06 May 2011

Unhealthful News 126 - To the WHO, headaches only hurt productivity

A recent WHO report on the burden of disease from headaches came out and numerous news sources reported the same story about it.  It was kind of an amusing case study in news reporting, because basically all the news sources ran the exact same Reuters story, obviously based on the WHO press release, right down to the headline:  "WHO report finds headaches have 'enormous' costs".  This was odd because these were mostly actual human news outlets, not just websites that just use bots to capture and reprint press releases and wire stories.  It is not unusual for many news sources to run a wire service story with only minor variations, but usually there are some edits or additions, and the headlines almost always vary, but not this time.  I did notice one headline that varied because they presumably had to cut it for length; it read: "WHO report finds headaches".  Kind of koan-like.

Anyway, what was striking about the news stories was that none that I saw acknowledged that a headache's primary effect is making the person who has it suffer.  Instead, according to the WHO, headaches (with particular emphasis on migraines and other recurring severe headache syndromes) matter because they make huge dents in productivity and lead to medical expenses.  The news story said:
Publishing its first global atlas on headaches, the Geneva-based United Nations health body said it found that 47 percent of all adults have a headache disorder and "the financial costs to society through lost productivity are enormous."  In the European Union (EU) alone, 190 million days are lost from work every year because of migraine, it said.
Migraine alone is the cause of an estimated 400,000 lost days from work or school every year per million of the population in developed countries, and in the EU, the total annual cost of all headache has recently been estimated at 155 billion euros ($229 billion).
The articles went on to say:
Headaches can be debilitating for many people…
Aha, an acknowledgment that we are talking about suffering people here. 

Oh wait, that sentence continued with:
...rendering them unable to work. During migraine attacks, 90 percent of people postpone household chores, almost three-quarters have limited ability to work and half of them miss work entirely.
My mistake.  People are just laborers and housekeepers. 

Without further research, it would be possible to attribute this denigration of the real human experience to sloppy news reporting, wherein the reporters fixate on anything that is quantified (typically done, though probably not very accurately, for medical costs and productivity effects) and ignore concerns about the real human cost.  But searching the WHO report itself reveals that the fault is in the original.  The word "suffer" is just used as a valueless synonym for "experience" (as in "those who suffer headaches"); only the section labeled "Epidemiology and Burden", which is less than one page out of the 35 page report, uses "suffer" once in the humanitarian sense of the word.  No forms of words like "misery" appear, and the word "pain" is just a technical feature of headaches, save for two uses in the "Epidemiology and Burden" section.  By contrast, forms of the word "productivity" appear on about one third of all the pages, and the word "cost" is quite common, always in reference to either financing or productivity.

Frankly, none of this is surprising, though it is interesting to see it so starkly evident.  There are two kinds of operations in public health.  They all try to make themselves out to be the first type, humanitarian welfare-based organizations.  But more total resources can be found in the second type, organizations that use public health to make people better able to contribute net benefits to those who are in control.  There is a reason that the U.S. Surgeon General wears a Navy uniform: the U.S. Public Health Service was created as a way of keeping weapons in a good state of repair (I refer to the human weapons, obviously).

The WHO is not the humanitarian organization that many people might think it is.  It is a special-interest medical-industry-oriented organization with an emphasis on the interests of governments, not people.  Its emphasis on productivity in looking at headaches is similar to how it ignores people's welfare in its completely inflexible anti-tobacco rules, the FCTC.  All of this reflects an underlying ethic that people's labor and health belong to the state or community and so their health is not primarily about their own welfare.  This is the communist or fascist ethical system (which is analysis, not name-calling; despite the bad name those ethics have earned, they have had strong intellectual support and are still accepted by many people), though sometimes it is difficult to not sometimes see the WHO's hierarchical approach and support for oligarchs as being more like feudalism a rather less ethically defensible organizing principle.

Not that this lets the reporters off the hook.  Just because WHO's report views the world's people from a fascist perspective does not mean the reporters could not have brought some humanity to a story about headaches.  This is not something complicated and somewhat arcane like WHO's recent discussion on the burden of non-communicable diseases.  Every reporter knows someone who suffers from severe headaches; how hard would it have been to have added some humanity to this "public health" story?

[Completely random postscript.  That "two kinds of operations" reminded me of a humorous observation I saw on another blog recently:  There are two kinds of people in the world, people who are comfortable figuring things out in the face of missing information

1 comment:

  1. Wonder how Claude Shannon would interpret that last (brilliant) sentence (signal or noise)...ironic that he succumbed to Alzheimers, the ultimate noise overwhelming signal condition.


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