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From Evidence To Policy---From The Perspective Of An Experienced Legislator

Researchers at Johns Hopkins have had a longstanding interest in how to translate research into policy or practice. This was evidenced over 15 years ago by a workshop on the topic reported in this newsletter (EM August/September 1998, see https://tinyurl.com/pr8jxgq  ) and in the American Journal of Epidemiology. In keeping with that interest, the fall issue of Johns Hopkins Public Health magazine includes an interview with former Congressman Henry Waxman who was instrumental in passing legislation which reduced smoking, expanded Medicaid coverage, and increased access to generic drugs.

Below are excerpts from the interview conducted by Clarence Lam, MD, MPH, and himself recently elected as a Maryland state delegate.

CL: Is the politicization of science—whether that’s climate change, environmental issues or vaccination policy—a growing trend?

HW: Until five to 10 years ago, most people would pay a lot of deference to scientists because their decisions are based on evidence. Now I see a lot of people in power dismiss science as just another point of view, and probably one that’s biased.

Ideology seems to be much more prevalent in approaching a number of issues that otherwise should be looked at as scientific issues.

CL: What motivates politicians and special interest groups to discredit scientists today?

HW: There are a lot of groups that oppose what the scientists think we ought to do, for ideological reasons—but more often than not, it’s for profits.

CL: What’s your advice to scientists, researchers and others reaching out to legislators to effect policy change?

HW: I think it’s important that people who have expertise and knowledge share that with the policymakers. They ought not to feel any reluctance in that kind of a role. They’re the ones who have a special knowledge and whose views carry a lot of weight. So my recommendation is that they try to get those views across.

Because of the nature of what they do, scientists and researchers often don’t want to say things in a conclusive kind of way—because their scientific method is to always keep looking to revise the hypothesis based on new evidence. And so they say, “It appears to be,” or “The overwhelming evidence would indicate…” They need to be honest about how they express it, but not in any way be cowed by the difficulties.

CL: When you first arrived on Capitol Hill, I think there was a greater sense of collegiality and working amongst colleagues, particularly those across the aisle. Do you believe that today’s bickering and grandstanding is the new norm? Or is there hope that the pendulum will once again swing back to that spirit of bipartisanship?

HW: I think the idea of the spirit of bipartisanship is overrated, because we [always] had people who were partisans. But the parties had a more diversity of opinion than each party now has. …But we’ve seen a transition to the two political parties going to polar points on a lot of issues.

CL: So you attribute a lot of what we’re seeing today to further entrenchment within the parties themselves. And that’s led to fewer areas where they could work across the aisle?

HW: The idea of working across the aisle is still there. It’s a question of being patient enough. I look at my career in Congress as a good example. I authored many bills that became law that people now would say, “Well, of course we should be able to get nutritional information when we buy a food item.” Or, “Of course we shouldn’t have to breathe in someone else’s tobacco smoke in a public place.” Or, “It’s obvious that we ought to do everything we can to clean up the air we breathe.”

But there’s no inevitability to anything. Even the simple labeling law took years to pass, to develop the consensus behind it. The Clean Air Act took us 10 years of battling. On a lot of the laws, it sometimes took a decade or more to pass them as we tried to educate people, so that when they heard a quick sound bite from somebody on the other side—who usually had an economic interest in the outcome—to step away and evaluate the evidence and to see what’s really at stake. And eventually, people did come around.

To read the full interview, visit:

https://tinyurl.com/ozsjhon  ■


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