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"Follow the Science"
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Author: Bruce Lanphear, MD, MPH
Editor's note:
We Keep Ignoring the Warnings at the Cost of Lives—and Trust “Follow the Science”—But Which Science? “Follow the science” became a rallying cry during the pandemic. It was painted on protest signs, invoked in political speeches, and deployed in countless social media posts. At its best, the phrase calls for humility: let evidence, not ideology, guide our decisions. At its worst, it becomes a slogan without substance—an empty reassurance that what’s being done is backed by reason, even when crucial evidence is ignored. The problem isn’t science itself. The problem is which science we choose to follow—and which science we choose to ignore. Science is not a set of commandments. It’s a method—a way of asking questions, gathering evidence, and testing ideas against reality. It’s neutral in the sense that it can be used for noble or destructive ends. The same chemistry that gave us antibiotics also gave us nerve gas. The same industrial ingenuity that created clean drinking water systems also produced PFAS, “forever chemicals” that now contaminate those systems. The same scientific principles that led to life-saving statins were also behind the invention of tetraethyl lead, a fuel additive that poisoned entire generations. The problem isn’t science itself. The problem is which science we choose to follow—and which science we choose to ignore. When Science Serves Power Instead of People Throughout the 20th century, we saw a pattern that should have been impossible to miss. Industrial breakthroughs were hailed as triumphs of human ingenuity. Years or decades later, those same breakthroughs turned out to be environmental disasters. Tetraethyl lead reduced engine knock but unleashed a neurotoxic metal that lowered IQs and increased crime rates. Asbestos made buildings fire-resistant but left workers and residents with mesothelioma. DDT wiped out mosquitoes but devastated bird populations and elevated the risk for breast cancer. PFAS made cookware non-stick and firefighting foam more effective—but now they’re in the blood of nearly every American, linked to cancer and immune dysfunction. In each case, the hazards were known early. Scientists warned about lead’s toxicity before it was added to gasoline. Evidence of asbestos disease existed decades before the bans. Studies on PFAS health risks date back to the 1960s. Yet regulation lagged far behind the science—not because the evidence was unclear, but because corporate and political power worked to suppress, delay, or discredit it. We’re seeing the same pattern with plastics. They’re more than waste in our oceans—plastic chemicals are a mix of polymers and thousands of additives, from phthalates to flame retardants. Many disrupt hormones, harm the brain, or strain the heart. Studies now link everyday plastic exposures to falling fertility, everyday plastic exposures to falling fertility, heart attacks, and ADHD. Microplastics have turned up in blood, placentas, and even the brain, raising urgent questions about their long-term effects. Yet international talks to curb plastic production have stalled, with industry steering the focus to recycling—an inadequate fix that leaves unchecked the rising tide of new plastic. The Science We Cherry-Pick When leaders say “follow the science,” they often mean the science that supports immediate action on a politically palatable problem—developing vaccines, improving storm forecasts, launching Mars rovers. They rarely mean following the science that challenges entrenched industries, questions long-standing public health practices, or calls for costly regulation. Consider air pollution. We have known for decades that it causes premature death, heart attacks, and lung cancer. We can quantify how many lives would be saved by tougher standards. And yet, regulatory action is slow, often stalled by legal challenges from polluting industries. Consider fluoridation. The policy was adopted in the mid-20th century to prevent cavities, based on the best evidence at the time. Today, new studies show that fluoride impairs brain development in children at levels found in fluoridated communities. But questioning fluoridation is still treated as heresy in much of the public health establishment. Following the science here would mean re-evaluating old assumptions—not because we’ve “changed sides” but because the evidence has changed. How Ignoring Science Breeds Distrust When science that threatens powerful interests is ignored, the public notices—even if they don’t know the details. Communities living near chemical plants, fracking sites, or lead-contaminated water supplies can see the gap between official assurances and lived reality. They learn, sometimes the hard way, that the government is not protecting them from industrial harms. This breeds not just cynicism, but anger. And in a political climate already primed for grievance, that anger can be redirected. People who have seen their health ignored or sacrificed may come to believe that all institutions are corrupt, all expertise is suspect, and that the only truth is the one that confirms their own tribe’s beliefs. It’s not a big leap from there to the distrust and defiance we’ve seen among some MAHA followers. If the “official” science failed to protect your child from autism or your community from toxic waste, why would you believe it now about vaccines or climate change? The irony is that ignoring inconvenient science doesn’t just harm public health—it erodes the very trust needed to mobilize public health measures in the future. Following All the Science If “follow the science” is to mean anything, it must mean following all the science—not just the parts that make for good headlines or fit neatly into our political comfort zones. It means:
And it also means adopting the precautionary principle. The default should be to protect the public from plausible hazards while we gather more evidence, not to wait for proof beyond all doubt before acting. The Real Test Following the science isn’t tested in the moments when science confirms what we want to believe. It’s tested when the evidence forces us to rethink, to disrupt profitable industries, or to admit we were wrong. In the case of PFAS, the science told us early on that these chemicals were persistent and bioaccumulative. We didn’t follow that science. In the case of lead, we had clear toxicology a century ago. We didn’t follow that science. In the case of asbestos, the link to fatal disease was undeniable decades before bans. We didn’t follow that science. Instead, time and again, we allowed the economic interests of a few to outweigh the health of the many. The result is not just a legacy of environmental damage, but a corrosive loss of public trust. A Stronger Standard The next time you hear “follow the science,” ask: Which science? Who decided which evidence counts? And what happens to the science that doesn’t make the cut? Because the science we ignore is often the science that matters most for protecting health. If we truly want to follow the science, we need to make it harder to bury inconvenient findings, easier to act on early warnings, and unacceptable to treat prevention as optional. We need to admit that our track record—on regulating toxic chemicals, on confronting environmental hazards, on acting in time—is abysmal. And we need to understand that every time we fail, we deepen the distrust that fuels not only public health crises but political ones. Following the science must mean more than chasing innovation. It must mean controlling environmental hazards, asking uncomfortable questions, and protecting the public even when it’s inconvenient, costly, or unpopular. That’s the kind of science worth following—and the only kind that can rebuild the trust we’ve squandered. ■ This article was originally printed on Substack in Plagues, Pollution & Poverty. To read more content from this source subscribe to Plagues, Pollution & Poverty: https://tinyurl.com/3rfeuama |
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