The Centers for Disease Control and Prevention (CDC) issued a bulletin last week advising all women of reproductive age who are sexually active and not using birth control to abstain from alcohol. Yale sociologist Rene Almeling and Harvard historian Sarah Richardson teamed up to write a piece that was published in the Boston Globe. They argue that the CDC risks its credibility when it issues such broad guidelines. In response to widespread criticism, the CDC took down the accompanying infographic. However, much of the original, controversial language remains on the CDC website.
Almeling, who is the author of “Sex Cells: The Medical Market for Eggs and Sperm” and the forthcoming book “Guynecology: Men, Medical Knowledge, and Reproduction,” recently spoke to YaleNews. The following is an edited version of that conversation.
The CDC’s original infographic focused solely on women. Why is it important to also focus on men when it comes to reproductive health?
When it comes to reproductive risk, we need to stop focusing so myopically on women’s health and behavior. There is growing evidence that men’s exposure to various chemicals, from tobacco to toxins, can damage sperm and affect pregnancy outcomes and children’s health. The CDC’s own website includes a list of guidelines for men about how to grow healthy sperm, but last week’s bulletin contains no mention of men whatsoever. It’s time to stop ignoring the role men play in reproductive outcomes.
If the CDC’s infographic presented unhelpful advice, what would an infographic with helpful advice on this topic look like?
The CDC can once again become an authority on this topic by providing information to women and men that details the relative risks of various behaviors, as well as the state of scientific debate regarding the evidence supporting these assessments. Rather than its now-infamous infographic depicting the many harms awaiting a woman who drinks, imagine instead a CDC-designed graphic for both women and men. It would array a range of risks to a fetus from women’s and men’s health behavior, from an occasional alcoholic beverage to binge drinking — and also skiing, hot tubs, or speeding down the interstate at 70 miles an hour. For each risk claim, the CDC would provide an assessment of the degree of scientific certainty given the current state of medical research. Individuals could then easily compare and weigh the risks in reference to their own lives and values.
The CDC presented specific guidelines for women and reproduction. What are some guidelines that men should follow?
The CDC offers a “preconception” guide for men on its website. Among other things, they suggest men be screened for sexually transmitted diseases. Men should also avoid tobacco, drugs, and excessive alcohol. To whatever extent they can, men should also try to avoid toxic substances at home and work.
Are there any models that can accurately assess scientific claims so individuals can make informed decisions about the risks of certain behaviors?
Two models come to mind. The highly respected Cochrane reviews weigh the strength and relevance of diverse forms of scientific evidence pertaining to public health decisions. The British National Health Service’s “Behind the Headlines” series helps consumers interpret the evidence underlying often-hyped health warnings.
Moving forward, how can the CDC regain its credibility on this topic?
The CDC’s mission is to identify and address clear and present dangers to the public health. As such, their credibility is literally a matter of life and death. Most recently, women turned to the CDC for guidance about the Zika virus, a situation where the scientific evidence is sparse and sometimes conflicting. When it comes to everyday reproductive risks, the CDC can play a valuable role in helping women — and men — navigate the morass of conflicting data. Issuing guidelines with all the nuance of a sledgehammer only damages the public’s trust in federal health recommendations.
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