How the nanny state mentality hurts public health

How the nanny state mentality hurts public health

When my daughter was born, I hired a nanny. Her name was Kelly. She was great, a savior. She collaborated with me in running the household, enforcing the rules of the home. She even had a set of her own rules. I learned from her and her rules because she had more experience tending children than me. She wasn’t a dictator, she was wise. Experience and wisdom are the makings of a great nanny.

Somewhere along the line “nanny” has become a bad word.  A “nanny state” refers to government that is “authoritarian, interfering, and overprotective.” Recently, some politicians and other public health advocates have been deemed “nannies” when they have put forth health policies. The problem with the “nanny state” mentality is that in the past many health policies have been very effective, so this new kneejerk reaction against health policy may prevent us from passing legislation that stands to significantly impact public health.

Recently, Paul LePage, Governor of Maine, vetoed a bill passed in both the Maine House and Senate that would ban minors from tanning salons. Such a ban is in place in 3 states, the city of Chicago, and 11 countries around the world. A ban is pretty extreme, why are governments doing this? The United States Department of Health and Human Services, United States Food and Drug Administration, World Health Organization, American Medical Association, American Academy Pediatrics, and American Academy of Dermatology have all agreed the scientific data on the association between indoor tanning and melanoma is inarguable. Use of indoor tanning devices before age 35 is associated with a 75% increased risk for melanoma. Artificial sources of ultraviolet radiation actually join tobacco and asbestos in the most dangerous category of human carcinogens per the International Agency for Research on Cancer. Making matters even more concerning, recent studies show that 33-41% of tanning booth users exhibit a pattern of tanning that is identical to what we see in people with chemical dependencies, i.e., addiction.

LePage said banning minors strips parents of their rights to protect their children. As he put it, the bill, “tells parents that Augusta knows better than they do when it comes to their children.” How many parents do you think are aware of the research on melanoma and indoor tanning? To his point about parental oversight, studies show that parental consent laws do not reduce indoor tanning, and worse, that parents are often the ones inspiring their children to tan, bringing them along on their own tanning salon visits. The only right we strip from a parent with a ban is of unknowingly harming their child (or knowingly in some cases). Is the Governor aware of the data? Is he aware that he has single-handedly overridden the recommendations of several national and international health organizations who have scrutinized the data?

Perhaps he is against all health policy based on a “nanny state” mentality. This is hard to imagine because myriad health policies are in place and get plenty of bipartisan support. Plus, consider the implications of completely eliminating health policy. Imagine what companies would put in baby food to make it tastier and cheaper. Imagine what would end up in our water. Imagine cigarette vending machines in elementary schools. Imagine universities putting tanning beds in dormitories as a way to lure incoming freshmen.  Oh wait, that last one is actually happening.

As a parent, I wish my lawmakers were like Kelly, the nanny: experienced, wise, and interested in educating parents and protecting children. We can’t possibly be aware of all the ways our children might be in danger. We can’t listen to what companies tell us because their business is bottom lines not public health. We can’t become members of every nonprofit organization that monitors health and safety. This is why we have governmental organizations charged with overseeing public health. I wish law makers’ decisions were based on data, not politics. Our role as parents is to demand that policymakers make decisions on sound data, not whims, favors or votes.

As a scientist, I am deeply concerned that the knowledge gained from science is too often ignored by policymakers. Scientists need to get outside of the ivory tower to educate policymakers and the public about what we do, the data, and why it is important.  We are failing at this mission. Now that I’m both a parent and a scientist, I truly realize this.

Whether you are for or against city/state/federal government bans of minors from indoor tanning, I implore you to ban your own children from indoor tanning. I have nothing to gain or lose if you do or don’t, and I do not get paid to disseminate health information to the public via mass media. It is simply the case that I have seen the data and it is terrifying. You should be aware of the risks because the Governor is disregarding the data that your tax dollars paid scientists like me to gather in an effort to improve public health.

Sherry Pagoto is associate professor of medicine, University of Massachusetts Medical School. She blogs at Shrink and can be reached on Twitter @DrSherryPagoto.

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  • buzzkillerjsmith

    It is acceptable for the state to protect children from themselves. Next case.

    • James

      In the nanny state mindset we are all children of the state. To be cared for and directed by our benevolent leaders. Just ask Bloomberg and his soda ban.

  • Tom33

    A lot of places/situations which may be harmful to children are off-limits to minors. That’s not what most people are complaining about when they complain of the “nanny state”.

