Genetic data sets skew too European, threatening to narrow who will benefit from future advances.
Louis Reed on Unsplash
Genomics has begun its golden age. Just 20 years ago, sequencing a single genome cost nearly $3 billion and took over a decade. Today, the same feat can be achieved for a few hundred dollars and the better part of a day . Suddenly, the prospect of sequencing not just individuals, but whole populations, has become feasible.
The genetic differences between humans may seem meager, only around 0.1 percent of the genome on average, but this variation can have profound effects on an individual's risk of disease, responsiveness to medication, and even the dosage level that would work best.
Already, initiatives like the U.K.'s 100,000 Genomes Project - now expanding to 1 million genomes - and other similarly massive sequencing projects in Iceland and the U.S., have begun collecting population-scale data in order to capture and study this variation.
<p>The resulting data sets are immensely valuable to researchers and drug developers working to design new 'precision' medicines and diagnostics, and to gain insights that may benefit patients. Yet, because the majority of this data comes from developed countries with well-established scientific and medical infrastructure, the data collected so far is heavily biased towards Western populations with largely European ancestry. </p><p>This presents a startling and fast-emerging problem: groups that are under-represented in these datasets are likely to <a href="https://www.cell.com/fulltext/S0092-8674(19)30231-4" target="_blank" rel="noopener noreferrer"><u>benefit less</u></a> from the new wave of therapeutics, diagnostics, and insights, simply because they were tailored for the genetic profiles of people with European ancestry. </p><p>We may indeed be approaching a golden age of genomics-enabled precision medicine. But if the data bias persists then there is a risk, as with most golden ages throughout history, that the benefits will not be equally accessible to all, and existing inequalities will only be exacerbated. </p><p>To remedy the situation, a number of initiatives have sprung up to sequence genomes of under-represented groups, adding them to the datasets and ensuring that they too will benefit from the rapidly unfolding genomic revolution.</p>
Global Gene Corp
<p>The idea behind Global Gene Corp was born eight years ago in Harvard when Sumit Jamuar, co-founder and CEO, met up with his two other co-founders, both experienced geneticists, for a coffee.</p><p>"They were discussing the limitless applications of understanding your genetic code," said Jamuar, a business executive from New Delhi. </p><p>"And so, being a technology enthusiast type, I was excited and I turned to them and said hey, this is incredible! Could you sequence me and give me some insights? And they actually just turned around and said no, because it's not going to be useful for you - there's not enough reference for what a good Sumit looks like."</p><p>What started as a curiosity-driven conversation on the power of genomics ended with a commitment to tackle one of the field's biggest roadblocks - its lack of global representation. </p><p>Jamuar set out to begin with India, which has about 20 percent of the world's population, including over 4000 different ethnicities, but contributes less than 2 percent of genomic data, he told Leaps.org.</p><p>Eight years later, Global Gene Corp's sequencing initiative is well underway, and is the largest in the history of the Indian subcontinent. The program is being carried out in collaboration with biotech giant Regeneron, with support from the Indian government, local communities, and the Indian healthcare ecosystem. In August 2020, Global Gene Corp's work was recognized through the $1 million 2020 <a href="https://roddenberryfoundation.org/blog/awardee/global-gene-corp/" target="_blank" rel="noopener noreferrer"><u>Roddenberry award</u></a> for organizations that advance the vision of 'Star Trek' creator Gene Roddenberry to better humanity. </p><blockquote>This problem has already begun to manifest itself in, for example, much higher levels of genetic misdiagnosis among non-Europeans tested for their risk of certain diseases, such as hypertrophic cardiomyopathy - an inherited disease of the heart muscle.</blockquote>
<p>Global Gene Corp also focuses on developing and implementing AI and machine learning tools to make sense of the deluge of genomic data. These tools are increasingly used by both industry and academia to guide future research by identifying particularly promising or clinically interesting genetic variants. But if the underlying data is skewed European, then the effectiveness of the computational analysis - along with the future advances and avenues of research that emerge from it - will be skewed towards Europeans too.</p><p>This problem has already begun to <a href="https://www.nejm.org/doi/10.1056/NEJMsa1507092" target="_blank" rel="noopener noreferrer"><u>manifest itself</u></a> in, for example, much higher levels of genetic misdiagnosis among non-Europeans tested for their risk of certain diseases, such as hypertrophic cardiomyopathy - an inherited disease of the heart muscle. Most of the genetic variants used in these tests were identified as being causal for the disease from studies of European genomes. However, many of these variants differ both in their distribution and clinical significance across populations, leading to many patients of non-European ancestry receiving false-positive test results - as their benign genetic variants were misclassified as pathogenic. Had even a small number of genomes from other ethnicities been included in the initial studies, these misdiagnoses could have been avoided.