Government health advice: Is it too complicated or is the public too simple?

Having enjoyed a few extra days off over the holidays, I’ve taken the opportunity to catch up with an old friend: BBC Radio 4. The station’s consumer programme, You and yours, has been running a series of pieces on government initiatives and guidelines to do with public health, trying to find out whether they are sensible and successful. You know, the constant reminder to eat 5 portions of fruit and veg a day, drink two litres of water, only drink alcohol in moderation on days spelled with a ‘y’, sprint for 30 seconds every full moon, always wear a condom while driving a car and so on.

Photo: Flickr/Faith Goble

Firstly, to determine whether the advice provided by the government was scientifically sound, the programme-makers spoke to a range of scientists. Although not all the scientists could agree on what precisely the targets and limits should be, some very interesting facts emerged, building up a complex picture of the health effects of various, er, variables.

Regarding alcohol, for instance, the risk of liver disease does not rise significantly with the consumption of 20 units or less per week, and even up to 40 units can be taken in with only a small increase, but beyond that limit the risk goes up exponentially. For women, however, the risk of contracting breast cancer increases from 10% (if they drink no alcohol) to 11% if they drink 20 units per week, 12% for 40 units per week and so on, rising in a straight line.

Well, I found it very interesting, anyway.

But what was even more interesting was that the scientists didn’t all agree on the ‘safe’ level of alcohol a man or woman could consume in a day, or a week. I think that’s because the key word in all of these statistics is risk. Although the scientists presumably had access to the same data, they had different notions of what level of risk is acceptable.

E=mc^smashed

Photo: Flickr/RDECOM

Fortunately for these eggheads, their ginormous brains understand all the fiddly sciencey bits well enough to make an informed decision about how much wine they should glug. But what about the rest of us numbskulls? Shouldn’t we also be entitled to make our own decisions about the lifestyle-based risks we take? If surveyed, I think most people would agree. As long as it doesn’t involve any thinking of course. Or, even worse, reading. Or maths, by God!

So another question the programme-makers asked was whether the slogans and guidelines were memorable and clear enough for the general public to make use of, and it was this part that I found the most disheartening. It was here that that unspeakable monster, general ignorance, raised its ugly head, as physician turned TV-presenter/diet-book-author Dr Michael Mosley asked punters in a pub whether they understood the guidance on booze.

The consensus seemed to be that the advice is too complicated. One woman helpfully suggested: “If it was clearer why the limit is set there, I’d be more likely to stick to it,” but I instantly doubted whether, if presented with the above statistics on liver disease and cancer, she would be able to read through the whole paragraph without getting bored and starting a game of Fruit Ninja on her smartphone. A man piped up: “I count my drinks in glasses, not in units, so the government advice isn’t that useful. It’s too technical,” suggesting that he isn’t even aware of the difference between the volume of liquid he is consuming and the amount of alcohol. What would he make of the word ‘exponentially’? I shudder to think.

"I wasn't sure how much a unit was so I just got this much beer."

All of which was accepted without comment by the doctor and Peter White back in the studio, who set about scratching his head over how the guidelines could be made easier to understand. The true problem was thereby totally bypassed, namely, the problem of getting people to think about their health seriously and learn some of the complicated facts that will help them to make their own informed lifestyle choices.

This is equally true of the politicians, who naturally aren’t overly keen to accuse their constituents of gross witlessness. Much better, they appear to think, to simplify the science to the point where it really becomes more or less a lie, presumably in the hope that if the public is too stupid to understand, it will at least follow instructions, just as long as they are in short, snappy sentences. Not so! Those interviewed for You and Yours were justifiably sceptical about the health dictats from on high. Unfortunately, these same shrewd critics of the official line don’t appear to care enough about their own health to bother to find out the facts for themselves.