The Path from Evidence to Policy –The Perspective of an Experienced Legislator

Author: Roger Bernier, MPH, PhD

[Editor’s Note: In an increasingly divided world we thought it appropriate to look back to 2015 when one former congressman reflected on what it took at that time to move from scientific evidence to government policies.]

Researchers at Johns Hopkins have had a longstanding interest in how to translate research into policy or practice. This was evidenced over 15 years ago by a workshop on the topic reported in this newsletter (EM August/September 1998, see https://tinyurl.com/pr8jxgq ) and in the American Journal of Epidemiology. In keeping with that interest, the fall issue of Johns Hopkins Public Health magazine includes an interview with former Congressman Henry Waxman who was instrumental in passing legislation which reduced smoking, expanded Medicaid coverage, and increased access to generic drugs.

Below are excerpts from the interview conducted by Clarence Lam, MD, MPH, and himself recently elected as a Maryland state delegate.

CL: Is the politicization of science whether that’s climate change, environmental issues or vaccination policy a growing trend?

HW: Until five to 10 years ago, most people would pay a lot of deference to scientists because their decisions are based on evidence. Now I see a lot of people in power dismiss science as just another point of view, and probably one that’s biased.

Ideology seems to be much more prevalent in approaching a number of issues that otherwise should be looked at as scientific issues.

CL: What motivates politicians and special interest groups to discredit scientists today?

HW: There are a lot of groups that oppose what the scientists think we ought to do, for

- Policy cont'd on page 9 ideological reasons—but more often than not, it’s for profits.

CL: What’s your advice to scientists, researchers and others reaching out to legislators to effect policy change?

HW: I think it’s important that people who have expertise and knowledge share that with the policymakers. They ought not to feel any reluctance in that kind of a role. They’re the ones who have a special knowledge and whose views carry a lot of weight. So my recommendation is that they try to get those views across.

Because of the nature of what they do, scientists and researchers often don’t want to say things in a conclusive kind of way—because their scientific method is to always keep looking to revise the hypothesis based on new evidence. And so they say, “It appears to be,” or “The overwhelming evidence would indicate…”

They need to be honest about how they express it, but not in any way be cowed by the difficulties.

CL: When you first arrived on Capitol Hill, I think there was a greater sense of collegiality and working amongst colleagues, particularly those across the aisle. Do you believe that today’s bickering and grandstanding is the new norm? Or is there hope that the pendulum will once again swing back to that spirit of bipartisanship?

HW: I think the idea of the spirit of bipartisanship is overrated, because we [always] had people who were partisans. But the parties had a more diversity of opinion than each party now has. …But we’ve seen a transition to the two political parties going to polar points on a lot of issues.CL: So you attribute a lot of what we’re seeing today to further entrenchment within the parties themselves. And that’s led to fewer areas where they could work across the aisle?

HW: The idea of working across the aisle is still there. It’s a question of being patient enough. I look at my career in Congress as a good example. I authored many bills that became law that people now would say, “Well, of course we should be able to get nutritional information when we buy a food item.” Or, “Of course we shouldn’t have to breathe in someone else’s tobacco smoke in a public place.” Or, “It’s obvious that we ought to do everything we can to clean up the air we breathe.”

But there’s no inevitability to anything. Even the simple labeling law took years to pass, to develop the consensus behind it. The Clean Air Act took us 10 years of battling. On a lot of the laws, it sometimes took a decade or more to pass them as we tried to educate people, so that when they heard a quick sound bite from somebody on the other side who usually had an economic interest in the outcome to step away and evaluate the evidence and to see what’s really at stake. And eventually, people did come around.

To read the full Johns Hopkins interview, visit: https://tinyurl.com/ozsjhon ■

Editor's Note: All of us are confronted with more material than we can possibly hope to digest each month. However, that doesn't mean that we should miss some of the articles that appear in the public media on topics of interest to the epi community. The EpiMonitor curates a monthly list of some of the best articles we've encountered in the past month. See something you think others would like to read? Please send us a link at info@epimonitor.net and we'll include it in the next month

Public Health Topics

♦ Florida reports 7th case of locally acquired Malaria (Fox News) https://fxn.ws/44STU9r

♦ Ongoing avian influenza outbreaks in animals pose risks to humans (WHO) https://bit.ly/3q2WXNv

♦ World War III will be fought with viruses (WSJ via AppleNews+) https://on.wsj.com/3NYYrQT

♦ WHO reports dozens of babies sickened by deadly viral infections (NBC News) https://bit.ly/3O0zrZp

♦ The WHO declares aspartame “possibly” causes cancer. (NY Times) https://nyti.ms/3DkcYSh

♦ How to lose a century of [public health] progress (The Atlantic via AppleNews+) https://bit.ly/3K4AuXs

♦ Causaly raises $60M to give scientists access to “all of biology” (Sifted via AppleNews+) https://bit.ly/3Q2DFlW

♦ Study demonstrates cellular immunity of “comb-structured mRNA” as a novel mRNA cancer vaccine (MedicalXpress via AppleNews+) https://bit.ly/3YdXQQh

