"Our Grandchildren Will Not Live as Long as We Do"
Dr. Francis Collins has served as the director of the National Institutes of Health since August, 2009. He is the former director of the National Human Genome Research Institute, where he led the successful effort to complete the Human Genome Project—which mapped and sequenced all of the human DNA and determined aspects of its function. The project built the foundation upon which subsequent genetic research is being performed. He is a member of the Institute of Medicine and the National Academy of Sciences. In 2007 Collins received the Presidential Medal of Freedom, the nation's highest civilian honor, and in 2009 Pope Benedict XVI appointed him to the Pontifical Academy of Sciences.
Collins has also published several books about the intersection of science and faith, including the New York Times bestseller "The Language of God: A Scientist Presents Evidence for Belief."
Question: What are the biggest health risks facing America?
Francis Collins: If you look at health in the United States, you could point to some really significant achievements and you could also point to the role that NIH has played in making those things happen; cardiovascular disease has dropped by more than 60% in mortality over the course of the last 30 to 40 years, much of it from insights derived from groups like the Framingham Study which pointed out what the risk factors were and what we could do about them. Cancer is dropping in its frequency, finally, after many years of going up.
But there are clouds on the horizon of public heath, obesity and it’s related disease, diabetes, probably is the one that causes the greatest concern when you see the way in which our population is growing more overweight almost year by year with no sign that we’ve managed to turn this around. And that could, if not somehow addressed, result in an outcome where our grandchildren will not live as long as we do and we would therefore turn down what has been upward curve in longevity over many decades. A critical need there through research, research that involves nutrition, research that involves understanding exercise, then understand the built environment and how to motivate health behaviors to try to turn around this obesity epidemic.
Certainly other areas of concern... Alzheimer’s Disease comes to mind as a condition which as our population is aging and as the Boomers are coming into this phase of potentially higher risk of Alzheimer’s, that we are gong to see very large numbers of people affected by this heartbreaking disease with terrible consequences for themselves and their families and for our medical economics because of the cost of caring for them. So this has to be a very high priority for our high intensity efforts to come up with new solutions about prevention and treatment.
Question: How much of research should be focused on prevention, as opposed to treatments and cures?
Francis Collins: NIH is intensely interested in prevention. I think everybody would agree that we haven’t paid enough attention to this approach to maintaining health, that we’ve not had a health care system in terms of medical care—we’ve had a "sick care" system where if you get sick there might be some help for you, but there’s been relatively little invested in terms of helping people stay well. And maybe as a part of that we’ve had modest efforts, really, to try to invest in research on prevention. That’s all changing. Some of that’s coming about because of a better understanding of the environment and things that people should be careful about as far as bad influences on their future health, whether it’s smoking or diet or exercise. We’re learning a lot about that.
And some of it is the ability through personalized medicine to begin to identify individual risks for a future illness to get us beyond the one-size fits all approach to prevention, which has been not that effective. People haven’t necessarily warmed to these recommendations about what you should do about diet, exercise, colonoscopies, mammograms and so on because it all sounds very much generic.
But if you could provide people with information about their personal risks and allow them therefore to come up with a personalized plan for maintaining health that seems to inspire a lot more interest. Genomics is moving us in the direction of being able to do that and I think that’s one of the more exciting developments in the prevention arena even though it’s early days yet, to see how that’s going to play out.
Recorded September 13, 2010
Interviewed by David Hirschman
We must confront our national obesity crisis, warns NIH director Francis Collins, or face a decrease in life expectancy.
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- Pfizer partnered with AMP and the World Health Organization to develop a training program for healthcare workers.
Political division is nothing new. Throughout American history there have been numerous flare ups in which the political arena was more than just tense but incideniary. In a letter addressed to William Hamilton in 1800, Thomas Jefferson once lamented about how an emotional fervor had swept over the populace in regards to a certain political issue at the time. It disturbed him greatly to see how these political issues seemed to seep into every area of life and even affect people's interpersonal relationships. At one point in the letter he states:
"I never considered a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend."
Today, we Americans find ourselves in a similar situation, with our political environment even more splintered due to a number of factors. The advent of mass digital media, siloed identity-driven political groups, and a societal lack of understanding of basic discursive fundamentals all contribute to the problem.
Civil discourse has fallen to an all time low.
The question that the American populace needs to ask itself now is: how do we fix it?
Discursive fundamentals need to be taught to preserve free expression
In a 2017 Free Speech and Tolerance Survey by Cato, it was found that 71% of Americans believe that political correctness had silenced important discussions necessary to our society. Many have pointed to draconian university policies regarding political correctness as a contributing factor to this phenomenon.
It's a great irony that, colleges, once true bastions of free-speech, counterculture and progressiveness, have now devolved into reactionary tribal politics.
Many years ago, one could count on the fact that universities would be the first places where you could espouse and debate any controversial idea without consequence. The decline of staple subjects that deal with the wisdom of the ancients, historical reference points, and civic discourse could be to blame for this exaggerated partisanship boiling on campuses.
Young people seeking an education are given a disservice when fed biased ideology, even if such ideology is presented with the best of intentions. Politics are but one small sliver for society and the human condition at large. Universities would do well to instead teach the principles of healthy discourse and engagement across the ideological spectrum.
