How many of our "facts" about society, health, and the economy are fake?

The rise in maternal mortality, the fall in geographic mobility, the rise in teen suicide, and many other "facts" are being called into question.

Remember the maternal mortality crisis? In 2022 and 2023, a lot of people were wringing their hands about how American mothers were dying at skyrocketing rates. Here’s what the Commonwealth Fund, a health-care-focused think tank that’s generally regarded as one of the top sources of public information on the U.S. health system, told us in 2022:

The maternal mortality rate in the United States has for many years exceeded that of other high-income countries…The U.S. maternal mortality rate has been on the rise since 2000 and has spiked in recent years.

And in 2023, the Wall Street Journal declared that U.S. maternal mortality was the highest it had been since 1965. These were only two of many outlets that reported on the trend. Politicians took note. Social media shouters declared one more piece of evidence of America’s rapid decline as a nation.

There’s just one problem: The U.S. maternal mortality increase was fake. It was a thing that never happened.

In 2021, Joseph et al. published a paper in Obstetrics & Gynecology demonstrating that the entire recorded increase in maternal mortality since 2003 was due to a change in the way data was gathered. In 2003, U.S. states began to include pregnancy checkboxes on death certificates. This led to a whole lot more women who died while pregnant being identified as such. The apparent steady increase in maternal mortality was due to the fact that states adopted this new checkbox at different times:

Source: Joseph et al. (2021)

In fact, when the authors looked at the common causes of death from pregnancy, they found that these had all declined since 2000, implying that U.S. maternal mortality has actually been falling. Meanwhile, a CDC report in 2020 had found the same thing as Joseph et al. (2021) — maternal mortality rose only in states that added the checkbox to death certificates.

So if the rise in maternal mortality was known to be fake as early as 2020 or 2021, why were prominent think tanks and news outlets still reporting it as fact in 2022 and 2023? Yes, it takes a while for research findings to enter the public consciousness. But how fast they do so is partly a function of how loudly experts broadcast new findings. And in a recent writeup of the maternal mortality debacle, Jerusalem Demsas uncovers one possible reason why the discovery that American mothers actually weren’t dying at higher rates wasn’t immediately shouted from the rooftops:

Christopher M. Zahn, the interim CEO of the American College of Obstetricians and Gynecologists, wrote a lengthy statement in response, arguing that “reducing the U.S. maternal mortality crisis to ‘overestimation’” is “irresponsible and minimizes the many lives lost and the families that have been deeply affected.” Why? Because it “would be an unfortunate setback to see all the hard work of health care professionals, policy makers, patient advocates, and other stakeholders be undermined.” Rather than pointing out any major methodological flaw in the paper, Zahn’s statement expresses the concern that it could undermine the…goal of improving maternal health.

This is absolutely breathtaking, and not in a good way. One of the most prominent doctors in the field of obstetrics is openly arguing that positive data about U.S. health should be suppressed, and that popular misconceptions based entirely on data artifacts should be encouraged to persist, in order to motivate the public to devote more resources to the goals he thinks are important.

To me, this clearly qualifies as disinformation. Zahn is demanding that researchers bury their findings so that the doctors, activists, and politicians he likes can get more money. That deserves to be a bigger scandal than it is. But as Demsas reports, this kind of thing is a lot more widespread than many realize:

Similar arguments are rarely stated aloud but are highly influential behind the scenes: If you want to help people, you should show how they are in crisis. Anything that makes others more complacent about their problem is working against the victims.

This dynamic is evident well beyond the maternal mortality debate. A couple of years ago I reported on dire COVID-related economic predictions that didn’t pan out: Among them were the eviction tsunami, in which 30 million or more renters would be kicked out of their homes, and the “she-cession,” wherein women would drop out of the labor market en masse.

One problem, my article noted, is that experts and activists alike have policy preferences—such as a preference for greater housing assistance for people at risk of eviction—that influence what they observe…One sociologist told me that high estimates of potential evictions may have been useful “from a lobbying standpoint.” “It was helpful to the movement of activists who were pushing for relief measures to be put into place to cite some of these larger figures,” a housing analyst told me. At the time, my assertion that these predicted catastrophes had not come to pass prompted a significant backlash.

This is exactly what I meant back in 2021 when I wrote that experts will sometimes lie to the public in order to further what they see as the greater good. It’s also one reason why I believe that politicized science is bad and that science and activism don’t mix.

But disinformation by experts is far from the only reason why the public gets misinformed about social, economic, and health trends. The unfortunate fact is that social science, public health, and any other fields that rely on observational data are simply not very precise. Data is hard to gather, and hard to interpret even after you have it. Causality is hard to isolate, and theories are hard to validate. Trends and other unobserved factors can change, so that what looked like a bedrock “fact” suddenly vanishes into thin air.

This is a big challenge for writers like me, part of whose job is to communicate research findings to the public. And it’s become an even more difficult problem since 2010 or so, when the rise of mass social media vastly increased the amount of observational findings making their way into the public discourse. In fact, I’m noticing a steady drumbeat of stories about how “facts” that many of us regarded as ground truth in the last decade are now being suddenly called into question.

Is falling geographic mobility fake? Is the teen mental health crisis fake?