Thursday, 11 May 2017

Study Shows Link Between Discrimination and Type 2 Diabetes

Public HealthFat causes [insert health issue here.] We here this every day.  The problem is, it’s not true. The research about weight and health isn’t about causation, it’s about correlation and that’s an important distinction.  Correlation means that two things happen at the same time.  Causation means that one thing is the result of the occurrence of the other thing.

This is not an unimportant distinction.  Let’s say that men with certain types of baldness have higher rates of heart attacks.  Let’s say the correlation is extremely high. So, healthcare practitioners say that obviously we’ve got to help these guys grow hair so that they can reduce their heart attack risk!  But let’s say that the treatments that lead to men growing hair only work on about 5% of men, the rest grow hair in the short term but lose it all again in a couple of years with a majority ending up with less hair than they started with.

So let’s say that healthcare practitioners (encouraged by people who sell the hair regrowth treatments) blame the men, claiming that anyone who tries hard enough can grow hair. People start to calculate the cost of these guys heart attacks and calling them a “drain on society.”  The government starts a War on Baldness and every person that bald men come in contact with are encouraged to let them know that they need to grow hair, that they are obviously weak willed, and they are a drain on society.  It becomes ok to not hire bald men (so that the companies insurance isn’t affected.) People suggest that maybe bald men shouldn’t qualify for insurance, or healthcare at all until they do what it takes to grow hair.  A dangerous surgery is developed that may help men grow hair, but is also likely to leave them with lifelong side effects, and the surgery kills many of them.

If this sounds ludicrous then look no farther than the way that fat people are treated. It’s happening right now. The thing about bald men having higher numbers of cardiac incidents is true by the way – and the correlation is very high. But what researchers found when the dug a little deeper was that both the baldness and the cardiac incidents were caused by a third factor.  That’s not unusual, the thing about correlation is that if A and B are correlated it’s possible that A causes B, it’s possible that B causes A, it’s possible that A and B are both caused by a third factor, and it’s also possible that they are, in fact, unrelated and the correlation is a coincidence.

I’m bringing this up because a new study shows a correlation between discrimination and Type 2 Diabetes. This isn’t new, Peter Muennig found correlation between stigma the comes with being fat in a fatphobic society, and the health conditions that are correlated with being fat.

This doesn’t just apply to fat people, it’s an issue for every marginalized person. And it’s one more way that hate speech and discrimination affect us negatively.  The study found that those who reported two or more major discrimination experiences had a 34% increased risk of diabetes (over nine years) than those with no reported experience of major discrimination. In terms of health care for fat people this is important because, while we don’t know how to make fat people thin, we do know how to stop discriminating against them and we can start right now (and of course that goes for other marginalized groups as well.)

The lead author, Kara Whitaker, said ““It may be beneficial for clinicians to ask patients about their experiences with discrimination as an additional method to identify individuals who may be at increased risk for developing type 2 diabetes or cardiovascular disease.”

I agree, but as a fat person who has dealt with all kinds of fatphobic nonsense at the doctor I would suggest that it may be beneficial for clinicians to ask themselves if they are contributing to that discrimination.  And people who create public health messaging should make sure that their messages aren’t adding to discrimination.  And while we’re at it, it’s important for all of us to remember that “everybody knows” is not the same as “evidence shows,” and correlation never ever, never ever, implies causation.

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