</p><p>"Unless we have a data set which is unbiased and representative, we're never going to achieve the success that we want," Jamuar says. </p><p>"When Siri was first launched, she could hardly recognize an accent which was not of a certain type, so if I was trying to speak to Siri, I would have to repeat myself multiple times and try to mimic an accent which wasn't my accent so that she could understand it.</p><p>"But over time the voice recognition technology improved tremendously because the training data was expanded to include people of very diverse backgrounds and their accents, so the algorithms were trained to be able to pick that up and it dramatically improved the technology. That's the way we have to think about it - without that good-quality diverse data, we will never be able to achieve the full potential of the computational tools."</p><p>While mapping India's rich genetic diversity has been the organization's primary focus so far, they plan, in time, to expand their work to other under-represented groups in Asia, the Middle East, Africa, and Latin America. </p><p>"As other like-minded people and partners join the mission, it just accelerates the achievement of what we have set out to do, which is to map out and organize the world's genomic diversity so that we can enable high-quality life and longevity benefits for everyone, everywhere," Jamuar says.</p>
Empowering African Genomics
<p>Africa is the birthplace of our species, and today still retains an inordinate amount of total human genetic diversity. Groups that left Africa and went on to populate the rest of the world, some 50 to 100,000 years ago, were likely small in number and only took a fraction of the total genetic diversity with them. This ancient bottleneck means that no other group in the world can match the level of genetic diversity seen in modern African populations.</p><p>Despite Africa's central importance in understanding the history and extent of human genetic diversity, the genomics of African populations remains wildly understudied. Addressing this disparity has become a central focus of the H3Africa Consortium, an initiative formally launched in 2012 with support from the African Academy of Sciences, the U.S. National Institutes of Health, and the UK's Wellcome Trust. Today, H3Africa supports over 50 projects across the continent, on an array of different research areas in genetics relevant to the health and heredity of Africans. </p><p>"Africa is the cradle of Humankind. So what that really means is that the populations that are currently living in Africa are among some of the oldest populations on the globe, and we know that the longer populations have had to go through evolutionary phases, the more variation there is in the genomes of people who live presently," says Zane Lombard, a principal investigator at H3Africa and Associate Professor of Human Genetics at the University of the Witwatersrand in Johannesburg, South Africa. </p><p>"So for that reason, African populations carry a huge amount of genetic variation and diversity, which is pretty much uncaptured. There's still a lot to learn as far as novel variation is concerned by looking at and studying African genomes."</p><p>A recent landmark H3Africa <a href="https://www.nature.com/articles/s41586-020-2859-7" target="_blank" rel="noopener noreferrer"><u>study</u></a>, led by Lombard and published in <em>Nature</em> in October, sequenced the genomes of over 400 African individuals from 50 ethno-linguistic groups - many of which had never been sampled before. </p><p>Despite the relatively modest number of individuals sequenced in the study, over three million previously undescribed genetic variants were found, and complex patterns of ancestral migration were uncovered. </p><p><strong>"</strong>In some of these ethno-linguistic groups they don't have a word for DNA, so we've had to really think about how to make sure that we communicate the purposes of different studies to participants so that you have true informed consent," says Lombard.</p><p>"The objective," she explained, "was to try and fill some of the gaps for many of these populations for which we didn't have any whole genome sequences or any genetic variation data...because if we're thinking about the future of precision medicine, if the patient is a member of a specific group where we don't know a lot about the genomic variation that exists in that group, it makes it really difficult to start thinking about clinical interpretation of their data."</p><p>From H3Africa's conception, the consortium's goal has not only been to better represent Africa's staggering genetic diversity in genomic data sets, but also to build Africa's domestic genomics capabilities and empower a new generation of African researchers. By doing so, the hope is that Africans will be able to set their own genomics agenda, and leapfrog to new and better ways of doing the work. </p><p>"The training that has happened on the continent and the number of new scientists, new students, and fellows that have come through the process and are now enabled to start their own research groups, to grow their own research in their countries, to be a spokesperson for genomics research in their countries, and to build that political will to do these larger types of sequencing initiatives - that is really a significant outcome from H3Africa as well. Over and above all the science that's coming out," Lombard says. </p><p>"What has been created through H3Africa is just this locus of researchers and scientists and bioethicists who have the same goal at heart - to work towards adjusting the data bias and making sure that all global populations are represented in genomics."</p>
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Farhan Mitha is a freelance science writer based in London. He regularly writes about biotechnology, synthetic biology, and natural history, and is currently studying for a master's degree in Evolutionary Genomics. Find him on Twitter @FarhanMitha.
