08 November 2010

Issue Advocacy and Science Arbitration

In my book, The Honest Broker, I describe four ideal types of interaction between experts and decision makers.  In capsule form they can be summarized as follows:
The Pure Scientist - seeks to focus only on facts and has no interaction with the decision maker.

The Science Arbiter - answers specific factual questions posed by the decision maker.

The Issue Advocate - seeks to reduce the scope of choice available to the decision maker.

The Honest Broker of Policy Options - seeks to expand, or at least clarify, the scope of choice available to the decision maker.
In THB, I argue that each of these roles are important to effective decision making, but that experts must choose what role to play in particular contexts. Confusion about roles, and even pretending to play one role when really playing another, can lead to a breakdown in the process of expert advisory mechanisms The result might not simply be poorly informed deicsions, but a loss of credibility of the organization providing the advice.

A n example of such dynamics can be found in yesterday's New York Times which had an elightening article about the US Department of Agriculture and cheese.  The USDA seeks to at once serve as a science arbiter on questions of a healthy diet while at the same time serving as an issue advocate for cheese producers.  This sets up a situation of conflict because a healthy diet means limiting cheese consumption whereas meeting the needs of producers means expanding consumption.

USDA's issue advocacy is centered on an organization called Dairy Management, which is funded by a government-imposed tax on cheese as well as direct spending by USDA:
And Dairy Management, which has made cheese its cause, is not a private business consultant. It is a marketing creation of the United States Department of Agriculture — the same agency at the center of a federal anti-obesity drive that discourages over-consumption of some of the very foods Dairy Management is vigorously promoting.

Urged on by government warnings about saturated fat, Americans have been moving toward low-fat milk for decades, leaving a surplus of whole milk and milk fat. Yet the government, through Dairy Management, is engaged in an effort to find ways to get dairy back into Americans’ diets, primarily through cheese. . .

. . . in a series of confidential agreements approved by agriculture secretaries in both the Bush and Obama administrations, Dairy Management has worked with restaurants to expand their menus with cheese-laden products.

Consider the Taco Bell steak quesadilla, with cheddar, pepper jack, mozzarella and a creamy sauce. “The item used an average of eight times more cheese than other items on their menu,” the Agriculture Department said in a report, extolling Dairy Management’s work — without mentioning that the quesadilla has more than three-quarters of the daily recommended level of saturated fat and sodium.

Dairy Management, whose annual budget approaches $140 million, is largely financed by a government-mandated fee on the dairy industry. But it also receives several million dollars a year from the Agriculture Department, which appoints some of its board members, approves its marketing campaigns and major contracts and periodically reports to Congress on its work.

The organization’s activities, revealed through interviews and records, provide a stark example of inherent conflicts in the Agriculture Department’s historical roles as both marketer of agriculture products and America’s nutrition police.
The conflicting roles inevitably influences the nature of advice provided by USDA experts to consumers:
In one instance, Dairy Management spent millions of dollars on research to support a national advertising campaign promoting the notion that people could lose weight by consuming more dairy products, records and interviews show. The campaign went on for four years, ending in 2007, even though other researchers — one paid by Dairy Management itself — found no such weight-loss benefits.

When the campaign was challenged as false, government lawyers defended it, saying the Agriculture Department “reviewed, approved and continually oversaw” the effort.
At the same time:
Agriculture Department data show that cheese is a major reason the average American diet contains too much saturated fat.

Research has found that the cardiovascular benefits in cutting saturated fat may depend on what replaces it.

Refined starches and sugar might be just as bad or even worse, while switching to unsaturated fats has been shown to reduce the risk of heart disease.

The department’s nutrition committee issued a new standard this summer calling for saturated fat not to exceed 7 percent of total calories, about 15.6 grams in a 2,000-calorie-a-day diet. Yet the average intake has remained about 11 percent to 12 percent of total calories for at least 15 years.

The department issued nutritional hints in a brochure titled “Steps To A Healthier You!” It instructs pizza lovers: “Ask for whole wheat crust and half the cheese” — even as Dairy Management has worked with pizza chains like Domino’s to increase cheese.
The NYT article reveals some troubling details about USDA promotional campaigns based on untrue claims based on alleged weight-loss effects of dairy products:
When the campaign began in 2003, a Dairy Management official said it was inspired by newly relaxed federal rules on health claims and the ensuing “rapid growth of ‘better for you’ products.”

It was based on research by Michael B. Zemel, a University of Tennessee nutritionist and author of “The Calcium Key: The Revolutionary Diet Discovery That Will Help You Lose Weight Faster.” Precisely how dairy facilitates weight loss is unclear, Dr. Zemel said in interviews and e-mails, but in part it involves counteracting a hormone that fosters fat deposits when the body is low on calcium.

Dairy Management licensed Dr. Zemel’s research, promoted his book and enlisted a team of scientific advisers who “identified further research to develop more aggressive claims in the future,” according to a campaign strategy presentation.

One such study was conducted by Jean Harvey-Berino, chairwoman of the Department of Nutrition and Food Sciences at the University of Vermont. “I think they felt they had a lot riding on it,” she said of the weight loss claim, “and felt it was a cash cow if it worked out.”

“I’m a big promoter of dairy,” she added, noting that her research was also paid for by Dairy Management.
But by 2004, her study had found no evidence of weight loss. She said Dairy Management took the news poorly, threatening to audit her work. She said she was astonished when the organization pressed on with its ad campaign.

“I thought they were crazy, and that eventually somebody would catch up with them,” she said.

Her study was published in 2005, and at scientific meetings she heard from other researchers who also failed to confirm Dr. Zemel’s work, including Dr. Jack A. Yanovski, an obesity unit chief at the National Institutes of Health.

But in late 2006, Dairy Management was still citing the weight-loss claim in urging the Agriculture Department not to cut the amount of cheese in federal food assistance programs. “The available data provide strong support for a beneficial effect of increased dairy foods on body weight and body composition,” two organization officials wrote, making no mention of Dr. Harvey-Berino’s findings.

Having dismissed the weight-loss claim in 2005, the federal nutrition advisory committee this summer again found the underlying science “not convincing.”

The campaign lasted until 2007, when the Federal Trade Commission acted on a two-year-old petition by the Physicians Committee for Responsible Medicine, an advocacy group that challenged the campaign’s claims. “If you want to look at why people are fat today, it’s pretty hard to identify a contributor more significant than this meteoric rise in cheese consumption,” Dr. Neal D. Barnard, president of the physicians’ group, said in an interview.

The trade commission notified the group that Agriculture Department and dairy officials had decided to halt the campaign pending additional research.
The NYT has even more troubling revelations.  The lesson of the USDA experience is that experts play different roles in society -- one of them is to advocate for specific outcomes, like, eat more cheese.  Another role is to render judgments on specific questions that can be addressed with the tools of science, such as, the more cheese that you eat, the greater the risk of certain health outcomes.  Both of these roles are perfectly legitimate and indeed important.

However, when experts conflate these roles, it is often issue advocacy that triumphs, and credibility and legitimacy that suffer.  USDA provides an excellent case study for experts in other areas who think that they can swim without getting wet.