Unhealthful News 108 – News from the John Snow Pub

Travel day today, so a quick post from an airport, which just has to be about epidemiology’s most famous pub, the one in London named after John Snow.  (I tried, with my Beer Seminars on epidemiology and health policy, to make some other pub famous for epidemiology – particularly the Gingerman in Houston – but I just did not have that kind of pull.)  For those who do not know, John Snow is famous for a study that revealed the source of a cholera outbreak in London (it was a particular water source) and there is a legend of him removing the handle of the offending water pump in an act of public health vigilantism (which is not quite true, but makes a good story).  The pub sits on the site of that pump and there is a replica of the pump outside of it.

And for those of you who do not follow the titillating news of the day, this same pub was the site of a “mass gay snog-in”, to use the local vernacular from several of the hundreds of stories, to protest a gay couple being thrown out of the pub for kissing.  Details of the specific allegations vary, including an attempted defense based on the claim that the couple was doing more than just kissing.  Some stories suggest a possibility that this could become a somewhat important civil rights case, with the key, of course, being whether a straight couple would have been kicked out for doing the same, whatever that was.

There is really no significant tie between the pub and public health science – it is just a place to make a pilgrimage to.  But it is hard to resist making connections with this story.  Instead of organizing a mass of gay kissing on the street outside, the better design would be for couples, half gay and half straight, to be assigned a particular level of …um… let’s call it passion… in their kissing and to then be randomly sent to pubs (perhaps oversampling the ones owned by the same company) to determine what kind of reaction they got. 

That would provide useful policy information, allowing a measured decision by the authorities about whether this is a serious civil rights problem or random discriminatory pique by a single employee, and would help sort out the question of whether something more than a mere bit of kissing was what triggered the problem.  After all, the more convincing versions of Snow’s story tell us that he actually took his information to the authorities to get the contaminated water system shut down, rather than engaging in monkeywrenching.  As much as I like the idea of one of epidemiology’s founding moments being an act of defiant populism, it is sometimes wiser to respond to an emergent issue differently – like doing some research if there is a civil rights concern, rather than just lashing out over one incident.

Also, it would be amusing to train the field researchers for the study I proposed.  I am sure there would be plenty of volunteer labor for it, and they would probably even pay for their own pints.

Finally, it may be bitter irony to some of my readers who did not know, that there is a connection between epidemiology and a pub, given the apparent role of epidemiology in causing the demise of so many English pubs over the last few years.  (Anti-smoking rules and anti-drinking crusades are blamed for hundreds of pubs shutting down.)  But realize that the actual epidemiology shows that there is no reliably measurable risk of life-threatening disease from the second-hand smoke exposure in a pub.   (This is not to say there is no risk – there presumably is some, it is just much smaller than is widely claimed; and there are other objections to rooms thick with second-hand smoke – personally I hate it – but that is not about epidemiology.)  And broad-based anti-alcohol campaigning similarly has no serious support in the actual epidemiologic science.  Both of those are political efforts that co-opt epidemiology in pursuit of their goals, and have severely damaged the credibility and honesty of that science.

I suspect that John Snow would not be pleased about some bits of what is above, but I could only guess which bit.

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