Sunday, September 28, 2008

A matter of perspectives

When we say epidemiology is a crude form of calculation which reveals nothing beyond direction. Many, if not most, don’t comprehend what is being said.

We can visualize life and risk factors on a geometric plane, lessening the complication, deliberately introduced, to avoid scrutiny above all else. Intimidation has worked well in reducing the critics of statements which defy common sense and grow the power of irresponsible fear mongering dividing society upon itself in far too many ways.
Picture life as box existing for only an instant in time, with four 90 degree angles at the corners. If we divide the box into smaller identical squares each representing a person, the size of the population group always determines the size of the box; no other factor can change that dimension. If we draw a diagonal line from the top left corner to the lower right we define the average risk of all members within the group, the area above the line defines those already dead as a result of the total of all risks in a lifetime, including old age and the number below the line defines the living who for the most part fear the line, although eventually all will cross it. No one gets to move beyond the confines of the box and no one can be added without adjusting the size of the box and the relevant geometry within the box, which would capture a different instant in time.

Hucksters armed with epidemiology studies will always attempt to confuse the issue, by implying other instants are equal to the instant they actually examined. If the size of the box changes the geometry within it changes. Sub groups are compared this way by including their numbers, as the vertical and horizontal lines of height and length. Every person within the box will have a unique life and a unique set of risk factors which might or might not determine eventually the date and time they will cross the line. By multiplying them together, we find the total area of the box and by dividing that number in half we find the area occupied in equal and average area divisions, by the living group to be observed. If we know the numbers of the two groups we know the dimensions of the box by ratio. The line of risk average can be manipulated by adjusting the numbers included in the respective groups however the true average and absolute risk is always found at the center of that line dissected by a line of average and ultimate longevity.

We complete the picture with the opposite diagonal line representing longevity between lower left and upper right corners. Risk is oriented in a clockwise perspective more risk would move the lifespan line down creating a distortion or a longevity curve, demonstrating those who will theoretically die “prematurely” represented by the increased number of those above the risk line about to cross the end of life line in larger numbers. We quickly see the largest number of all those who will die will be closest to the line of average risk where it naturally intersects the line of average life expectancy at the center of the square; which represents the norm including everyone and the decreasing or increasing numbers as we move away from center line of maximum and average risk, those farthest away from the center represent the exception and not the rule.

It doesn’t take a lot of imagination to understand how slight variations of risk demonstrate huge effects among a large population group in relation to demonstrating how many will die and when. Neither does it take a lot of imagination to understand; any level of misclassification or miscalculation among small groups, would also demonstrate huge variations in the numbers when applied to larger groups. For this reason; anyone with any modicum of integrity would absolutely reject the glamorization of “insignificant risk variations” to represent anything more than fear mongering and irresponsible exaggerations to promote unscientific politics which prey on the fears of others.

The preference in use of epidemiology in place of precise numbers, as you can see has obvious advantages in producing or eliminating any fear or promotion you can imagine, by simply demonstrating association and expressing that association as a credible level of risk variation, or in making claims beyond that, in describing a theoretic risk as a cause, which could affect the overall outcome, a level of effect which was never actually observed.

The average of maximum risk includes all risks and is not moved easily to any significant degree which could be detected beyond this instant, when only a change the line of life expectancy would be evident to a far lesser degree, even if there was a large change in lifestyles within the group, because by decreasing risks in one category you simply increase the number of those who will succumb by the risks in another risk category, as the constant tendency is, to maintain balance as geometry demonstrates, at any instant in time ever observed. It would therefore be impossible even within this instant, to determine if the average mortality number will even be affected, even if we attempt to change the line of risk by manipulating personal choices, without knowing the instant everyone should die from the ultimate risk of aging, so we have to estimate for the value of that unavoidable effect as well.

Medicine defines all mortality in disease management initiatives as requiring a cause, which is not aging. The charities and the medical institutions promote fear to promote self interest, in the elimination of age as a risk despite the fact it represents the sum of all risk. In deflating their own credibility they have never defined what now constitutes natural death and what percentage they believe to be premature and caused by another factor. By furthering the illusion they now distribute blame for large risks to personal lifestyles, in total numbers which count many people multiple times, expanding the box well beyond its boundaries, expanding fears proportionately.

The effect of coincidental mortality by other causes is thought to be contained within the level of allowance for error, although even that notion, by the law of averages, is found to be wrong as often as it is found to be right with many unknowns yet to be discovered subsequently many past assumptions are demonstrated to be inaccurate, marring current perspectives, which rely on historical findings, with no revisions being applied to published research when those facts are revealed.
Misclassification is often admitted in the studies as having an effect on the validity of the results, more as an excuse for limitations in the observational model designed or the personal assumptions made, than a description of any unforeseen events. Risk itself is a misnomer when expressed only in a negative perspective, because human activities known as risk factors which will reduce longevity for some, will also increase longevity for others, the combined effect further distorts all observations and significantly limits the precision of the conclusions.

The perspective that; eliminating smoking will have only an upside, is deflated by the realities of such effects as; reduced exchange of personal economies, which will have an effect of diminished economic growth. At a personal level think of eliminating smoking in prisons in another example, if we extend the life and fitness of violent criminals we increase the risk to society when they are released. By the extension of their lives and the increased fitness levels increasing their abilities to do harm, if smoking does have a significant effect and if the prisoners affected, do endanger society.

The statement “one half of smokers will die because they smoke” seems to produce a highly unlikely equality, between smoking balanced equally against all other risks in life, including age. This would tend to imply either smoking has zero effect, or it will eliminate all other risks on balance, which should be much harder to sell than the original idea that smoking actually does decrease an average life expectancy. Alternatively by the balance within the smoking group, we see in the equal division also equating average numbers, in real observations. From this we could understand smoking has little effect on average lifespan, in spite of its implied effects. A smokers choice to smoke, other than being punished by a moral a restriction, applies little to average life expectancy, by means of smoking related diseases, because of the duration of time between exposures and effect, seem to be balanced quite well against the effect of other risks which could end a life first. That is true of course, if we believe the numbers guiding our perspectives as they stand. Making smokers the same as everyone else, in spite of the fears created in advertisements, depreciating their integrity and worth, guiding the hatred which convinces most of us otherwise.

If we wish to measure risks on an equal scale; describing someone as defective because they smoke, could be countered by a smoker with much more credibly, who defines you as defective by your display of intolerance. In the overall perspective of defining which factor historically reduces life expectancy to a larger degree; smoking or intolerance?

The answer should be obvious; Tobacco Control is a defective and divisive process with its foundation only strengthened by fear, intolerance and the misconceptions empowering both.