324,940.

Additional analyses were performed controlling for prevalent chronic disease at baseline using data from the CPS1 and NHS. After controlling for preexisting disease, the mean annual number of obesity-attributable deaths was estimated to be 374,239 (330,324 based on CPS1 data and 418,154 based on NHS data).

Over 350,000 Americans die annually of obesity. For the Republican Congresspersons in the audience, "annually" means every year. Last year, this year, next year. Over 350,000.

No biggie, right?
Whoops, maybe it is worse than we thought?

Researchers found that obesity accounted for nearly 20 percent of deaths among white and black Americans between the ages of 40 and 85. Previously, many scientists estimated that about 5 percent of deaths could be attributed to obesity.

And is coming close to beating smoking as the top preventable killer of American citizens?
Flegel et al 2004 and Flegel et al 2013 provide some handy context to estimating mortality causes for the nerdier types. From the 2013 meta-analysis:

[overweight (BMI of 25-<30), obesity (BMI of ≥30), grade 1 obesity (BMI of 30-<35), and grades 2 and 3 obesity (BMI of ≥35) ] .. CONCLUSIONS AND RELEVANCE: Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality.

So. Just this easily we can confirm that obesity is a major public health concern from mortality alone. This doesn't even get into non-mortal effect of obesity on personal well-being. Major public health concerns are the very province of NIH-funded academic research.

So once again, the applicability of grants that are targeted at reducing obesity (even if it is just understanding the causes of obesity) to the goals of the NIH, as mandated by Congress, is not in question. At all. This is not a frivolous expenditure.

That leaves us with the specific projects in question. I trotted over to RePORTER and pulled up 6 current awards- two are K-mechanism mentored training awards so we'll focus on the R-mechanism research projects.

R01 HD066963: SEXUAL ORIENTATION AND OBESITY: TEST OF A GENDERED BIOPSYCHOSOCIAL MODEL

nearly three-quarters of adult lesbians overweight or obese, compared to half of heterosexual women. In stark contrast, among men, heterosexual males have nearly double the risk of obesity compared to gay males. Despite clear evidence from descriptive epidemiologic research that sexual orientation and gender markedly pattern obesity disparities, there is almost no prospective, analytic epidemiologic research into the causes of these disparities. It will be impossible to develop evidence-based preventive interventions unless we first answer basic questions about causal pathways, as we plan to do.

I bolded a key part, from my perspective. You waste a ton of money, often public money, if you go off with solutions to problems without having a clear understanding of the things causing or following from this problem. Epidemiological and sociological research guides not just public policy but also additional studies of physiology, genetic liabilities, etc. So this specific project would seem to be of considerable use.

R01 DK099360:TYPE 2 DIABETES AND SEXUAL ORIENTATION DISPARITIES IN WOMEN

lesbian and bisexual (LB) women may be at elevated risk for developing T2D because they are more likely than heterosexual women to experience obesity and other risk factors linked with T2D such as cigarette smoking, violence victimization, and depressive distress. Nonetheless, knowledge of T2D and how it may disproportionately affect LB women is severely limited. Studies using longitudinal designs that have comprehensively examined how lifestyle, diet, and psychosocial risk factors for T2D may differ between LB and heterosexual women across the life course are virtually nonexistent.

This project emphasizes non-mortal morbidity, i.e., Type 2 Diabetes (T2D). And again, the abstract describes how we know almost nothing about the reasons for the obesity disparity between lesbian and heterosexual women. If we are going to disentangle potential social, behavioral, cultural, physiological and genetic contributors to the disparity, we need information. And very likely, through this research we will come to know more about how these variables affect obesity risk for all Americans, across all subpopulations. This will help us design better interventions to reduce the obesity burden. Clearly this is another grant that is clearly non-frivolous and fits into the public health mandate of the NIH.

R21 HD073120: UNDERSTANDING DISPARITIES IN OBESITY AND WEIGHT BEHAVIORS BY SEXUAL IDENTITY

Previous research indicates that lesbian, gay, bisexual and transgender (LGBT) adults experience more adverse health outcomes than their peers. Findings from the few studies examining weight disparities among adults suggest that lesbian women are more likely to be overweight or obese compared to their heterosexual peers, though less is known about gay men and bisexuals. Given the scant research to date in this area, the Institute of Medicine (IOM) recently issued a call for additional research on LGBT health. Furthermore, IOM highlighted the need to utilize a life-course framework when examining health disparities by sexual identity, acknowledging the unique influence of various life stages on health

What's this now? Even the US Institute of Medicine has reported on how important it is to combat obesity in US citizens? I mean dang, guys, it's the IOM.

