Do opinion polls counts as medical research?

Few consumers would guess how much of the medical literature is devoted to articles on how to sell the obesity crisis in order to garner the greatest support for obesity initiatives. One article recently published in the Journal of Epidemiology and Community Health provides a typical example.

In an article captioned “Evidence-based public health policy and practice,” German psychologists reported on a telephone survey conducted by a marketing and opinion agency, USUMA. They randomly selected 1,836 teens and adults, but were unable to reach one-third of them, and another 13.8% refused or didn’t complete the interview, leaving them with 1,000 people. As with many telephone surveys, those with land-line phones and the free time to participate don’t always represent the general population and, in this case, most of those interviewed were older and of low education.

Opinion polls and surveys may seem like an unusual form of research for publication in medical journals, since they’re always marketing. They’re a well-known tactic used by successful public relations firms and advertisers to create the bandwagon effect, sell an idea, create a demand for something and shape public opinion. Polls are enormously easy to manipulate to create any consensus the pollsters want to promote, by how the questions are worded, who the pollsters select to interview, how they ask the questions, and how the results are interpreted. With people asked to choose from restricted, prepared choices; the poll creators define the issue and the results depend on how questions are phrased and the choices arranged. Public opinion poll published in a peer-reviewed journal are no less worthy of skepticism than one in a checkout stand tabloid or on the nightly news.

The value in this survey, though, is as a heads up to how we may be being manipulated to get the greatest numbers of us behind obesity initiatives. In fact, the study was titled: “What determines public support of obesity prevention?” And, if the findings accurately portray the beliefs of consumers, it illustrates the success that marketing and the influence of the media has had.

Confirming years of similar papers, the researchers reported that those who believed that obesity is caused by overeating and sedentary behavior and a matter of individual behavior, were the most likely to support prevention initiatives. Women were most likely to regard the influence of food as significant than men. They reported that nearly 90% of consumers, again more women than men, agreed with statements about the causes for obesity as being lack of physical activity and eating too much unhealthy foods. Nearly the same number supported obesity initiatives focused on changing behaviors in children (more sports and PE, and school curriculums about healthy eating and physical activity).

However, support for regulations didn’t follow. The researchers found that few people supported regulations to tax unhealthy foods and restrict advertising, and only half agreed that unhealthy foods should be banned in schools.

In contrast, the researchers said that recent research demonstrating the major role of genetics had reached few people, with only one-third of those surveyed agreeing that obesity was hereditary. The authors also found that people “largely overestimated prevalence rates of obesity, [and] did not seem to distinguish overweight from obesity.” They also found that about 80% of people agreed with statements that obesity is one of the major health problems in the country and increased risk for diseases like cancer and diabetes.

The authors concluded that the public was ready for obesity prevention. A few of their findings of public support may be surprising to readers, though, and it would be interesting to see how they asked those questions and interpreted the responses.

They reported that 85% of participants agreed that health insurance companies should teach them about healthy eating and physical activity; and that 99% of people supported the idea that obesity is a societal problem and a responsibility for society to solve. Two thirds of those surveyed, said the authors, were willing to spend extra money on obesity prevention. It’s unclear if they are trying to rally the public or inspire their fellow colleagues.

But in what may be a glimpse of what’s to come, they concluded:

The results provide several clear implications for policymaking. Policy-makers can build on substantial support for childhood obesity prevention and information interventions....it seems particularly relevant to promote communication of research findings on environmental and genetic factors to the public. Furthermore, education on the definition of obesity is clearly indicated. Specifically, education on the role of physical inactivity for the development of obesity should be directed to those with lower socioeconomic status and younger age. Prevention programmes may further need to be carefully introduced to men and younger people. Finally, societal responsibility, emerging as a major determinant of prevention, could be strengthened and utilised when prevention measures are implemented.

© 2007 Sandy Szwarc