October 14 | 2020
Why Your Brain Falls for Misinformation – And How to Avoid It
Understanding the vulnerabilities of our own brains can help us guard against fake news.
Unsplash
This article is part of the magazine, "The Future of Science In America: The Election Issue," co-published by LeapsMag, the Aspen Institute Science & Society Program, and GOOD.
Whenever you hear something repeated, it feels more true. In other words, repetition makes any statement seem more accurate. So anything you hear again will resonate more each time it's said.
Do you see what I did there? Each of the three sentences above conveyed the same message. Yet each time you read the next sentence, it felt more and more true. Cognitive neuroscientists and behavioral economists like myself call this the "illusory truth effect."
Go back and recall your experience reading the first sentence. It probably felt strange and disconcerting, perhaps with a note of resistance, as in "I don't believe things more if they're repeated!"
Reading the second sentence did not inspire such a strong reaction. Your reaction to the third sentence was tame by comparison.
Why? Because of a phenomenon called "cognitive fluency," meaning how easily we process information. Much of our vulnerability to deception in all areas of life—including to fake news and misinformation—revolves around cognitive fluency in one way or another. And unfortunately, such misinformation can swing major elections.
<p><strong>The Lazy Brain</strong></p>
<p><a href="https://books.google.com/books/about/Thinking_Fast_and_Slow.html?id=ZuKTvERuPG8C&printsec=frontcover&source=kp_read_button&newbks=1&newbks_redir=0#v=onepage&q&f=false" target="_blank" rel="noopener noreferrer">Our brains are lazy</a>. The more effort it takes to process information, the more uncomfortable we feel about it and the more we dislike and distrust it. </p>
<p>By contrast, the more we like certain data and are comfortable with it, the more we feel that it's accurate. This intuitive feeling in our gut is what we use to judge what's true and false. </p>
<p>Yet no matter how often you heard that you should trust your gut and follow your intuition, that advice is wrong. You should <a href="https://disasteravoidanceexperts.com/nevergut" target="_blank" rel="noopener noreferrer">not trust your gut</a> when evaluating information where you don't have <a href="https://ieeexplore.ieee.org/abstract/document/6447634" target="_blank" rel="noopener noreferrer">expert-level knowledge</a>, at least when you don't want to screw up. Structured information gathering and decision-making processes <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/bdm.486" target="_blank" rel="noopener noreferrer">help us avoid</a> the numerous errors we make when we follow our intuition. And even experts can make <a href="https://journals.lww.com/anesthesia-analgesia/FullText/2019/06000/Anesthesiologists__Overconfidence_in_Their.14.aspx" target="_blank" rel="noopener noreferrer">serious errors</a> when they don't rely on such decision aids.</p><br>These mistakes happen due to mental errors that scholars call "<a href="https://psycnet.apa.org/record/1996-01780-007" target="_blank" rel="noopener noreferrer">cognitive biases</a>." The illusory truth effect is one of these mental blindspots; there are <a href="https://en.wikipedia.org/wiki/List_of_cognitive_biases" target="_blank" rel="noopener noreferrer">over 100 altogether</a>. These mental blindspots impact all areas of our life, from <a href="https://leapsmag.com/science-fact-vs-science-fiction-can-you-tell-the-difference/" target="_self">health</a> and <a href="https://blogs.scientificamerican.com/observations/how-to-fight-alternative-facts-in-politics/" target="_blank" rel="noopener noreferrer">politics</a> to <a href="https://disasteravoidanceexperts.com/blindspots/" target="_blank" rel="noopener noreferrer">relationships</a> and <a href="https://www.top10.com/blog/posts/what-really-drives-you-to-buy-what-you-buy" target="_blank" rel="noopener noreferrer">even</a><a href="https://www.top10.com/" target="_blank" rel="noopener noreferrer"> shopping</a>.
