A just illness theory?

I’ve seen a bunch of memes and agitprop on the internet complaining that healthy eating to build strong immune systems isn’t promoted as a primary means of beating Coronavirus by doctors. Why are they talking about masks and not the importance of fruit! It is true that healthy eating does support a healthy immune system, and while there is evidence obesity increases risk of mortality and more severe infection from Coronavirus. Yet there is only so much healthy eating can do. Nonetheless, a section of the public are convinced that healthy living will give them supercharged immune systems.

This seems to be fast becoming a precept of anti-mask Karens and Richards. There was a meme along the lines :”you protect yourself with a mask- I’m going to protect myself by eating right and building a strong immune system.” Similar points crop up among a lot among anti-vaxxers. This article charts the intersection between whole foods and anti-vaxxerism.

The common pattern is belief that actions which mark you out as a virtuous, health conscious member of the middle class will shield you. I say middle class because this belief system grows most fecundly there. The very wealthy also fall prey- as Steve Job’s conviction that he could beat his pancreatic cancer by drinking juice shows. In truth, health is somewhat random and arbitrary beyond the basic stuff we all know. Past: don’t smoke, don’t binge drink, don’t eat too many calories or too many high calorie density foods there’s only so much you can do. There’s no wonderberry in a Peruvian valley somewhere that will make you immortal. Any of us could fall gravely ill tomorrow.

Nonetheless many people- even people not generally cranks- love the idea that if they eat right they’ll be safe. What explains this recurring delusion? why does it so often accompany anti-maskism and antivaxxerism?

I’m interested in the possibility that it’s a symptom of The Just World Fallacy.

Per Wikipedia:

“The just-world fallacy or just-world hypothesis is the cognitive bias (or assumption) that a person’s actions are inherently inclined to bring morally fair and fitting consequences to that person, to the end of all noble actions being eventually rewarded and all evil actions eventually punished. In other words, the just-world hypothesis is the tendency to attribute consequences to—or expect consequences as the result of—a universal force that restores moral balance.”

People naturally think that “good” behaviour must be powerfully linked to “good” outcomes. Some people are more vulnerable to this cognitive trap than others. Part of what leads to the faux health conscious “hippie” variety of anti-maskism and anti-vaxxerism is a variant of the just-world fallacy. It’s a belief that illness comes from not doing the virtuous things that protect you against illness. Call this the just-illness fallacy. Unfortunately this viewpoint has little room for collective public health strategies. Why do I need a vaccine or a mask? Just let me get the right coffee enemas and I’ll be fine and so will all the other good and virtuous people. It’s all about your personal obeisance to the good health god, not our collective effort.

A connection between medical Karenism and the Just-World fallacy explains a lot. For example, it explains why many turn to anti-vaxxerism to explain why their child, or a friend’s child, developed autism. Random chance couldn’t be the cause. It must be some lapse of mine (or my doctor’s- not to mention big pharma). When the world gets confusing we turn to ways of understanding it which restore a moral order. It’s sometimes better even to blame yourself than to have nothing to blame at all.

It’s hard to resist the conclusion that some degree of narcissism is at play in the just-illness fallacy. A kind of existential hubris that leads you to believe that the universe cares about your little gestures of self-care.

I suspect health experts haven’t been too eager to dissuade people from the Just-illness fallacy. Public health experts do want you to get your fruits and veg- and if it promotes that, how harmful can it really be? Also, no one wants to be the fellow saying ” DEATH WILL COME FOR YOU IN ITS OWN TIME, YOU ARE NOT ABOVE DECAY OR MORTALITY”. It’s a bleak message.

Nonetheless, the Just-Illness fallacy is quite a nasty belief, with a lot of potential for harm, so it’s worth thinking about how to beat it. The Just-Illness theory might make people blase about dangerous symptoms or about seeing their doctor regularly. On a social level, there is every reason to speculate that it diminishes pity and empathy for the sick. During a pandemic, it has a lot of destructive potentials because it makes people understand health as a process of individual dessert and punishment. The collective element gets ignored.

Postscript: objections

A friend argues that actually high calorie density foods aren’t bad for you unless they’re high excess GI carbohydrates. I don’t know enough to comment on this debate, so consider that comment retracted.

A commentor argues that I’m making things more complicated than they really are- anti-vaxxerism and anti-maskism reflect an oppositional mentality and there’s nothing more to it than that. I certainly think this is part of the explanation, but it can’t explain the obsession with “alternative health” in a section of these people, who often invest far more time energy and money into measures they think will improve their health than others.

A number of commentators argue that I’m not being fair to the idea that careful diet, exercise etc. are the way to beat coronavirus. I would simply respond that I state quite clearly in the article that healthy living will help your immune system, but that it is unlikely to “supercharge it” to such a degree that even if you’re an elderly person, you have nothing to fear from coronavirus.

Another reader objects that it’s a bit odd to say that too much emphasis on personal responsibility leads people away from wearing masks and vaccines, which are, after all, steps you can take individually. My response is that it’s not so much about number of personal actions taken, it’s more about a demonstration of middle class virtue. Eating quinoa singles a kind of middle class virtue, but masks don’t. This may be changing in some sectors, for which I am grateful.

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