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The most problematic risk factor for Rothstein is the correlation between blood cholesterol and heart disease. Blood cholesterol’s role in the development heart disease is uncertain and Rothstein directly questions the findings of that a reduction in cholesterol levels prevents heart disease. The side effects of the drugs and the high cost outweigh any speculative benefits. Additionally, the focus on cholesterol has diverted attention from the most likely causes of heart disease, obesity and insufficient physical exercise. Rothstein’s conclusions fit neatly with the historical evidence provided earlier in the book that heart disease was uncommon before the twentieth century. According to Rothstein, obesity and exercise are the single greatest determining factors for heart disease. Unfortunately, physicians are not well-positioned to alter an individual’s weight or mandate exercise. Instead of focusing on these issues, the medical profession has been sidetracked by prescribing blood pressure and cholesterol medicines.
Rothstein does not appear to rely on any specific social theory. If anything, Rothstein’s work is more informed by a sophisticated understanding of statistics, probability, and mathematics. Whether or not that constitutes a type of social theory may be worth debating. Additionally, it is arguable whether his work would benefit from the inclusion of any specific social theory. Unlike Warwick Anderson in his work Colonial Pathologies, Rothstein is not particularly interested in the motivations, morality or ethics of scientists involved in the Framingham Heart Study. Instead, he is focused on analyzing whether their conclusions were supported by the accompanying statistical evidence. Rothstein seeks to undermine the contemporary understanding and treatment of coronary heart disease by questioning the validity of the interpretations of these statistical studies. Because the biological cause of heart disease has not been determined in the laboratory setting, it is may be possible for statistician or sociologist to ascertain risk factors as well as any physician.
[[Category:Book Review]] [[Category:Historiography]] [[Category:Medical History]] [[Category:United States History]]
