Aug 30 2007

Mike Huckabee on Healthcare and Skeptics on Huckabee

A reader pointed me to this recent blog entry over at EvolutionBlog by Jason Rosenhouse. The blog entry itself is short, and discusses Republican presidential candidate Mike Huckabee’s statements on Hardball concerning healthcare. What caught my interest more than Huckabee’s statements were the response of skeptics to them.

Here is the quoted statement of Huckabee’s from the Hardball transcript: (I include a more complete statement than in the original blog entry)

“Specifically, we know that a third of the cancer deaths in this country could be eliminated with nutrition and exercise alone, because bad nutrition and the lack of exercise breaks down a body‘s capacity to throw off bad cells, bad internal workings, that our – our bodies are a masterfully created and designed piece of work.

“I believe God created these wonderful bodies of ours. And they are a masterpiece, but they were designed to be used in a way that were fueled properly and then were exercised properly. And, when we don‘t fuel them properly or exercise them properly, it is like having a car in which you pour mud into the tank and never run it. Well, guess what? The car is not going anywhere.

“And we wonder why our bodies break down. The truth is, if we don‘t use these bodies in the manner in which they were intended to be properly fueled, with the foods that are a natural part of our world, and with the exercise for which we were created—we were created to be active and—and energetic, not sloughing about—it will eliminate a third of the cancers in this country.”

Jason used the statement to point out that if God wants us to eat right and exercise why is the Bible silent on this issue. That is a somewhat tangential point, but fair enough.

The comments, however, extend the criticism beyond fairness, in my opinion. One commenter wrote:

“There’s another issue about Huckabee’s comment that needs to be discussed: The comment implies that if you have cancer then you deserve it because you mistreated your body. I don’t know how to describe that sentiment other than as offensive.”

This sentiment was echoed by others, including the reader who pointed me to the blog entry.

Now, I am no admirer or defender of Huckabee. He is running as a religious right candidate and his views are often given in the context of his personal faith. He was one of three Republican candidates who indicated that they do not accept the scientific consensus of evolution – and this was reflected in his statements and should be soundly criticized.

But we must take each statement and each claim on its own merits. Otherwise we are committing the ad hominem logical fallacy – “Huckabee is wrong because he is a religious nut.” As skeptics we have to be especially careful not to commit the poor logic or sloppy arguing we so aggressively criticize in others.

Huckabee is a creationist – so he interprets every aspect of biological function as if it were designed by God. This does not mean that any particular biological claim is wrong. Newton thought that when he worked out the laws of mechanics he was peeking into the mind of God – his laws of mechanics are still valid.

At its core what Huckabee is saying is that we would be healthier if we have good nutrition and exercise regularly. This is true despite the fact that he framed it in the context of his religious faith and creationist beliefs.

He goes on to say that 1/3 of cancer could be prevented by good nutrition. Again, the religious context is irrelevant, and he did not say anything to infer that people with cancer therefore “deserve” it. I could say that smoking causes cancer and the best way to prevent cancer is to reduce or eliminate smoking. This does not imply that I think people who smoke and get lung cancer deserve it.

It also struck me that the focus on his irrelevant (to this issue) religious context and the false accusation that Huckabee implied people with cancer “deserve it” distracted from a more meaningful assessment of his statements. When asked about cancer, why did Huckabee focus on nutrition and exercise, rather than, say, reducing smoking, early detection, and cancer research?

I wanted to find out more about Huckabee’s views on healthcare and discovered this:

“Mike Huckabee is recognized as a national leader in the areas of education and healthcare reform, interests driven partly by his own struggle with his weight and health-damaging lifestyle. Once weighing about 300 pounds, Huckabee embarked on a fitness and nutrition transformation after being diagnosed with Type 2 diabetes. He lost 110 pounds. The author of “Quit Digging Your Grave with a Knife and Fork”, Huckabee often speaks on the need for Americans to improve their lifestyles.”

I think this tells us more about his focus on nutrition and exercise than his religious beliefs. The fact that Huckabee was being praised for his views on a pro CAM website also has me concerned about what his views on CAM are. I could not find anything definitive, but will have to keep an eye on this. If anyone has any links that would shed light on this question, please le me know.

What about the specific claim itself, that 1/3 of cancer can be prevented by nutrition and exercise? This figure comes from the American Cancer Society (I had to dig this up myself, Huckabee did not give a reference for his statements). So at least Huckabee is supported by a reputable institution and is not making this up himself or relying upon dubious sources.

I was curious about the accuracy of the 1/3 figure so I did some more digging. There is no question that obesity increases cancer risk. Here is one paper from the NEJM in 2003 that gives an overview of overweight, obesity, and all cancers. It states that

“On the basis of associations observed in this study, we estimate that current patterns of overweight and obesity in the United States could account for 14 percent of all deaths from cancer in men and 20 percent of those in women.”

That’s not quite a third, but we also have to add increased cancer risk from poor diet that is not related to weight. I could not find any good summaries with references to verify this percentage myself (If I dig one up or someone points me to one I will add it). I did find this from the National Cancer Institute that says:

“And while it is not yet possible to provide quantitative estimates of the overall risks, it has been estimated that 35 percent of cancer deaths may be related to dietary factors (Doll and Peto, 1981)”

While this confirms the 1/3 figure, the reference is 26 years old. Although one could argue that if anything obesity has increased in the intervening years and the figure might be higher. But also this figure won’t reflect the last 26 years of research on the topic. The bottom line is that the 1/3 figure quoted by Huckabee is reasonable and has credible sources.

The NCI, by the way, also estimates that smoking is responsible for 1/3 of cancers. To be fair, Huckabee has also called for a federal ban on smoking in public, so at least he is being consistent in his advocacy of cancer prevention.

To summarize, it seems that Huckabee’s statements on Hardball reflect the fact that he is a born-again health nut, not a born again Christian. The political implications are that he is selling himself as a health advocate with a plan to reform health care, partly based upon his personal life experience. This has caused some ruffling of feathers on the libertarian right who now think of Huckabee as a “nanny-stater.”

The skeptical response to his statements, however, focused on the irrelevant religious context with which he gratuitously flowered up his claims. Ultimately this was a distraction from the real source and implications of his statements.

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