<blockquote>We pay the most attention to whatever we find most emotionally salient in our environment, as that's the information easiest for us to process.</blockquote>
<p><strong>The Maladapted Brain</strong></p>
<p>Why do we have so many cognitive biases? It turns out that our intuitive judgments—our gut reactions, our instincts, whatever you call them—aren't adapted for the modern environment. They <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/9781119125563.evpsych241" target="_blank" rel="noopener noreferrer">evolved</a> from the ancestral savanna environment, when we lived in small tribes of 15–150 people and spent our time hunting and foraging. </p>
<p>It's not a surprise, when you think about it. Evolution works on time scales of many thousands of years; our modern informational environment has been around for only a couple of decades, with the rise of the internet and social media. </p>
<p>Unfortunately, that means we're using brains adapted for the primitive conditions of hunting and foraging to judge information and make decisions in a very different world. In the ancestral environment, we had to make quick snap judgments in order to survive, thrive, and reproduce; we're the descendants of those who did so most effectively. </p>
<p>In the modern environment, we can take our time to make much better judgments by using structured evaluation processes to protect yourself from cognitive biases. We have to train our minds to go against our intuitions if we want to <a href="https://disasteravoidanceexperts.com/author-page/the-truth-seekers-handbook-a-science-based-guide/" target="_blank" rel="noopener noreferrer">figure out the truth and avoid falling for misinformation</a>. </p>
<p>Yet it feels very counterintuitive to do so. Again, not a surprise: by definition, you have to go against your intuitions. It's not easy, but it's truly the only path if you don't want to be vulnerable to fake news.</p>
<p><strong>The Danger of Cognitive Fluency and Illusory Truth</strong></p><p>We already make plenty of mistakes by ourselves, without outside intervention. It's especially difficult to protect ourselves against those who know how to manipulate us. Unfortunately, the purveyors of misinformation excel at exploiting our cognitive biases to get us to buy into fake news. </p><p>Consider the illusory truth effect. Our vulnerability to it stems from how our brain processes novel stimuli. The first time we hear something new to us, it's difficult to process mentally. It has to integrate with our existing knowledge framework, and we have to build new neural pathways to make that happen. Doing so feels uncomfortable for our lazy brain, so the statement that we heard seems difficult to swallow to us.</p><p>The next time we hear that same thing, our mind doesn't have to build new pathways. It just has to go down the same ones it built earlier. Granted, those pathways are little more than trails, newly laid down and barely used. It's hard to travel down that newly established neural path, but much easier than when your brain had to lay down that trail. As a result, the statement is somewhat easier to swallow.</p><p>Each repetition widens and deepens the trail. Each time you hear the same thing, it feels more true, comfortable, and intuitive.</p><p>Does it work for information that seems very unlikely? <a href="https://link.springer.com/article/10.3758/s13423-019-01651-4" target="_blank" rel="noopener noreferrer">Science says yes</a>! Researchers found that the illusory truth effect applies strongly to implausible as well as plausible statements.</p><p>What about if you know better? Surely prior knowledge prevents this illusory truth! Unfortunately not: even if you know better, <a href="https://psycnet.apa.org/buy/2015-38275-001" target="_blank" rel="noopener noreferrer">research shows</a> you're still vulnerable to this cognitive bias, though less than those who don't have prior knowledge.</p><p>Sadly, people who are predisposed to more elaborate and sophisticated thinking—likely you, if you're reading the article—are <a href="https://www.sciencedirect.com/science/article/abs/pii/S1053810019301977" target="_blank" rel="noopener noreferrer">more likely</a> to fall for the illusory truth effect. And guess what: more sophisticated thinkers are <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fa0028857" target="_blank" rel="noopener noreferrer">also likelier</a> than less sophisticated ones to fall for the cognitive bias known as the bias blind spot, where you ignore your own cognitive biases. So if you think that cognitive biases such as the illusory truth effect don't apply to you, you're likely deluding yourself.</p><p>That's why the <a href="https://blogs.scientificamerican.com/observations/truth-isnt-truth-giuliani-borrows-from-the-climate-denial-tobacco-company-playbook/" target="_blank">purveyors of misinformation rely on</a> repeating the same thing over and over and over and over again. They know that despite fact-checking, their repetition will sway people, even some of those who think they're invulnerable. In fact, believing that you're invulnerable will make you more likely to fall for this and other cognitive biases, since you won't be taking the steps necessary to address them.</p>
