Heroin On Prescription – Bad Science
Those numbers are misleading for several reasons. First, the whole exercise of comparing outcomes in two different groups of states is fraught with imprecision. Because no state-level controls are employed, the study effectively assumes that the only relevant change between 2000 and 2005 is that sixteen states passed amendments defining marriage as the union of husband and wife, while the other thirty-four did not.
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As the debate over same-sex marriage proceeds, let’s drop the pretense of scientific disinterest and focus on the competing values that are really at stake.
And there is considerable ambiguity in the findings. Many health disorders among LGBs seemed to increase in both groups of states, but they seemed to go up more in the states that passed amendments. I say “seemed to” because the sample size of LGBs who had certain disorders is small, leading to estimates with wide confidence intervals. For example, the 42-percent increase in LGB alcohol abuse in states with marriage amendments is statistically significant (meaning greater than zero with 95-percent confidence), but there was also a 29-percent increase, which does not reach significance, in LGB alcohol abuse in states without amendments. The key test is whether the 42-percent increase is significantly greater than the 29-percent increase, but the authors do not appear to have performed that test.
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“Marriage equality is a civil rights issue—but it is a public health issue, too. And a growing body of research links bans on same-sex marriage with adverse health effects on lesbian, gay, and bisexual (LGB) individuals.” So begins the in support of same-sex marriage. The APHA says that its brief offers “another compelling reason” for the Supreme Court to overturn state laws that define marriage as the union of a man and a woman.
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The brief is one of several that cite scientific backing for a movement that was once about subjective notions of fairness and equality. The motivation is understandable: deep-seated ideological differences seem much easier to overcome when one side can claim the authority of Science (with a capital “S”). After all, who could be against Science?
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Not me. As someone who deals with numbers for a living, I want to see public policy informed by data to the greatest extent possible. When empirical evidence helps policymakers better understand an issue, that’s terrific.
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The APHA’s brief for same-sex marriage offers both weak evidence and an unjustified policy recommendation. It is therefore an excellent illustration of how advocates gild their political positions with the veneer of science. Call it the “science-gilding” of public policy.
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Let’s first consider the weakness of the evidence. The APHA’s brief cites only two studies that directly test the claim that marriage laws affect the health of LGB individuals. Here’s how the APHA summarizes the :
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LGB individuals experienced markedly increased rates of psychiatric disorders in states that erected constitutional amendments banning same-sex marriage during the 2004–2005 elections. Among LGB individuals living in states enacting such bans, the prevalence of general anxiety disorder increased by more than 248%, psychiatric comorbidity by over 36%, and alcohol abuse by 42%. LGB individuals living in states without such bans did not experience any of these spikes in adverse health outcomes.