The Institute of Medicine (IOM) is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public.

Established in 1970, the IOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln in 1863. Nearly 150 years later, the National Academy of Sciences has expanded into what is collectively known as the National Academies, which comprises the National Academy of Sciences, the National Academy of Engineering, the National Research Council, and the IOM.

And they do investigations, review evidence, compare the facts...

anyway, this R21 is going to focus on young adults and do studies under the following Aims:

(1) Quantify disparities in obesity, dietary intake, physical activity, unhealthy weight control behavior, body satisfaction and other weight-related health outcomes among LGB and heterosexual students; (2) Identify major weight-related health behavioral patterns, or profiles, and the extent to which these behavioral profiles differ by sexual identity and gender; and (3) Characterize these behavioral profiles by demographic factors and health outcomes (e.g., age, socioeconomic status, health care coverage, obesity, and health status). We hypothesize that LGB students engage in more adverse behaviors than their heterosexual peers and exhibit differential behavioral patterning.

Yep, more psycho-social research but I continue to assert that without this evidence, we run the risk of wasting more money pursuing directions that could have been falsified by the epidemiological and social science studies of this type.

The final research project is an R15/AREA grant:
R15 AA020424: MINORITY STRESS, ALCOHOL USE, AND INTIMATE PARTNER VIOLENCE AMONG LESBIANS

Ok, going by the Abstract this one is indeed focused on Alcohol abuse and intimate partner violence and I don't see why it is being triggered by the obesity keyword on the search. But still, I think we can see that this one ALSO would draw right wing fire. Even though, once again, alcoholism and intimate partner violence are huge health issues in the US.

As with the Origami Condom NIH Grant, we can find with relatively little thinking that the "National Institutes of Health (NIH) has spent more than $39 million on obese lesbians" comment is wrongly placed in an article addressing "wasteful" spending on the part of the NIH. These projects address the causes of obesity, which is basically a top predator of Americans at the moment. Obesity causes excess mortality and morbidity, which is of course associated with financial costs. Costs to the individual and costs to us all as a society that shares some degree of social support for the health care of our fellow citizens. It is in our direct and obvious interests to conduct research that will help us reduce this burden of obesity. As far as studying subpopulations who appear to be at increased risk for obesity goes, there is no reason not to want to help African-Americans, Southern Americans, Flyoverlandia Americans or...Lesbian-Americans. Right? And while it may take a little bit of a leap of faith for those who haven't thought hard about it, understanding the causes of a major health condition in those other people over there helps to understand the causes in people who are just like ourselves. By subtraction if by no other means.

For my regular Readers I'll close with a plea. Use analysis like this one to beat back this stupid meme that is going around about "frivolous" NIH expenditures. This is not just about this current Ebola fervor. This is about the normal operations of the NIH as it has progressed over decades. There are always those wanting to score cheap political points by bashing science as trivial or obviously ridiculous. Nine times out of ten, these charges are easily rebutted. So take the time to do so, even if it just posting some text pulled from the grant abstract and a link to a morbidity report on whichever health concern happens to be under discussion.

__
*"poorly considered" meaning he didn't apparently anticipate handing such a bunch of base-bait to the Republicans.

26 responses so far

  • becca says:

    Huh, that's weird.

    Lesbians are threatening to right wing republicans BECAUSE they are more likely to be obese, i.e. less likely to feel pressure to give a flying fig about the male gaze. You'd think they'd be in favor of convincing those women to become as preoccupied with loosing weight as their Sexuality Approved counterparts.

  • Davis Sharp says:

    For my regular Readers I'll close with a plea. Use analysis like this one... .

    I'll add that even though there won't be time to check PubMed or NIH Reporter for a well-researched analysis when a family member brings up a topic at the holiday dinner table, if you ad lib that [topic] is a model for [x behavior/disease] and understanding [topic] may inform interventions, and say it authoritatively (because, y'know, you have a PhD in some sciency field) then it may be effective.

  • Dude, don't you get that NIH funding is supposed to only address the health issues of Real White Male Heterosexual Christian Americans?

  • Philapodia says:

    Perhaps one of the reasons that more of us don't do this kind of analysis is because it feels like fricken wack-a-mole. Here's an example from Coburn's Wastebook screed

    (http://www.coburn.senate.gov/public/index.cfm/pressreleases?ContentRecord_id=e7359436-1572-414e-8acc-0222cad1c7d5).