<p><strong>Other Important Cognitive Biases</strong><br></p><p>What are some other cognitive biases you need to beware? If you've heard of any cognitive biases, you've likely heard of the "<a href="http://psycnet.apa.org/buy/1998-02489-003" target="_blank" rel="noopener noreferrer">confirmation bias</a>." That refers to our tendency to look for and interpret information in ways that conform to our prior beliefs, intuitions, feelings, desires, and preferences, as opposed to the facts. </p><p>Again, cognitive fluency deserves blame. It's much easier to build neural pathways to information that we already possess, especially that around which we have strong emotions; it's much more difficult to break well-established neural pathways if we need to change our mind based on new information. Consequently, we instead look for information that's easy to accept, that which fits our prior beliefs. In turn, we ignore and even actively reject information that doesn't fit our beliefs. </p><p>Moreover, the more educated we are, the more likely we are to engage in such active rejection. After all, our smarts give us more ways of arguing against new information that counters our beliefs. That's why <a href="https://www.pnas.org/content/114/36/9587" target="_blank" rel="noopener noreferrer">research demonstrates</a> that the more educated you are, the more polarized your beliefs will be around scientific issues that have religious or political value overtones, such as stem cell research, human evolution, and <a href="https://www.nytimes.com/interactive/2017/11/14/upshot/climate-change-by-education.html" target="_blank" rel="noopener noreferrer">climate change</a>. Where might you be letting your smarts get in the way of the facts?</p><p>Our minds like to interpret the world through stories, meaning explanatory narratives that link cause and effect in a clear and simple manner. Such stories are a balm to our cognitive fluency, as our mind constantly looks for patterns that explain the world around us in an easy-to-process manner. That leads to the "<a href="https://www.gpb.eu/wp-content/uploads/2019/06/The-Narrative-Fallacy.pdf" target="_blank" rel="noopener noreferrer">narrative fallacy</a>," where we fall for convincing-sounding narratives regardless of the facts, especially if the story fits our predispositions and our emotions. </p><p>You ever wonder why politicians tell so many stories? What about the advertisements you see on TV or video advertisements on websites, which tell very quick visual stories? How about salespeople or fundraisers? Sure, sometimes they cite statistics and scientific reports, but they spend much, much more time telling stories: simple, clear, compelling narratives that seem to make sense and tug at our heartstrings. </p><p>Now, here's something that's actually true: the world doesn't make sense. The world is not simple, clear, and compelling. The world is complex, confusing, and contradictory. Beware of simple stories! Look for complex, confusing, and contradictory scientific reports and high-quality statistics: they're much more likely to contain the truth than the easy-to-process stories.</p><p>Another big problem that comes from cognitive fluency: the "<a href="https://www.frontiersin.org/research-topics/1845/behavioral-and-physiological-bases-of-attentional-biases-paradigms-participants-and-stimuli" target="_blank" rel="noopener noreferrer">attentional bias</a>." We pay the most attention to whatever we find most emotionally salient in our environment, as that's the information easiest for us to process. Most often, such stimuli are <a href="https://www.sciencedirect.com/science/article/abs/pii/S0272735817304014?via%3Dihub" target="_blank" rel="noopener noreferrer">negative</a>; we feel a lesser but real attentional bias to <a href="https://psycnet.apa.org/record/2015-42376-001" target="_blank" rel="noopener noreferrer">positive</a> information.</p><p>That's why fear, anger, and resentment represent such powerful tools of misinformers. They know that people will focus on and feel more swayed by emotionally salient negative stimuli, so be suspicious of negative, emotionally laden data.</p><p>You should be especially wary of such information in the form of stories framed to fit your preconceptions and repeated. That's because cognitive biases build on top of each other. You need to learn about the most dangerous ones for <a href="https://disasteravoidanceexperts.com/how-to-evaluate-unconscious-bias-caused-by-cognitive-biases-at-work/" target="_blank">evaluating reality clearly and making wise decisions</a>, and watch out for them when you consume news, and in other life areas where you don't want to make poor choices.</p>
<p><strong>Fixing Our Brains</strong></p>
<p>Unfortunately, knowledge only weakly protects us from cognitive biases; it's important, but far from sufficient, as the study I cited earlier on the illusory truth effect reveals.</p>
<p>What can we do? </p>
<p>The easiest decision aid is a personal commitment to twelve truth-oriented behaviors called the Pro-Truth Pledge, which you can make by signing the pledge at <a href="https://www.protruthpledge.org/" target="_blank" rel="noopener noreferrer">ProTruthPledge.org</a>. All of these behaviors stem from cognitive neuroscience and behavioral economics research in the field called debiasing, which refers to <a href="https://disasteravoidanceexperts.com/12-mental-skills-to-defeat-cognitive-biases/" target="_blank" rel="noopener noreferrer">counterintuitive, uncomfortable, but effective strategies to protect yourself from cognitive biases</a>. </p>
<p>What are these behaviors? The first four relate to you being truthful yourself, under the category "share truth." They're the most important for avoiding falling for cognitive biases when you share information:</p>
