It seems the lunatics at HHS have restored funding for the Women's Health Initiative. We don't know what actually happened but I'm guessing some 19 year old college dropout working for Muskmelon saw the title of the project and assumed it was some kind of feminist woke mind virus conspiracy. Anyway, we've seen a few examples now of successful pushback against these maniacs and I hope more people are learning the lesson that giving in to them just means they come back for more, but if you punch a bully in the nose he'll turn out to be a sniveling coward.
That said, I'll take this occasion to make a few remarks about these long-term prospective cohort studies. The most famous is probably the Framingham Heart Study, which has its own web site here, but it's not really all that friendly to the general public. The Wikipedia article is an easier way to learn the basics. The study began in 1948 and is now on its third generation of participants. This was one of the most important studies that demonstrated the toxic effects of smoking, and what is now common knowledge about risk factors for heart disease and stroke -- discoveries that are major contributors to the increased life span people enjoy today.
This kind of study is the most powerful form of epidemiological research. It's generally very difficult to sort out what exposures cause specific outcomes for many reasons. Correlation is not causation, as they say, and many characteristics of people and their environments are correlated in complex ways. Also too, it can take a long time for effects to be seen. Environmental factors in early childhood may be associated with outcomes in middle age or later. While we could ask people in middle age about their childhoods, the information we get is not going to be very detailed or reliable. With a prospective cohort study, we can collect a lot of high quality, reliable information about children and then see what happens to those same children 30 or 40 or more years later.
Of course, this costs a lot of money and while there may be some useful information in the short term, the main payoff won't be for a long time, and it's hard to convince politicians to make that kind of investment. At least it is now, although evidently it was not so difficult in 1948. That's something to think about. However, given that funding will have to be finite, the question of exactly what information to collect at baseline is going to be critical to the ultimate payoff. If we don't ask the right questions to begin with, we won't get the most important answers.
Which brings us to the tragic case of the proposed National Children's Study. The study's archive page doesn't explain why it never happened, but I'll tell you. Originally, the plan was to focus on environmental factors associated with health throughout the life course. But a faction within NIH that was interested almost exclusively on genetics became powerful, and a feud ensued between those who wanted to focus on environment and those who wanted to focus on genes. They spent so much energy trying to sabotage each other that the project disintegrated in squabbling and congress eventually canceled it.
I shouldn't have to tell you how absurd this was. Now that genetic testing is cheap, fast and easy there's no reason why we can't do both at once, which is what obviously is logically the right thing to do, so if we ever have a sane congress and president, I hope we can try again. I won't live long enough to see the results, but some people might who wouldn't otherwise.
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Our time frames keep getting shorter. Maybe we're getting softer or we may be molded by instantaneous communication or corporate harping on "nowW", but we're also learning to understand the critical importance of gradual processes and long cycles. China, which sees itself as the continuation of a 5,000 year culture, is in a better position to take the long view. We're starting to see some of them bearing fruit already, and they're proving to be a formidable adversary because of it. Climate scientists are already looking at consequences 100 or more years from now of the choices we're making today. The programs you describe have that sense of time. We have to teach ourselves to think of 100 years from now as the near future, and 1,000 years as perhaps the midterm future. It will take the oceans at least that long to release the heat our actions have injected into them with. The entombed reactor at Chernobyl will be a problem for much longer.
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