Brown is exactly right on the reality of the social. Her cure, however, is to introduce more of the disease rather than the remedy.
In the early-1980s, West Germany was experiencing an epidemic of motorcycle thefts approaching 150,000 per year. Then, out of nowhere, these thefts dropped precipitously. By 1986, just 54,000 motorcycles were stolen. This kind of change in criminal behavior is rare, and no one seemed to know why it had happened. Various theories began to emerge. Was it tougher law enforcement and penalties, or did thefts fall with unemployment? Or maybe it was the result of some sort of new government outreach to troubled youth?
The real answer turned out to be about as mundane as possible: around 1980, the West German government imposed a helmet law. Since most motorcycle thefts were crimes of opportunity (and motorcycle thieves didn’t generally roam the streets carrying helmets), when the police spotted a helmetless rider they had a good chance of a two-fer arrest. The risks associated with stealing a motorcycle went up and the number of thefts declined. There is no discernable moral to the story except that the world is a complex, unpredictable place; changing one thing means changing innumerable other things.
Complexity and contingency are at war with an important facet of human nature. Human beings are unique in the way we tell stories about ourselves. Given the vast array of often conflicting data we gather through our senses, the human mind seeks patterns that lead us toward causal theories (outcome “C” is the result of factor “A” or, sometimes “A plus B”). Our minds are big, and they require furnishing. For the human mind, any answer is preferable to an unresolved mystery.
Causal Wheat and Contingent Chaff
In contemporary times, this theorizing and pattern-seeking has been raised to the status of science we call research studies. In diverse areas of life—health, technology, social sciences—we generate formal studies that are intended to help us understand and influence the reality in which we live. These studies have as their primary method efforts to isolate the discrete factors, inputs, and variables that are “really” behind what’s going on, to separate the causal wheat from the contingent chaff.
But what if this approach stands our true situation on its head? What if the world we live in and constantly shape and reshape through our values, beliefs, actions, and even our genes, truly is as unpredictable and contingent as the “noise” that surrounds our narrow social and economic policy interventions suggests? What if the noise is the signal?
These are the questions and themes that journalist Michael Blastland explores in his recent book, The Hidden Half: How the World Conceals its Secrets. Blastland’s message, like his subject matter, is both simple and complex. We are surrounded by problems and challenges which need to be fixed. To navigate these difficulties, we need theories about their causes, data about when and where they occur, and interventions, built on our theories and data, to address them. We build our actions around chains of logic that, to our eyes, appear water-tight but in reality are riddled through with unknown unknowns.
This combination of urgent need and incomplete understanding (what Blastland thinks is better described as a state of “pig-ignorance,” although that may be a bit hard on the pigs), is leading us into research cul-de-sacs in many domains. His book is replete with discouraging examples. Problems large and small, from the level of individuals to communities to nations are subject to what he calls “radical uncertainty”—a version of the “man plans, God laughs” dilemma.
Consider some of the assumptions we regularly make in medicine: Studies show a connection between high cholesterol and heart disease. We have drugs to reduce cholesterol. Unfortunately, they are effective for only 1 in every 24 people for whom they are prescribed. Have you been told that eating bacon causes colon cancer? Maybe, but for 100 people eating four pieces of the sweet/salty stuff daily (to borrow from Christopher Buckley in Thank You for Smoking, a high dose, even by industry standards) there will be 6 cases of colon cancer compared to 5 among less hearty eaters. Figuring out who among the heavy consumers will be the unlucky sixth is virtually impossible. So instead, we stick to the population-level findings and transform an occasional morning pleasure into an experience larded with fear and guilt.
Even research on medical treatments get swallowed up in the quicksands of quality, application, and replicability. One researcher set out to replicate 53 of the most important findings in the field of hematology-oncology (treatment of blood cancers); only six successfully replicated, an 89 percent failure rate. A meta-analysis of 146 studies that appeared in the New England Journal of Medicine between 2001 and 2010 found that many of the conclusions from these studies were being ignored, and that as much as 40 percent of commonly used medical procedures were either ineffective or actually harmful.
In the social sciences, Blastland’s look at several foreign aid programs helps to illustrate how clear, seemingly simple, problems do not yield to our logical solutions. One project sought to support the construction of toilets in India where the absence of basic sanitation continues to be the source of infant mortality and other human misery. One would think building toilets to be a relatively straightforward enterprise. Then the contingencies began to interfere. Giving money to families to build toilets ended in funds being diverted to what the families perceived to be more urgent needs. Reimbursing for toilet construction didn’t work either because the families lacked other ways of financing the construction. The program directors reverted to grants but required that families attend a class on the importance of building the toilet. Finally, the toilets got built but appeared to make no difference to health outcomes because either a) people didn’t use them, or b) not enough toilets had been built to make a dent in the sewage problem.