<p><strong><em>Share truth</em></strong></p><ul><li><strong>Verify: </strong><a href="https://www.protruthpledge.org/threading-fact-checking-needle/" target="_blank" rel="noopener noreferrer">fact-check</a> information to confirm it is <a href="https://www.protruthpledge.org/misinformation" target="_blank" rel="noopener noreferrer">true</a> before accepting and sharing it</li><li><strong>Balance:</strong> share the whole truth, even if some aspects do not support my opinion<strong></strong></li><li><strong>Cite:</strong> share my sources so that others can verify my information</li><li><strong>Clarify:</strong> distinguish between my <a href="https://www.protruthpledge.org/facts-opinions-experts/" target="_blank" rel="noopener noreferrer">opinion and the facts</a></li></ul>
<p>The second set of four are about how you can best "honor truth" to protect yourself from cognitive biases in discussions with others:</p>
<p><em><strong>Honor truth</strong></em></p><ul><li><strong>Acknowledge:</strong> when others share <a href="https://www.protruthpledge.org/misinformation" target="_blank" rel="noopener noreferrer">true</a> information, even when we disagree otherwise</li><li><strong>Reevaluate:</strong> if my information is challenged, retract it if I cannot verify it</li><li><strong>Defend: </strong>defend others when they come under attack for sharing <a href="https://www.protruthpledge.org/misinformation" target="_blank" rel="noopener noreferrer">true</a> information, even when we disagree otherwise</li><li><strong>Align:</strong> align my opinions and my actions with <a href="https://www.protruthpledge.org/misinformation" target="_blank" rel="noopener noreferrer">true</a> information</li></ul>
<p>The last four, under the category "encourage truth," promote broader patterns of truth-telling in our society by providing incentives for truth-telling and disincentives for deception:</p>
<p><em><strong>Encourage truth</strong></em></p><ul><li><strong>Fix:</strong> ask people to retract information that <a href="https://www.protruthpledge.org/misinformation" target="_blank" rel="noopener noreferrer">reliable sources</a> have disproved even if they are my allies</li><li><strong>Educate: </strong>compassionately inform those around me to stop using <a href="https://www.protruthpledge.org/misinformation" target="_blank" rel="noopener noreferrer">unreliable sources</a> even if these sources support my opinion</li><li><strong>Defer:</strong> recognize the <a href="https://www.protruthpledge.org/facts-opinions-experts/" target="_blank" rel="noopener noreferrer">opinions of experts</a> as more likely to be accurate when the facts are disputed</li><li><strong>Celebrate: </strong>those who retract incorrect statements and update their beliefs toward the <a href="https://www.protruthpledge.org/misinformation" target="_blank" rel="noopener noreferrer">truth</a></li></ul>
<p>Peer-reviewed research has shown that taking the Pro-Truth Pledge is effective for <a href="https://link.springer.com/content/pdf/10.5210/bsi.v27i0.9127.pdf" target="_blank">changing people's behavior</a> to be more truthful, both in their own statements and in <a href="https://jspp.psychopen.eu/article/view/856" target="_blank">interactions with others</a>. I hope you choose to join the many thousands of ordinary citizens—and over 1,000 politicians and officials—who committed to this decision aid, as opposed to going with their gut.</p><p><em>[Adapted from: Dr. Gleb Tsipursky and Tim Ward, <a href="https://www.amazon.com/Pro-Truth-Practical-Putting-Politics/dp/1789043999" target="_blank">Pro Truth: A Practical Plan for Putting Truth Back Into Politics</a> (Changemakers Books, 2020).]</em></p>
<p>[<strong>Editor's Note: To read other articles in this special magazine issue, visit the beautifully designed </strong><a href="https://online.flippingbook.com/view/604426/" target="_blank" rel="noopener noreferrer"><u>e-reader version</u></a>.]</p>
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Dr. Gleb Tsipursky is an internationally recognized thought leader on a mission to protect leaders from dangerous judgment errors known as cognitive biases by developing the most effective decision-making strategies. A best-selling author, he wrote Resilience: Adapt and Plan for the New Abnormal of the COVID-19 Coronavirus Pandemic and Pro Truth: A Practical Plan for Putting Truth Back Into Politics. His expertise comes from over 20 years of consulting, coaching, and speaking and training as the CEO of Disaster Avoidance Experts, and over 15 years in academia as a behavioral economist and cognitive neuroscientist. He co-founded the Pro-Truth Pledge project.
On left, people excitedly line up for Salk's polio vaccine in 1957; on right, Joe Biden gets one of the COVID vaccines on December 21, 2020.
Wikimedia Commons and Biden's Twitter
On the morning of April 12, 1955, newsrooms across the United States inked headlines onto newsprint: the Salk Polio vaccine was "safe, effective, and potent." This was long-awaited news. Americans had limped through decades of fear, unaware of what caused polio or how to cure it, faced with the disease's terrifying, visible power to paralyze and kill, particularly children.
The announcement of the polio vaccine was celebrated with noisy jubilation: church bells rang, factory whistles sounded, people wept in the streets. Within weeks, mass inoculation began as the nation put its faith in a vaccine that would end polio.