    It takes a lot of different things out of context, make bullshit claims about the work with no supporting evidence or links to the original study to justify their claims, and then state that the projects are a waste of money.

    Here are some lovely examples:

    -Government Study Finds Out Wives Should Calm Down (NIH) $325,525

    If your wife is angry at you and you don’t want her to stay that way, you might avoid passing along the findings of this government study. Wives would find marriage more satisfying if they could calm down faster during arguments with their husbands, according to government-funded research.

    - Need Brains! Fighting Zombies with Pluses and Minuses -- (NC) $150,000

    A grant from NSF went to a company in North Carolina to develop a math learning game based on the zombie apocalypse.

    With two-three sentences that some staffer pulled out of his/her ass in about 2 minutes, whole lines of research are drowned in the bathtub. And because Coburn has power this is taken seriously. However, if we want to start to refute this crap we have to spend hours doing research and construct a logical argument. It doesn't matter that we can refute every point and demonstrate the value of the work, because in the public eye simple explanations (i.e. this is a waste of money) trump complex justifications (this work helps kids stay engaged in the game and increases skill retention). Truthiness also plays a big role here. If people think something sounds true based on their beliefs they are unlikely to critically assess the information.

    I wish the non-governmental societies like AAAS or Research! America with a bigger megaphone than individual scientists like us would take a more active role in refuting these types of claims. It would be more believable to the public than just Joe Scientist writing a letter to the editor, although I think this still has value.

  • Philapodia says:

    Also, 90%+ of the US population has never heard of PubMed or RePorter, making it exceedingly difficult for the unwashed masses to actually look up some of these dubious claims if they would actually care to do so.

  • drugmonkey says:

    At the very least understand that people seek information with Google these days. The mole whack has a longer tail than you imagine. Speaking as a guy who gets Google sourced traffic on blog posts written half a decade ago.....

  • Philapodia says:

    Googling fat lesbians brings up some interesting results...

  • DJMH says:

    Duh, if we shit-can these studies and let a lot of lesbians die of obesity, then we (straight white men) save money, and there are fewer of them! WIN-WIN.

  • louis says:

    Right. Googling fat lesbians brings out a whole lot of porn videos. That's surely going to be very helpful for science.

  • Philapodia says:

    "Googling fat lesbians brings out a whole lot of porn videos. That's surely going to be very helpful for science."

    Exactly. The Google is a powerful tool, but word choice makes a difference. Searching for "fat lesbians" brings up porn whereas searching for "obese lesbians" brings up a bunch of Faux News articles that re-emphasize the original point. Joe the Plumber won't see a difference between using fat lesbians and obese lesbians due to the fact that he's an idiot and won't get past the porn sites to find out that these studies are good for the public health and aren't a waste of money.

    In regard to posting counter-arguments, is there really any value posting on hyper-right wing sites like Fox News where a lot of this crap is coming from? My few times looking at the comment threads on that site made me feel unclean, and people who dissent are attacked pretty quickly and savagely. Posting pseudonymously that you're a scientist and here are the reasons that the meme is wrong lacks power from authority, whereas posting your IRL info seems like a dangerous thing to do professionally and personally.

  • drugmonkey says:

    You post here anonymously and seem to feel that is a productive use of your time despite not leveraging your IRL credibility. How would or be different on an article that passes along the science bashing tropes?

  • Philapodia says:

    Because your audience is actually willing to have a real conversation and critically think about arguments presented in a logical and rational fashion, as well as being respectful of others views. Therefore this place is not a waste of any of our time and is a good forum to help us clarify our thinking. The audience at those other venues do not necessarily want to hear things that don't agree with their world-view, and reasoned arguments from anonymous commenters are shouted down without any logical reasoning or respect of alternative viewpoints. Therefore it's a waste of time posting on those forums, especially anonymously. It's just spittin' in the wind.

  • Philapodia says:

    Besides, in certain states in the US it's a career-threatening offense for professors to publicly state what you think in online forums.

    http://www.huffingtonpost.com/2013/10/25/university-of-kansas-david-guth_n_4164298.html

    Perhaps it's cowardly to not come right out and fight with the RWNJ in open battle, but tell that to a spouse and kids when you lose your job over it.