Further complicating the research picture is the fact that what works in one place may not work in another, and vice-versa. Aid organizations estimated that cow ownership in India would add significantly to family incomes and improve nutrition. The cows were dutifully supplied but nutrition didn’t improve and incomes went down due to the increased cost of maintaining the cow. A clear case of an unworkable intervention? Maybe not. The same scheme was found to improve both nutrition and incomes in Uganda. As Blastland notes, our efforts are subject not just to uncertainty, but radical uncertainty. An approach to a problem works here but not there; now but not then; for this person but not that one. As the director of the toilet project said, “Causality is really . . . really . . . hard.”
Blastland sees the contingency rule even behind such things as free trade and populism. At a macro-level the case for trade and against protectionism is unassailable. When nations specialize everyone has the chance to get richer and indeed they have. With the expansion of relatively free global trade, global wealth has skyrocketed and poverty has been dramatically cut. The problem with the analysis is that it ignores the local impact of trade that rides below the top-line benefits.
Citing the work of MIT economist David Autor, Blastland says that before trade normalization with China, the U.S. had about 400,000 textile production jobs, a tiny fragment of an economy with 150 million workers. These jobs were, however, concentrated in a handful of Southern states, and in some counties accounted for 1 in 6 jobs mainly for white, male workers with only a high school education or less. Man-splaining to these workers that their pain at lost employment and community in single-industry towns was the other end of enormous gains being made by their fellow citizens living elsewhere or the impoverished of China and Southeast Asia was unpersuasive in the extreme, adding to the cascade of forces that brought us the presidency of Donald Trump. Jumping over the pond to England, when a government official explained to a Newcastle housewife how the impact of losses to GDP from Brexit would vastly outstrip any savings on money transferred to Brussels, she responded, “That’s your bloody GDP, not mine!”
If reliable, replicable knowledge is so hard to come by and so fraught with unintended consequences, why bother trying to understand? The first answer is straightforward: we pursue knowledge and seek to solve problems because that’s what human beings do. Just as our ancient ancestors scanned the savannah for signs of lions, so we are engaged in a constant process of threat assessment and mitigation. We can no more stop seeing problems, hypothesizing about their sources, and trying to fix things than we can stop breathing. The second answer is equally obvious: through patient trial and error processes, humanity has made enormous advances against ignorance, poverty, and disease. More of that, please. But in the process, let’s not lose sight of how limited and conditional our knowledge often is.
The Haunting Pretense of Knowledge
The underlying challenge Blastland points to is that we are now dicing knowledge and insight so finely that many of our conclusions just don’t hold up. As one wag in biomedical research says in the book, “unfortunately, we are still very successful”; too successful, in fact, to be credible. The pressure on researchers to show positive outcomes, and thereby sustain funding from government and industry, means that institutions or even researchers themselves often suppress failures, depriving scholars and the public of the benefits derived from analyzing failure, a proper understanding of the contingency of knowledge, and the opportunity to ask why our approaches to research lead to such contradictory, unsatisfying, and frequently false-positive outcomes.
When it comes to addressing the research crisis, Blastland sounds suspiciously like a libertarian, complete with quotes from F. A. Hayek on “the pretense of knowledge”. Markets, Blastland says, are the best available model for understanding how the world around us works. Human existence is a massive, unintelligibly complex system (or perhaps better, a system of systems) that is constantly morphing and changing based on the actions of individuals, communities, and nations nestled in unique cultures shaped by constantly changing circumstances. Any attempt to understand motivations and behaviors needs to proceed on the basis that they are dealing not with a photograph but with a fast moving picture. Life’s plot is unpredictable.
Our interventions in the world, from medicine to economics to social science, must be conditioned by experimentation and a willingness to think hard and adapt as life “talks back”. Especially in the realm of policy, we need to acknowledge that our cause-and-effect understandings are hazy “bets” on the future and that we need to anticipate and plan for unexpected outcomes. Most importantly, Blastland says, we should “treasure our exceptions” and look for ways of collecting narratives of individual experiences that help explain them. As Daniel Boorstin, the former Librarian of Congress, said, “The greatest obstacle to progress is not ignorance but the illusion of knowledge.” The only plausible approach to such a state of affairs is to embrace uncertainty and humbly inquire, “What is it trying to tell us?”