We need better and earlier public health education

View from Totnes

Totnes, the Devon town that I grew up in, is in the papers. The last few times it has hit the news it has been for refusing to allow chain cafes to join the High Street, or for painting a pedestrian crossing in rainbow colours for Pride. Sadly this time the news is not about the fantastic local cafes, or even the weird Elizabethan market on Tuesdays, but the high proportion of people who are anti-vaxx and think covid is a conspiracy theory. 

Totnes has always been alternative. I wrote about growing up there in my book about developmental psychology, Blueprint. I mused that my interest in mind and body was probably encouraged by “my upbringing in the hippy Westcountry town of Totnes, where crystal healing is abundant and on market days in the high street a bearded man offers gong showers.”

It’s alarming though, that alternative ways of life have led to local rates of childhood immunisation which are much lower than the rest of the country. These same anti-vaxx views translate easily to covid, and the last time I was visiting I heard first-hand from someone who thought doctors were falsifying death certificates. 

Not everyone in Totnes thinks the same, but the large proportion of people who are anti-vaccine raises interesting questions about how it got to this point, and what we can do to improve public understanding of vaccines and scientific evidence in general. It might be worse in Totnes but there are similar dilemmas all over. 

It’s not that it’s unreasonable to want to understand the balance of risks and benefits, but more that all evidence is weighed the same: from YouTube video to peer-reviewed academic paper. I think there needs to be better education about how to assess the validity of evidence.

Thinking back, I think I got this to some extent when I was studying A Level History (with Mr Sandham, who we were all a bit obsessed with) but it wasn’t taught elsewhere. Mr S talked a lot about the importance of evaluating where the source material was from, and understanding that much historical evidence comes from individual accounts where individual perspectives need to be weighed in. 

This is just as important in current reporting, when we look at who has written an article or who is producing YouTube videos: what are their credentials and expertise? What are their vested interests? What checks are in place to ensure the information is accurate? In some countries, for example Finland, children are taught about media bias and the importance of source evaluation as early as primary school. 

Good statistics education is also missing. I first learnt about statistics at university, as part of studying psychology, but we are presented with statistical information daily, throughout our entire lives, and our decisions are influenced by our understanding of this information. Advertising claims that a product is effective at reducing wrinkles in 50% of people, for example, may seem persuasive, until we know that the sample size was 10 and the measure of effectiveness was wholly subjective. At a deeper level, statistics about the impact of bigger things, like free movement, Brexit and covid-19 vaccines, are crucial to understand, challenge and critique.

Our current political landscape doesn’t help. Experts have been denigrated by politicians over several years, so even now when they are wheeled out to help deliver difficult messages its hard to feel that their advice is truly respected, especially when it seems to be selectively adhered to depending on political expediency. At least hearing directly from the scientists has given some possibility to hear from the horse’s mouth about how the science works and what the statistics mean, though, and most of these opportunities have been seized brilliantly, with clear explanations and calm, measured advice. I particularly like it when scientists are clear about the limits of their knowledge. I think it helps public understanding and trust.

Perhaps the focus on the vaccine that we will all be dependent on will help to change things – I really hope so. This is a great opportunity for some decent public health education about vaccines and how they work, and for thinking about how public understanding of science is facilitated from an earlier age, much better than it is at present. 

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