When I first learned about effective altruism, one of the most compelling aspects to me was the focus on neglected cause areas, and specifically the focus on the developing world versus the developed world when it comes to human health. Over time I have developed a slightly more nuanced view.
A few years ago someone posted about whether a cause that could theoretically improve human brain performance by 1% would be worthwhile of EA attention, and the author argued that it absolutely would. The argument was that the cumulative productivity impact of such an improvement would be stunning.
I was reminded of that post recently when reading Why We Sleep by Matthew Walker, who described the significant benefits that things as simple as switching away from LED lighting could have on sleep quality, which in turn has enormous impact on cognitive performance, mental health, car accidents, etc. I started to think that further investments in sleep research could potentially have high societal returns.
I have become more convinced that public health research, in general, even if not specific to the developing world, might be a worthwhile cause area. For example, a recent study (https://www.usnews.com/news/health-news/articles/2021-08-31/kids-piled-on-extra-pounds-during-pandemic) claims that 46% of 5-11 year old children in the United States are now obese. This is an outrageous failure of our public health infrastructure. When one considers how much obesity contributes to other debilitating chronic diseases, the implications for the future are enormous.
I have heard the cliche that our health care system is good at acute issues but bad at chronic issues, but I now believe that's more true than I previously appreciated. For example, it's clear to me that pediatricians are not being proactive enough in guiding parents about how to keep children at healthy BMI levels.
There was recently a series of blog posts (https://slimemoldtimemold.com/2021/07/07/a-chemical-hunger-part-i-mysteries/) about the obesity "mystery", and I realized that we don't even really know what's behind the obesity epidemic. This seems to represent an important place to allocate further research dollars given the scale of the problem and the potential rewards to addressing it.
Hmm I sort of agree with this. I think when I run back-of-the-envelope calculations on the value of information that you can gain from "gold standard" studies or models on questions that are of potential interest in developed-world contexts (eg high-powered studies on zinc on common cold symptom, modeling how better ventilation can stop airborne disease spread at airports, some stuff on social platforms/infrastructures for testing vaccines, maybe some stuff on chronic fatigue), it naively seems like high-quality but simple research (but not implementation) for developed world health research (including but not limited to the traditional purview of public health) is plausibly competitive with Givewell-style global health charities even after accounting for the 100x-1000x multiplier.
I think the real reason people don't do this more is because we're limited more here on human capital than on $s. In particular, people with a) deep health backgrounds and b) strong EA alignment have pretty strong counterfactuals in working or attempting to work on either existential biorisk reduction or public health research for developing world diseases, both of which are probably more impactful (for different reasons).
I agree that relatively small improvements in public health could potentially be highly beneficial. Research on this might be totally tractable.
What I am concerned might be intractable is deploying results. Public health (and all health-relevant products) is a massive industry, with a lot of strong interests pushing in different directions. It seems entirely possible that all the answers are already out there, just drowned out by food, exercise, sexual health, self-help, and other industries.
There's so much noise out there, it seems unlikely that a few EAs will be able to get a word in edgewise.
I agree on the challenges of deploying results. I think the primary value in public health research is empowering individuals to make good decisions for themselves. For example, sites like WedMD and Healthline add a lot of value for individuals trying to improve their families' health. I don't think the answer is already out there on obesity and many other chronic diseases. If it is, I would appreciate someone directing me to it. :)
It's worth noting that Walker's book significantly misrepresents the science. Quoting at length from Guzey: