American health experts often emphasize the risks of sun exposure due to the vital link between UV radiation and skin cancer, particularly melanoma, which is the most dangerous type. The Skin Cancer Foundation reports that more people are diagnosed with skin cancer each year in the US than all other cancers combined, and one in five Americans will develop skin cancer by the age of 70 (Downing, 2022). This concern about skin cancer often overshadows the potential benefits of moderate sun exposure.

Another reason is that the definition of 'moderate' sun exposure can vary greatly depending on a person's skin type, geographic location, and the time of year. For someone with fair skin, even a short amount of time in the sun can lead to sunburn and increase their risk of skin cancer. Therefore, it can be difficult for experts to provide a one-size-fits-all recommendation for safe sun exposure.

Furthermore, the benefits of sun exposure, such as vitamin D production, can be obtained through other, less risky means. Dietary sources and supplements can provide sufficient vitamin D without the associated risks of skin damage and skin cancer. This makes it easier for experts to recommend these alternatives rather than moderate sun exposure. 

In contrast, according to The New England Journal of Medicine, "noted that no benefits for Vitamin D supplements whatsoever had been found for any of the health conditions that the study tracked. "Vitamin D supplementation did not prevent cancer or cardiovascular disease, prevent falls, improve cognitive function, reduce atrial fibrillation, change body composition, reduce migraine frequency, improve stroke outcomes, decrease age-related macular degeneration, or reduce knee pain," the journal said (Jacobsen, 2024). For example:

• The World Health Organization (WHO) states that moderate sun exposure is essential to produce vitamin D, which is crucial for bone health and immune function. Approximately 1 billion people worldwide are estimated to have vitamin D deficiency, partly due to inadequate sun exposure.

• Research published in the Journal of the American Medical Association (JAMA) indicates that moderate sun exposure can reduce the risk of certain cancers, such as colorectal and breast cancer, by up to 30%. This underscores the potential health benefits of ensuring equitable access to safe outdoor spaces.

Consequently, public health messages need to be clear and straightforward. Recommending moderate sun exposure might confuse the public, given the well-established risks associated with sun exposure. It's simpler and safer to advise people to seek vitamin D from dietary sources and supplements and to protect their skin from the sun.

Therefore, it's important to note that some experts acknowledge moderate sun exposure's benefits. Still, they also stress the importance of taking precautions such as using sunscreen, wearing protective clothing, and limiting sun exposure during peak UV radiation times.

Ultimately, however, this discrepancy highlights a critical need for better education among healthcare providers. Doctors must be equipped with the knowledge to assess individual patient needs accurately and provide tailored advice on sun exposure. A team of experts is addressing this by developing a website that allows doctors to input patient-specific information—such as location, skin color, and risk factors—and receive customized recommendations.

We can make significant strides in addressing recommendation inequality by closing the knowledge gap among healthcare providers. Ensuring that all individuals receive appropriate guidance on sun exposure can help improve public health outcomes, particularly for those at low risk of skin cancer who stand to benefit the most from increased sun exposure.

                                  References                  

Brouwer-Brolsma, E. M., Vaes, A. M., Van der Zwaluw, N. L., Van Wijngaarden, J. P., Swart, K. M., Ham, A. C., Van Dijk, S. C., Enneman, A. W., Sohl, E., Van Schoor, N. M., Van der Velde, N., Uitterlinden, A. G., Lips, P., Feskens, E. J., Dhonukshe-Rutten, R. A., & De Groot, L. C. (2016). Relative importance of summer sun exposure, vitamin D intake, and genes to vitamin D status in Dutch older adults: The B-PROOF study. The Journal of Steroid Biochemistry and Molecular Biology, 164, 168-176. https://doi.org/10.1016/j.jsbmb.2015.08.008

Downing, L. (2022, July 28). Can you reverse sun damage to your skin? NA Derm. https://naderm.com/can-you-reverse-sun-damage-to-your-skin/

Jacobsen, R. (2024, May 10). Against sunscreen absolutism — The Atlantic. Apple News. https://apple.news/AJyGDhJ0pQNexKMPA2KlYRg

Radiation: Protecting against skin cancer. (2024). World Health Organization (WHO). https://www.who.int/news-room/questions-and-answers/item/radiation-protecting-against-skin-cancer

What doctors wish patients knew about wearing sunscreen. (2022, March 18). American Medical Association. https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-wearing-sunscreen

 Photo credit Dr. Donald Billings