TCS Daily

Talking Headaches

By Henry I. Miller - May 6, 2003 12:00 AM

Americans are very risk-conscious. We buy muscular SUVs and spend billions on all manner of alternative medical therapies. Often, we learn about risks and remedies by relying on the media to interpret medical research and other data that purport to tell what is bad (or good) for us.

Tad Friend wrote in The New Yorker, "It often seems that there is only one show on television, 'Dateline NBC: 48 Hours of 20/20, PrimeTime Thursday,' and that this show endlessly repeats one basic story, The Thing That Went Terribly Wrong." Enter SARS, severe acute respiratory syndrome, a new, potentially fatal atypical pneumonia that has no known treatment. Rest assured that as the war in Iraq fades from the headlines, SARS will supplant it.

The incidence and death toll of SARS continue to rise, and public health authorities are increasingly worried. The illness, a pneumonia caused by a previously unknown coronavirus, has stricken at least 6,200 and killed more than 430 worldwide, causing the World Health Organization to issue an unprecedented warning against unnecessary travel to parts of Asia where SARS is prevalent. The U.S. Centers for Disease Control has activated its Emergency Operations Center to track the disease and coordinate a national response.

But we need to place SARS in perspective. Influenza, which kills, on average, about 30,000 Americans annually -- in spite of widespread vaccination -- is a vastly greater threat, but the media will seize on SARS' mysterious nature and the absence of any effective treatment. The death toll from SARS is zero in the United States, but after a month of 24/7 exposure to SARS on the cable networks, SARS will seem like the Invasion of the Body Snatchers.

Media coverage does not exist in a vacuum. It merely amplifies the "emotional dimension" of peoples' worries about various public health and environmental risks, and those "feelings" then affect individuals' perceptions of risks. These emotional factors include, for example, whether the illness, activity or product is more, or less, voluntary, familiar, controllable, self-initiated, dreaded, immediate, detectable, and "natural."

SARS should rank somewhere around the low middle on this scale: the disease is unfamiliar, transmissible through the air from person to person, caused by an invisible "germ", has no treatment, and is potentially lethal. On the other hand, the virus is detectable, natural, not highly contagious, has caused no fatalities in this country, and has stricken mostly persons who have traveled recently in Asia and medical personnel who have cared for SARS patients.

Emotional responses to potential risk often are grossly distorted. In the risk-analysis community, there's an old joke about the swimmer at a beach on Lake Michigan who hears there's been a shark sighting; fearing an attack, he gets out of the water, finishes off his six-pack of beer, lights up a cigarette, and, helmet-less, zooms off on his motorcycle.

But more realistically, the ranking of risks by experts and consumers is often quite divergent. Among the risks most often overestimated by consumers are accidents, pregnancy and childbirth, abortion, tornadoes, floods, botulism, cancer, fire and homicide. (SARS is in this group.) Among those most often underestimated are smallpox vaccination, diabetes, lightning, stroke, tuberculosis, asthma and emphysema.

Another important aspect of the public perception of risks from various activities, products, technologies, and natural events is that in order to further their self-interest, a large coterie of activists and government regulators, abetted by a handful of scientists outside the scientific mainstream, relentlessly manipulate and terrify the public over hypothetical or minimal risks. It is important to understand the techniques they use to exploit the public's emotions.

One of these is information overload. At best, non-experts are likely to understand only a limited number of aspects of a risk analysis problem, so they are easily overloaded with data. Information overload of the public is a strategy often used by those who would elicit fear about or disparage new technology. (Or even to sell a new product: think of the mind-numbing, repetitive, TV infomercials that sell acne cures and breast-enhancers.)

Second, a common response to fear and uncertainty about risk is a tendency to split those involved in controversy into opposite camps - us vs. them - and to project onto them conspiratorial and iniquitous intentions. This is especially easy when the "enemy" is painted as faceless, profit-hungry, multinational companies that will benefit handsomely from the sale of products. Psychologically, this is an attempt to reduce anxiety and re-impose certainty and clarity, but such mechanisms are unproductive because they polarize thinking, encourage one-sidedness and actually distort sound decision-making.

A third factor is a yearning for a return to purity and innocence. This romantic, puerile view, which reflects a desire to escape from complex realities and choices - like war and a sluggish economy - can give rise to a kind of puritanical, reactionary, anti-technological view of the world. Purity and simplicity - often erroneously considered synonymous with what is "natural," as opposed to synthetic, or technological - become desired ends in themselves, to the exclusion of other goal such as maximizing our choices and thinking quantitatively.

Finally, we are often victims of manipulation of our environmental and health anxieties. Most Americans consider themselves to be "environmentalists," but the hidden agenda of many of those who have attempted the "greening" of Western societies and governments - environmental organizations, certain political leaders, and a large segment of the media - appears to be their own self-interest. An unfortunate by-product is increasingly widespread acceptance of junk science that denigrates the scientific method and the fruits of technology.

Distortion of risk perception increasingly causes us to lose the ability to discriminate between plausibility and provability, between plausibility and reality. The answer? We need to learn more about what we don't understand, and to seek out the advice of genuine experts for guidance. And, oh, yes, to take with a large grain of salt the pronouncements of TV's talking heads.

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