Media Make Risks Sensational

June 27, 1993|By RICHARD E. VATZ and LEE S. WEINBERG

Last week, there was this shocking headline on an AssociatedPress story about AIDS deaths in young adults, based on a report published in the Journal of the American Medical Association: "AIDS decimates young; HIV-related illnesses are now No. 1 killer of young males in 5 states."

The absolute numbers behind these claims appear less catastrophic. For example, in one of the states, Massachusetts, this constituted 300 deaths, a terribly sad situation, but not the pandemic situation the language of "decimation" implies.

This example highlights a serious problem in the reporting of medical research findings by major media: Reports of newly discovered risks are almost always presented in relative numbers, which reflect only the proportional increase in risk. While these relative numbers make for sensational headlines, they often create exaggerated fears in the public.

The relative-risk reporting phenomenon can be understood this way: If your chances of dying from a heart attack in the next seven years are 1 in 100, and your particular cholesterol level raises that to 1 in 50, then your cholesterol level has doubled your risk (the probable headline). But, the absolute risk increase can be understood by realizing that only 10 additional people out of 1,000 in your situation are likely to die from the increased risk.

Presented this way, the public would have a more realistic understanding and, consequently, a more tempered reaction than was evidenced in the recent scare caused by the report that a certain type of baldness could add "up to" (the highest possible risk usually gets the headline) an additional 370 percent risk of heart attack.

To the casual reader, this may seem like a death sentence; in fact, one bald columnist wrote, facetiously but with obvious concern, that he needed to write quickly, since he could be dead before completing his column. What the panicked baldy didn't realize is that even if balding somehow contributes to causing heart attacks -- a big if -- the actual risk is much less than the scary headlines implied.

In one study on risk factors for coronary heart disease, smoking was shown to more than double the risk of death from heart disease for middle-aged men over a seven- In fact, one bald columnist wrote that he needed to write quickly, since he could be dead before completing his column.

year period, but the absolute increase in risk was from about 1.5 percent to 3.5 percent. This may offer little solace to the additional 2 percent of middle-aged men who get sick, but it hardly constitutes the death sentence that the "doubling of risk" implies.

The disproportionate fear of serious or life-threatening disease may lead to lifestyle and economic decisions that bring more pain than benefit. This problem is discussed infrequently in the popular media, although it sometimes gets attention in professional journals.

It was reported in the mid-1980s, for example, that the drug cholestyramine reduced heart attacks in adult men by about one-fifth (19 percent) over a decade. Letters and articles in the Journal of the American Medical Association questioned whether was worth it for people to spend so much money and consume an unpleasant-tasting drug for so long when the absolute protection was so small: The average gain in life expectancy of those who began cholestyramine therapy between 45 and 49 years of age was about four months, and the lifetime cost amounted to tens of thousands of dollars.

There are other reasons that media reports lead to exaggerated risk perception. Studies may use questionable methodology, the risks may be statistically associated without a cause-and-effect relationship, and reports may have come from convention papers or minor journals that go through much less serious gate-keeping than the top medical journals. There is even the growing problem (or perhaps just growing awareness of) scientific fraud.

These problems are real, but often will be corrected by later studies. The enduring problem is the incomplete reporting of risks which causes misperception and unwise personal and public policy choices.

The motives for the media's sensationalizing use of relative statistics in reporting health risks range from ignorance to a desire to "do the right thing," such as scaring people about smoking or "doing their part" to reduce the prejudice against homosexuals by exaggerating the risk of AIDS to heterosexuals. Regardless, the responsible reportage of health risk requires more reporting of absolute figures.

Author John Allen Paulos warns about the American public's problem with "innumeracy," which he defines as "an inability to ,, deal comfortably with the fundamental notions of number and chance." In the area of health risks, the media's penchant for reporting only relative risk makes a substantial contribution to public panic or at least to disproportionate concern. Furthermore, the costs associated with overprotection add substantially to our national health care costs. We need to take this realization from the professional journals and transfer it to the popular press, the primary source of public knowledge and decision-making.

Richard Vatz is professor of rhetoric at Towson State University. Lee Weinberg is associate professor in the Graduate School of Public and International Affairs at the University of Pittsburgh.

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