♦ Deadly Typhus spread by bug bites now found in US (NY Post) https://bit.ly/3pXsSPx

- Reading cont'd on page 13

What We're Reading This Month - con't from

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♦ A new study shows your brain is shrinking for the wrong reason (Popular Mechanics via AppleNews+) https://bit.ly/46XKVFK

♦ Antibiotic shortage could worsen Syphilis epidemic (NY Times) https://bit.ly/3Oke1rJ

COVID-19

♦ Genetic variant may be why some people test positive for COVID-19 with no symptoms (Washington Post) https://wapo.st/3Q1Znqf

♦ America’s best Covid dodgers revealed – 60M of us haven’t caught it (DailyMail) https://bit.ly/44wDnIq

♦ Study finds children born during the pandemic have poorer communications skills (The Guardian) https://bit.ly/44txdZI

♦ Harvard and Yale scientists study new condition dubbed “Long Vax” (DailyMail) https://bit.ly/3q31way

♦ There’s now a rapid, accurate COVID-19 air detector (Time Magazine) https://bit.ly/43xXXqN o you have news about yourself, a colleague, or a student?

Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at this address for inclusion in our next issue. people@epimonitor.net

Honored: Amanda Crowson, MPH, RN, CPU, CIC was honored by APIC with the esteemed New InvestigatorAware at the 2023 Association for Professionals in Infection Control and Epidemiology (APIC) Conference and Exhibition. Crowson started her professional journey at AdventHealth Tampa in Florida, where she completed her field experience while a Master of Public Health student at the University of South Florida. She has dedicated herself to the field of infection prevention and even returned to school to become a registered nurse during the COVID-19 pandemic.

Honored: Henning Tiemeier, MD, PhD has been named one of the two recipients of the2023 Alzheimer Award by the Journal of Alzheimer’s Disease. Dr. Tiemeier received his Doctorate in Medicine and his sociology degree from the University of Bonn, Germany, and his PhD in Epidemiology from the Erasmus University in Rotterdam, the Netherlands. He is Professor of Psychiatric Epidemiology at the Erasmus University Medical Center Rotterdam and in 2018, was appointed Professor of Social and Behavioral Science and Sumner and Esther Feldberg Chair in Maternal and Child Health at the Harvard TH Chan School of Public Health.

Honored: Roseanne Freak-Poli, PhD has been named one of the two recipients of the2023 Alzheimer Award by the Journal of Alzheimer’s Disease. She is a life-course epidemiologist. Her work is strongly driven by social justice, being the distribution of wealth, opportunities, and privileges within a society. She is a Senior Research Fellow at the School of Clinical Sciences at Monash Health, Melbourne, Australia. She has been awarded an NHMRC Early Career Research Fellowship and a National Heart Foundation of Australia Postdoctoral Fellowship.

Appointed: The Philadelphia Department of Public Health announces the appointment of Dr. Landrus Burress as their new Director of the Division of Disease Control. Dr. Burress is an Air Force veteran and served as Chief of Public Health Operations for the Preventive Aerospace Medicine Division, US Air Force Central Command, 332nd Expeditionary Medical Group in Southwest Asia. In that role, he directed public health operations which included disease reporting and surveillance, communicable diseases, population health, occupational health, and public health emergency preparedness to maintain health for three global Southwest Asian locations.

Do you have news about yourself, a colleague, or a student?

Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at this address for inclusion in our next issue. people@epimonitor.net

Appointed: Professor Marian Knight, who is Professor of Maternal and Child Population Health and Director of the National Perinatal Epidemiology Unit at Oxford Population Health, has been appointed National Institute for Health and Care Research (NIHR) Scientific Director for Research Infrastructure. She will lead on the strategic development of the NIHR’s infrastructure, working in partnership with infrastructure leaders. As part of her role on the NIHR Board, Professor Knight will support the Department of Health and Social Care Chief Scientific Advisor and NIHR Chief Executive, and the Director of Science Research and Evidence to deliver against the NIHR’s mission to improve the health and wealth of the national through research.

Honored: Dr. Joseph Pater has been recognized for a lifetime of work in cancer research with his appointment as an Officer of the Order of Canada. The honor acknowledges the impact of his dedication to clinical research which has improved the lives of Canadians with cancer. He is a Professor Emeritus at Queen’s, was the head of the Department of Community Health and Epidemiology, where he taught clinical trials courses and supervised graduate students and fellows. For over 40 years, he has advanced clinical trial research in Canada. “Dr. Pater is one of the most important individuals in Canadian cancer research, having built a network that has defined new standards of practice, improved patient outcomes, and is recognized globally as a centre for excellence," says Dr. Janet Dancey, Director of the Canadian Cancer Trials Group (CCTG). He is sometimes called the “father” of cancer clinical trials research in Canada.