The fundamentals of logic, debate and the rich artistic heritage of western civilization need to be the central focus of an education. They help to create a well-rounded citizen that can deal with controversial political issues.
It has been found that in the abstract, college students generally support and endorse the first amendment, but there's a catch when it comes to actually practicing it. This was explored in a Gallup survey titled: Free Expression on Campus: What college students think about First amendment issues.
In their findings the authors state:
"The vast majority say free speech is important to democracy and favor an open learning environment that promotes the airing of a wide variety of ideas. However, the actions of some students in recent years — from milder actions such as claiming to be threatened by messages written in chalk promoting Trump's candidacy to the most extreme acts of engaging in violence to stop attempted speeches — raise issues of just how committed college students are to
upholding First Amendment ideals.
Most college students do not condone more aggressive actions to squelch speech, like violence and shouting down speakers, although there are some who do. However, students do support many policies or actions that place limits on speech, including free speech zones, speech codes and campus prohibitions on hate speech, suggesting that their commitment to free speech has limits. As one example, barely a majority think handing out literature on controversial issues is "always acceptable."
With this in mind, the problems seen on college campuses are also being seen on a whole through other pockets of society and regular everyday civic discourse. Look no further than the dreaded and cliche prospect of political discussion at Thanksgiving dinner.
Talking politics at Thanksgiving dinner
As a result of this increased tribalization of views, it's becoming increasingly more difficult to engage in polite conversation with people possessing opposing viewpoints. The authors of a recent Hidden Tribes study broke down the political "tribes" in which many find themselves in:
- Progressive Activists: younger, highly engaged, secular, cosmopolitan, angry.
- Traditional Liberals: older, retired, open to compromise, rational, cautious.
- Passive Liberals: unhappy, insecure, distrustful, disillusioned.
- Politically Disengaged: young, low income, distrustful, detached, patriotic, conspiratorial
- Moderates: engaged, civic-minded, middle-of-the-road, pessimistic, Protestant.
- Traditional Conservatives: religious, middle class, patriotic, moralistic.
- Devoted Conservatives: white, retired, highly engaged, uncompromising,
Understanding these different viewpoints and the hidden tribes we may belong to will be essential in having conversations with those we disagree with. This might just come to a head when it's Thanksgiving and you have a mix of many different personalities, ages, and viewpoints.
It's interesting to note the authors found that:
"Tribe membership shows strong reliability in predicting views across different political topics."
You'll find that depending on what group you identify with, that nearly 100 percent of the time you'll believe in the same way the rest of your group constituents do.
Here are some statistics on differing viewpoints according to political party:
- 51% of staunch liberals say it's "morally acceptable" to punch Nazis.
- 53% of Republicans favor stripping U.S. citizenship from people who burn the American flag.
- 51% of Democrats support a law that requires Americans use transgender people's preferred gender pronouns.
- 65% of Republicans say NFL players should be fired if they refuse to stand for the anthem.
- 58% of Democrats say employers should punish employees for offensive Facebook posts.
- 47% of Republicans favor bans on building new mosques.
Understanding the fact that tribal membership indicates what you believe, can help you return to the fundamentals for proper political engagement
Here are some guidelines for civic discourse that might come in handy:
- Avoid logical fallacies. Essentially at the core, a logical fallacy is anything that detracts from the debate and seeks to attack the person rather than the idea and stray from the topic at hand.
- Practice inclusion and listen to who you're speaking to.
- Have the idea that there is nothing out of bounds for inquiry or conversation once you get down to an even stronger or new perspective of whatever you were discussing.
- Keep in mind the maxim of : Do not listen with the intent to reply. But with the intent to understand.
- We're not trying to proselytize nor shout others down with our rhetoric, but come to understand one another again.
- If we're tied too closely to some in-group we no longer become an individual but a clone of someone else's ideology.
Civic discourse in the divisive age
Debate and civic discourse is inherently messy. Add into the mix an ignorance of history, rabid politicization and debased political discourse, you can see that it will be very difficult in mending this discursive staple of a functional civilization.
There is still hope that this great divide can be mended, because it has to be. The Hidden Tribes authors at one point state:
"In the era of social media and partisan news outlets, America's differences have become
dangerously tribal, fueled by a culture of outrage and taking offense. For the combatants,
the other side can no longer be tolerated, and no price is too high to defeat them.
These tensions are poisoning personal relationships, consuming our politics and
putting our democracy in peril.
Once a country has become tribalized, debates about contested issues from
immigration and trade to economic management, climate change and national security,
become shaped by larger tribal identities. Policy debate gives way to tribal conflicts.
Polarization and tribalism are self-reinforcing and will likely continue to accelerate.
The work of rebuilding our fragmented society needs to start now. It extends from
re-connecting people across the lines of division in local communities all the way to
building a renewed sense of national identity: a bigger story of us."
We need to start teaching people how to approach subjects from less of an emotional or baseless educational bias or identity, especially in the event that the subject matter could be construed to be controversial or uncomfortable.
This will be the beginning of a new era of understanding, inclusion and the defeat of regressive philosophies that threaten the core of our nation and civilization.
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