  • Comradde PhysioProffe says:

    Arguing with morally and intellectually degenerate RWNJ filth is a waste of time. What we need to do is defang their political power and kick them into the electoral gutter where they belong.

  • Juan Lopez says:

    After reading the "story" in Fox News about NIH "waste" I had been anxiously waiting for this forum's response. Thank you. I try to help by talking with people not about specific stories, but about how to listen to the news. Some don't even notice that the stories have a political underpinning and many are aired because of this. I may not convince them that funding research on obese lesbians is worthwhile, but if I instill in them some doubt about the news being fed, it may help. Remember Sara Palin's jokes about studying fruit flies?

  • drugmonkey says:

    PP- and we do that how? By providing counterpoint that the reasonable middle can read and think about.

  • Philapodia says:

    Where is the most effective place(s) to reach this reasonable middle? Obviously RW media is not the way to go as people who go there are looking for an echo chamber. Are we talking writing letters-to-the-editor to the NY Times (liberal), Washington Post (conservative), both and try to hit a large swath of the middle while, or would our best bet be to focus on regional newspapers like the Times-Piciyune? I imagine all of the above is the answer, but from a time:benefit standpoint what would reach the "receptive" audience most effectively.

    I think that having larger lobbying groups like AAAS and Research! America taking point on these types of counterpoint essays would be most effective way to go because it takes the onus off of individual scientists to put their neck on the line and puts the heft of the group behind the message. It also allows a single entity to present opinions on multiple topics (obesity in the LGBT community, global warming, emerging infectious diseases, dangers of escaping nanoswarms from Area 51, etc) and would be a single-stop shopping experience for these middle of the road voters.

  • drugmonkey says:

    from a time:benefit standpoint

    It takes a trivial amount of time to make a comment on a Fb or twitter feed. Minimal effort to make a blog post that sits there all ready for Google traffic. Not that much effort to talk about it with friend, neighbors, family, etc. That's my approach.

    having larger lobbying groups like AAAS and Research! America taking point on these types of counterpoint essays would be most effective way

    While we need this for relatively immediate Congressional traction, changing the hearts and minds of our fellow citizens one person at a time has the potential for lasting change. IMO.

  • newapporach? says:

    I sometimes wonder why these overly simplistic assertions aren't/can't be countered by overly simplistic assertions. So when someone says the NIH is wasting money on LGBT obesity research couldn't the response be, 'oh, so you're okay with people dying from obesity'? Or with the zombie math example the response could be, 'if you're against math games then you must be against our children's learning' and so on.

    If it's these soundbites that really matter when communicating with the larger public, can't we come up with some inflammatory ones of our own? I'm all for a well-reasoned logical argument, but that approach hasn't really been working very well lately.

  • theLaplaceDemon says:

    "Or with the zombie math example the response could be, 'if you're against math games then you must be against our children's learning' and so on. "

    Even better for the right-leaning crowd: "So you're cool with China kicking our asses at math and engineering, then?"

  • Lady Scientist says:

    DM: I don't even think that the average right-winger can comprehend counter-arguments. THAT's the problem. I've attempted coherent arguments (with citations, even, to keep things based in fact!) to right-wing acquaintances before, but they don't seem to be able to understand the citations (even though they are written for the lay public).

    The best way to defang would be to decimate the financial backers of this nonsense, as they pay people to write all kinds of crap that just gets regurgitated around the web. Nip it in the bud. How best to decimate the financial backers? Not sure. Boycott, but that probably won't happen, given how dependent this country is on things that those people provide (e.g. fossil fuel industry, which backs public climate change deniers, and affiliated individuals who have their own conservative agendas and fund other anti-science campaigns).

  • Lady Scientist says:

    And, when I say "decimate," I mean decimate *financially*.

  • Lady Scientist says:

    Although, I personally wouldn't mind if God decided to strike them all with lightning and literally decimate them.

  • K99er says:

    This morning I posted the NIH Reporter link to one of the "fat lesbian" grants on my facebook page, so that my friends could actually read what it's about. So far the only responses I received were private messages saying, "What the heck are you talking about?" I think we scientists are far more tuned in and sensitive to this anti-science stuff than the average person.

  • drugmonkey says:

    Even better, you got your licks in first. Inoculation

  • Lady Scientist says:

    I'm guessing that this is only the tip of the anti-science iceberg. It seems like money is influencing election outcomes even more than ever, and favoring Republicans: http://www.commondreams.org/news/2014/10/21/dark-money-spending-key-senate-races-shattering-records-report

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