Named: The University of Chicago has announced that Dan Nicolae has been named the Elaine M. and Samuel D. Kersten, Jr. Distinguished Service Professor in the Departments of Statistics and Medicine and the College. Nicolae joined the faculty at the University of Chicago in 1999. He has served as chair of the Department of Statistics from 2016-2022, section chief for the Section of Genetic Medicine from 2015-2016, and currently as faculty co-director of the Data Science Institute. Nicolae’s research seeks to understand the role of genetic, genomic and environmental factors, and their interactions, in the development of common diseases. A statistical geneticist and a mathematical statistician, he specializes in developing methodological advances for large data problems in biology and medicine.

Do you have news about yourself, a colleague, or a student?

Please help The Epidemiology Monitor keep the community informed by sending relevant news to us at this address for inclusion in our next issue. people@epimonitor.net

Jodie Guest, PhD, professor and senior vice chair of the Department of Epidemiology was awarded the 2023 Kenneth Rothman Career Accomplishment Award, which honors an outstanding scholar who has made extraordinary contributions to the field of epidemiology or whose work has had a profound impact on epidemiology.

Lauren Christiansen-Lindquist,PhD, assistant professor and director of graduate studies for MPH and MSPH programs in the Department of Epidemiology was awarded the 2023 Tom Koepsell & Noel Weiss Excellence in Education Award, which is awarded to an individual who has made substantial contributions to the field of epidemiology through mentoring, training and/or teaching.

Neel Gandhi, MD, and Sarita Shah, MD, professors in the Department of Epidemiology at Rollins with secondary appointments in Emory’s School of Medicine . Gandhi and Shah were awarded the 2023 Roger Detels Distinguished Researcher in Infectious Disease Award, which recognizes extraordinary contributions to the research field of infectious disease epidemiology.

Shakira Suglia, ScD, professor and vice chair in the Department of Epidemiology was awarded the 2023 Carol J. Rowland Hogue Award for Outstanding Mid-Career Achievement, which is given to a midcareer scientist who has made an exceptional contribution to the practice of epidemiology.

Near Term Epidemiology Event Calendar

Every December The Epidemiology Monitor dedicates that issue to a calendar of events for the upcoming year. However that often means we don't have full information for events later in the upcoming year. Thus an online copy exists on our website that is updated regularly.

To view the full year please go to: http://www.epimonitor.net/Events The events that we are aware of for the next month follow below

August 2023

August 3-4 https://bit.ly/34bPNIB

Conference: 7th International Conference on Public Health (ICOPH 2023) / Multiple / Kuala Lumpur, Malaysia & virtual

August 5-10 https://bit.ly/3HF6IYM

Conference: JSM 2023 (Joint Statistics Meeting) / American Statistical Association / Toronto, Canada

August 8-26 https://bit.ly/38pSFlY

Summer Program: Erasmus MC Summer Program / Erasmus MC / Rotterdam, The Netherlands

August 8-12 https://bit.ly/3pVSNDh

Short Course: Principles of Research in Medicine and Epidemiology / Erasmus MC / Rotterdam, The Netherlands

August 8-12 https://bit.ly/3pYjt6k

Short Course: Principles of Genetic Epidemiology / Erasmus MC / Rotterdam, The Netherlands

August 8-12 https://bit.ly/3pWfN4V

Short Course: Advances in Clinical Epidemiology / Erasmus MC / Rotterdam, The Netherlands

August 8-12 https://bit.ly/327ATVW

Short Course: History of Epidemiologic Ideas / Erasmus MC / Rotterdam, The Netherlands

August 15-19 https://bit.ly/3ILLQx4

Short Course: Causal Inference / Erasmus MC / Rotterdam, The Netherlands

August 22-26 https://bit.ly/3pV8Ml0

Short Course: Social Epidemiology / Erasmus MC / Rotterdam, The Netherlands

August 22-26 https://bit.ly/3pUSXus

Short Course: Practice of Epidemiologic Analysis / Erasmus MC / Rotterdam, The Netherlands

August 22-26 https://bit.ly/3E1IH8Y

Short Course: Data Science in Epidemiology / Erasmus MC / Rotterdam, The Netherlands

August 23-27 https://bit.ly/3mXQ4qe

Conference: ISPE Annual Conference / International Society for Pharmacoepidemiology / Halifax, Nova Scotia, Canada

September 2023

Sept 12-13 https://bit.ly/3C0IFjk

Conference: Swiss Public Health Conference 2023 / University of Bern / Bern, Switzerland

Sept 12-15 https://bit.ly/3PBGvME

Conference: 11th Southeast Asia and Western Pacific Bi-regional TEPHINET Scientific Conference / SAFETYNET & Australia National University / Canberra, Australia

Sept 17-20 https://bit.ly/3PANSnA

Conference: 35th Annual Conference of the Intl Society of Environmental Epidemiology / ISEE / Kaohsiung, Taiwan

Sept 20-22 http://bit.ly/35hZRhG

Conference: 2023 CityMatch Leadership & MCH Epi Conference / CityMatch / New Orleans, LA

Sept 24-27 https://bit.ly/3huUxTC

Conference: 17th Vaccine Congress / Elsevier / Glasgow, Scotland

Sept TBA https://bit.ly/3BMHkMR

Conference : American College of Epidemiology Annual Conference / ACE / Charlotte, NC

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