Today, most of us are blissfully ignorant of child polio deaths, making it easier to believe that we have not personally benefited from the development of vaccines. According to Dr. Steven Pinker, cognitive psychologist and author of the bestselling book Enlightenment Now, we've become blasé to the gifts of science. "The default expectation is not that disease is part of life and science is a godsend, but that health is the default, and any disease is some outrage," he says.
<p>We're now in the early stages of another vaccine rollout, one we hope will end the ravages of the COVID-19 pandemic. And yet, the Pfizer, Moderna, and AstraZeneca vaccines are met with far greater hesitancy and skepticism than the polio vaccine was in the 50s.</p><p>In 2021, concerns over the speed and safety of vaccine development and technology plague this heroic global effort, but the roots of vaccine hesitancy run far deeper. Vaccine hesitancy has always existed in the U.S., even in the polio era, motivated in part by fears around <a href="https://www.scientificamerican.com/article/paranoid-gossip-about-polio-vaccine/" target="_blank" rel="noopener noreferrer"><u>"living virus"</u></a> in a <a href="https://www.washingtonpost.com/history/2020/04/14/cutter-polio-vaccine-paralyzed-children-coronavirus/" target="_blank" rel="noopener noreferrer"><u>bad batch of vaccines produced by Cutter Laboratories</u></a> in 1955. But in the last half century, we've witnessed seismic cultural shifts—loss of public trust, a rise in misinformation, heightened racial and socioeconomic inequality, and political polarization have all intensified vaccine-related fears and resistance. Making sense of how we got here may help us understand how to move forward. </p>
The Rise and Fall of Public Trust
<p>When the polio vaccine was released in 1955, "we were nearing an all-time high point in public trust," says Matt Baum, Harvard Kennedy School professor and lead author of <a href="http://www.kateto.net/covid19/COVID19%20CONSORTIUM%20REPORT%2013%20TRUST%20SEP%202020.pdf" target="_blank" rel="noopener noreferrer"><u>several</u></a> <a href="https://shorensteincenter.org/wp-content/uploads/2020/09/COVID19-CONSORTIUM-REPORT-14-MISINFO-SEP-2020.pdf" target="_blank" rel="noopener noreferrer"><u>reports</u></a> measuring public trust and vaccine confidence. Baum explains that the U.S. was experiencing a post-war boom following the Allied triumph in WWII, a popular Roosevelt presidency, and the rapid innovation that elevated the country to an international superpower.</p><p> The 1950s witnessed the emergence of nuclear technology, a space program, and unprecedented medical breakthroughs, adds Emily Brunson, Texas State University anthropologist and co-chair of the Working Group on Readying Populations for COVID-19 Vaccine. "Antibiotics were a game changer," she states. While before, people got sick with pneumonia for a month, suddenly they had access to pills that accelerated recovery. </p><p>During this period, science seemed to hold all the answers; people embraced the idea that we could "come to know the world with an absolute truth," Brunson explains. Doctors were portrayed as unquestioned gods, so Americans were primed to trust experts who told them the polio vaccine was safe. </p><blockquote>"The emotional tone of the news has gone downward since the 1940s, and journalists consider it a professional responsibility to cover the negative."</blockquote>
<p>That blind acceptance eroded in the 1960s and 70s as people came to understand that science can be inherently political. "Getting to an absolute truth works out great for white men, but these things affect people socially in radically different ways," Brunson says. As the culture began questioning the white, patriarchal biases of science, doctors lost their god-like status and experts were pushed off their pedestals. This trend continues with greater intensity today, as President Trump has <a href="https://www.axios.com/trump-public-health-experts-cdc-fauci-e1509d14-0cf1-4b1c-b107-7753bf95395d.html" target="_blank" rel="noopener noreferrer"><u>led a campaign against experts</u></a> and <a href="https://www.nytimes.com/2019/12/28/climate/trump-administration-war-on-science.html" target="_blank" rel="noopener noreferrer"><u>waged a war on science</u></a> that began long before the pandemic.</p>
The Shift in How We Consume Information
