A study published by the University of Leicester last month gained a lot of media attention when it linked genetically short adult height to coronary artery disease. The results prompted some to ask questions of the medical field, and what doctors are doing to help their short statured patients preserve their health.
This request sounds reasonable in theory – the public should be aware of potential health risks regardless of who is affected. But unless there is a sense of perspective used in communicating the findings, there is potential for over exaggeration and misinterpretation. In particular I am referring to the simple and unavoidable fact that being short is not a disease in itself, and to treat it as one is insulting and unproductive. The issue is how medicine and society in general address the health of shorter individuals, without pigeonholing people unnecessarily.
Let’s start from the beginning. Why are some people shorter than others? Well, there are a variety of answers to that, each with varying degrees of complexity. The first is the genetic component to adult height. In very very general terms, if two short people from two short statured families have a child, there is a high likelihood that that kid will also be short. Adult height, unlike a lot of other physical attributes, is strongly (up to 80%) determined by ones genes.
The second is environment. Children who have poor nutrition, poor health and who live in low socioeconomic conditions will, on average, grow up to be shorter than those who were better off. This is primarily due to the quality and quantity of food that the child eats over the course of their development, combined with genetic factors.
But why does this matter?
Well, the study that inspired this article concluded that the shorter you are, the higher your risk of developing coronary artery disease. Specifically, for every 6.5cm decrease in height, there is a 13.5% higher chance of disease development. This information is fascinating and has potential for clinical advancement on the issue, but it poses some interesting ethical questions for how to approach disease prevention and risk communication.
As people learn about this research, and the results inevitably become blurred by journalists and bloggers, I can easily foresee some misinterpretation. I fear that if this is the case, short people will be viewed as less healthy than taller people – giving rise to discrimination and judgement against them. This would not be the first time shorter people have experienced discrimination either. Or the second time
. Eventually, short people will be seen inherently as victims, a title that is neither correct, nor beneficial to them. We must stop this before it starts.
As a community, science and science communicators in particular must emphasise that being short alone is not a statement about one’s health. The risk factors associated with short stature must be addressed, of course, but with a sensitive and realistic sense of what the health impacts actually are.