    “Nanny state” to most people is when the government treats free ADULT citizens as children and enacts reams of “for your own good!” laws in an attempt to legislate them into being healthy, wealthy & wise at a significant cost to their freedom.

    I’m fine with the government banning children from walking into a liquor store and buying a bottle of Jim Beam, for instance. I’m not fine with that same government telling me that my 30-something friends and I can’t order a pitcher of coke to go with our pizza because one or all of us might end up consuming more than 16 ounces of the stuff and that could lead to one or more of us becoming overweight. Come on.

    • http://onhealthtech.blogspot.com Margalit Gur-Arie

      It’s not “healthy, wealthy & wise”.
      It’s healthy, productive & complacent.

  • AuthenticBioethics

    Human nannies can be kind, caring, nurturing – and the best also prepare the children for independent adulthood. Some nannies fail at it and the kids grow up wild. Others over do it and either become tyrants over children exercising legitimate independence or they make the children who should be independent dependent and complacent. Same with governments; “nanny state” refers to the latter, as others have said.

    One difference between human nannies and nanny states is this: A human nanny takes direct orders from the parent, who can fire her relatively easily for overstepping her authority. Nanny states tend to see themselves as the bosses rather than the employee.

  • Tanning

    By far the worst sunburn I ever got was because of antibiotics I was given in my early teens. The prescribing doctor failed to warn me or my parents about sun exposure; in fact I’ve never had any doctor caution me about any prescription they’ve written.

    Article states: “data on the association between indoor tanning and melanoma is inarguable. Use of indoor tanning devices before age 35 is associated with a 75% increased risk for melanoma”

    Well here is the argument:
    Dr. Mercola says the right tanning beds are good for you: “mainstream media ignores the fact that this is the relative risk ratio. Your absolute risk of getting skin cancer from a tanning bed is less than three-tenths of one percent—and even then, this is likely only if you habitually overexpose yourself”

    “In a recent review of the available research into the relative risk for
    malignant melanoma and tanning bed use, the researchers concluded that tanning bed use was not associated with melanoma, and, in fact, can
    decrease ten times more cancers than they might potentially contribute
    to.”

    Maybe we should just outlaw experts!

    • http://twitter.com/DrSherryPagoto Sherry Pagoto

      You are focusing on a single study (and inappropriately), there is myriad research showing an association (including dose response effect) between use of tanning beds and cancer. I did not cite them all but instead referred to the orgs that have released position statements against tanning beds. The national and international organizations I mention above have reviewed the entire body of data and have drawn conclusions based on it. Nice try (again).

      • http://twitter.com/DrSherryPagoto Sherry Pagoto

        And in full disclosure, the commenter above is a tanning industry representative. (since he won’t disclose his own status). I have no conflicts of interest, by the way.

        • Tanning

          It’s unlikely that tanning industry representatives have public health in mind but I’m not so sure that some of the national and international organizations you mentioned do either. Is population control and profit the same as public health? Youtube:Codex Alimentarius – The End Of Healthy Food, Minerals and Vitamins.

          My motivations are strictly personal, I don’t profit from any tanning anything in any way, and I’ve never commented on any other article from this site.

      • Tanning

        I was simply quoting from a website. If you find that information false or misleading then you should do an article on Dr. Mercola and how he deceives people in order to sell tanning beds if this is the case. Dr. Mercola has stated the he financed his website for years before ever selling anything and he has admitted to being wrong before; furthermore, he practices what he preaches by tanning. Maybe people have poorly evolved to deal with sunlight, tanning beds are just bad, something else in our environment has increased our risk for melanoma
        (food, cell phones, lotions?), and/or the conclusions from studies are inaccurate.

        I’m all for banning, regulation, and suing. I have nothing
        but contempt for insidious profiteers that legally harm for profit but are never imprisoned. However, problems are often poorly understood and the solutions flawed.

        PBS recently aired a program on the dangers
        of flame retardants which were an inadequately thought out solution that was in the interest of public safety. The program stated that chemical companies have spent millions fighting new regulations.

        Nope, I’m not a “tanning industry representative” but I
        wholeheartedly endorse the spirit of your accusation. There are several websites (like tannersrights) opposing the sunlight scare if you wish to do an article to objectively debate them.

        • Suzi Q 38

          I am from Hawaii and live in California. We don’t need tanning salons.
          We just go outside.

          • Chris

            Careful, that will be illegal soon. “FOR YOUR OWN GOOD”.

          • Suzi Q 38

            LOL.
            Just like smoking. Yes, it is bad for you…but outside,” WHO OWNS THE AIR???”

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