<p>In the 1950s, the media created an informational consensus. The fundamental ideas the public consumed about the state of the world were unified. "People argued about the best solutions, but didn't fundamentally disagree on the factual baseline," says Baum. Indeed, the messaging around the polio vaccine was centralized and consistent, led by President Roosevelt's successful <a href="https://files.eric.ed.gov/fulltext/EJ978264.pdf" target="_blank" rel="noopener noreferrer"><u>March of Dimes crusade</u></a>. People of lower socioeconomic status with limited access to this information were <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1551508/?page=3" target="_blank" rel="noopener noreferrer"><u>less likely to have confidence</u></a> in the vaccine, but most people consumed <a href="https://www.c-span.org/video/?506891-1/a-special-report-polio" target="_blank" rel="noopener noreferrer"><u>media that assured them</u></a> of the vaccine's safety and <a href="https://www.cbsnews.com/news/the-salk-polio-vaccine-greatest-public-health-experiment-in-history/" target="_blank" rel="noopener noreferrer"><u>mobilized them</u></a> to receive it. </p><p>Today, the information we consume is no longer centralized—in fact, just the opposite. "When you take that away, it's hard for people to know what to trust and what not to trust," Baum explains. We've witnessed an increase in polarization and the technology that makes it easier to give people what they want to hear, reinforcing the human tendencies to vilify the other side and reinforce our preexisting ideas. When information is engineered to further an agenda, each choice and risk calculation made while navigating the COVID-19 pandemic <a href="https://www.nytimes.com/2020/12/19/opinion/sunday/coronavirus-science.html?referringSource=articleShare" target="_blank" rel="noopener noreferrer"><u>is deeply politicized</u></a>. </p><p>This polarization maps onto a rise in socioeconomic inequality and economic uncertainty. These factors, associated with a sense of lost control, prime people to embrace misinformation, explains Baum, especially when the situation is difficult to comprehend. "The beauty of conspiratorial thinking is that it provides answers to all these questions," he says. Today's insidious fragmentation of news media accelerates the circulation of mis- and disinformation, reaching more people faster, regardless of veracity or motivation. In the case of vaccines, skepticism around their origin, safety, and motivation is intensified. </p><p>Alongside the rise in polarization, Pinker says "the emotional tone of the news has gone downward since the 1940s, and journalists consider it a professional responsibility to cover the negative." Relentless focus on everything that goes wrong further erodes public trust and paints a picture of the world getting worse. "Life saved is not a news story," says Pinker, but perhaps it should be, he continues. "If people were more aware of how much better life was generally, they might be more receptive to improvements that will continue to make life better. These improvements don't happen by themselves."</p>The Future Depends on Vaccine Confidence
<p>So far, the U.S. has been unable to mitigate the catastrophic effects of the pandemic through social distancing, testing, and contact tracing. President Trump has <a href="https://www.washingtonpost.com/politics/bob-woodward-rage-book-trump/2020/09/09/0368fe3c-efd2-11ea-b4bc-3a2098fc73d4_story.html" target="_blank" rel="noopener noreferrer"><u>downplayed the effects and threat of the virus</u></a>, <a href="https://www.washingtonpost.com/outlook/2020/07/14/cdc-directors-trump-politics/" target="_blank" rel="noopener noreferrer"><u>censored experts and scientists</u></a>, <a href="https://www.theatlantic.com/science/archive/2020/06/america-giving-up-on-pandemic/612796/" target="_blank" rel="noopener noreferrer"><u>given up on containing the spread</u></a>, and <a href="https://www.nytimes.com/2020/09/16/world/covid-coronavirus.html" target="_blank" rel="noopener noreferrer"><u>mobilized his base to protest masks</u></a>. The Trump Administration failed to devise a national plan, so our national plan has defaulted to hoping for the <a href="https://www.politico.com/news/2020/08/26/nation-of-miracles-pence-coronavirus-vaccine-rnc-402949" target="_blank" rel="noopener noreferrer"><u>"miracle" of a vaccine</u></a>. And they are "something of a miracle," Pinker says, describing vaccines as "the most benevolent invention in the history of our species." In record-breaking time, three vaccines have arrived. But their impact will be weakened unless we achieve mass vaccination. As Brunson notes, "The technology isn't the fix; it's people taking the technology."</p><p> Significant challenges remain, including facilitating widespread access and supporting on-the-ground efforts to allay concerns and build trust with <a href="https://www.newyorker.com/news/daily-comment/african-american-resistance-to-the-covid-19-vaccine-reflects-a-broader-problem" target="_blank" rel="noopener noreferrer"><u>specific populations with historic reasons for distrust</u></a>, says Brunson. Baum predicts continuing delays as well as deaths from other causes that will be linked to the vaccine. </p><p> Still, there's every reason for hope. The new administration "has its eyes wide open to these challenges. These are the kind of problems that are amenable to policy solutions if we have the will," Baum says. He forecasts widespread vaccination by late summer and a bounce back from the economic damage, a "Good News Story" that will bolster vaccine acceptance in the future. And Pinker reminds us that science, medicine, and public health have greatly extended our lives in the last few decades, a trend that can only continue if we're willing to roll up our sleeves. </p>
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