May 29 2014
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Idea Gallery: Lessons from a Survey of Americans' Beliefs in Medical Conspiracy Theories

Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. In this Idea Gallery, Brian C. Quinn, PhD, the Robert Wood Johnson Foundation’s Assistant Vice President, Research-Evaluation-Learning, provided his perspective on how to address medical conspiracies and other controversial narratives when developing a Culture of Health.

file Brian C. Quinn, PhD, RWJF’s Assistant Vice President

You may have recently seen the headline “Half of Americans believe in medical conspiracy theories”—or one like it—on your favorite news outlet. Or even on The Onion.

When the Robert Wood Johnson Foundation decided to fund the study responsible for grabbing these headlines, we wanted to know much more than just how many—as in, “How many Americans believes in health conspiracies?” We wanted to answer many other “how” questions, too. How do these beliefs spread? How do they correlate with people’s health behaviors? How should providers and others approach treating and talking to those who hold these beliefs?

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It’s important to note that this study’s authors did not set out to pass judgment on these controversial narratives—or those who hold them. In fact, it was critical to the researchers’ success that they remain agnostic in that regard. The bottom line is nearly half of Americans believe in at least one health conspiracy, such as the government is hiding evidence that cell phones cause cancer or the U.S. Food and Drug Administration is intentionally suppressing natural cures for cancer. And, if we are serious about building a Culture of Health, we cannot afford to ignore the perspective of one in every two Americans.

I recently enjoyed a fascinating conversation with the study’s lead researcher, University of Chicago political scientist Eric Oliver, and came away with a few such insights that should enlighten—and may even surprise—some of you.

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First, and perhaps most surprising for many, Oliver pointed out, “People who embrace these theories are not [necessarily] less concerned about their health.” In fact, many people who his study classifies as “high conspiracists”—those who believe in three or more of the theories tested—are very health conscious. The survey results showed those people are more likely to prioritize organic foods, seek out natural cures and take vitamins. In other words, health providers, when communicating with such patients, should not mistake a difference of opinion for indifference.

The survey results of these same “high conspiracists” also brought forth a second interesting insight.  Although many value their health, they are also simultaneously less likely to engage in some more traditional healthy behaviors, such as using sunscreen or getting annual physicals. This seemingly contradictory behavior, as Oliver pointed out, is actually very common—just one of the many complex ways in which people make sense of their health.

“Not everyone thinks about health the way I do or the way you do,” he said. “Some approach health from the perspective of a strong religious tradition, others understand health from a more organic or holistic tradition, and some people understand health as evidence-based practice, strictly from the mantle of science.”

Third, the study also showed health professionals make good health educators—when they have a chance. “People who got most of their health information from a doctor or nurse tended to be much less likely to embrace these conspiracy narratives,” said Oliver.

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But, many Americans do not rely on doctors for most of their health information, turning instead to “celebrity” doctors, alternative sources or friends and family. We clearly have an opportunity to help more patients see and trust the clinic as a place to learn. Our Flip the Clinic initiative is a good start. And, there are undoubtedly many other ways research from Oliver and others can help us build on that effort to create the conditions and attitudes necessary to truly shift how patients interact with providers.

These first few insights led Oliver and me to a tough question, which he phrased aptly: “How do you promote a Culture of Health when you, in fact, have all of these different cultures [of health]?” It’s a very salient question, given the Foundation’s recent commitment to creating a Culture of Health across America.

His answer? “These different cultures of health don't necessarily always coincide with each other, and people choose or exist in one or sometimes many of these cultures simultaneously. Each of these is a different kind of culture and they engage in health practices in different ways and through different types of assumptions. [When] we approach people and try to improve cultures of health...We can’t have a one-size-fits-all health message.”

He is absolutely right. At the same time, it’s important to remember something else Oliver shared earlier in our conversation. It’s not that people who believe in health conspiracies don’t care about their well-being. In fact, many of them care a lot, which is why they go to great lengths to try new treatments or avoid GMOs.

What seems to hold true across the spectrum of skepticism in America is a desire to be healthy and have access to the tools we believe will make us healthy—whatever those are. It’s that shared desire for health that gives me hope we can indeed achieve a Culture of Health together.

Hear more from my conversation with Eric Oliver on our forthcoming episode of RWJF’s Pioneering Ideas podcast.

Tags: Idea Gallery, Patient safety and outcomes, Public health