Living in fear

After terrorists attacked the New York trade centre in 2001 travellers temporarily became too scared of similar attacks to travel by airplane. Instead, where possible, they went by car.

In 2006 Gerd Gigerenzer, a psychologist at the Max Plank Institute in Berlin, analysed the resulting number of traffic accidents in the US following September 11 and, as described in the recently published book entitled Risk by Canadian journalist Dan Gardner, calculated that almost 1,600 people died as a direct result of taking cars rather than planes.

As that figure is six times the total number of airplane passengers killed on that fateful day (with no subsequent attacks), by their fearful reaction travellers put themselves at far more risk than if they had simply ignored the incident altogether and gone by air. Of course the attacks gained saturation publicity, while the subsequent road deaths did not rate a mention in the media.

This pattern of response from both the media and the public in obsessing over obscure risks and reacting to them in such as way as to increase their personal risks has been evident for some time. Summer’s furore over shark attacks is one example, and the present fuss over swine flu is another. But for swine flu in particular, the publicity given to the disease, with a little help from the World Health Organization and various state ministers, is so wildly out of proportion to any actual risk to individuals, even in Mexico, and so far in excess of publicity given to any previous disease outbreaks, that something would seem to have changed in society, or the media, or both. Perhaps we have reached an obsession tipping point.

Although the media is going out of its way to whip up hysteria it seems, at least some media consumers are inclined to hysteria. At the time of writing there have been reports that people are stockpiling necessities in case there is any breakdown in normal business activity. Stockpiling would have been pointless even in the Spanish flu outbreak of 1919, far and away the worst recorded involving millions of deaths, let alone for swine flu.

The real difference between this strain and the others that regularly occur is the difference in attitude by both the public and the media. I contracted one strain of influenza in Sydney in 1989 - I can recall the year but not the name of that strain of flu - as part of a serious outbreak. I recall phoning a friend to apologise for not being somewhere due to my illness and her exclaiming “everyone’s got this”. There were even a couple of confirmed deaths in Australia, but the whole outbreak warranted perhaps a handful of media stories. The afflicted, including myself, recovered and returned to work

Fast forward to the avian flu outbreak and the SARS (severe acute respiratory syndrome) of 2005, both of which caused far less trouble in Australia than the flu I encountered, but received vastly more publicity and generated considerably more fear - fear far in excess of any risks involved. Even in the Asian areas affected by the outbreaks, the results of the diseases - to judge from media reports of the time - would barely be noticeable in health statistics. Yet flights to the areas were deserted, as were any flights to Australia that stopped at Asian airports.

Don’t believe this? Let’s look at some statistics. A glance at the relevant ABS statistics - causes of death (3.35MB), Australia 2007 shows that the biggest cause of death for citizens up to their mid-40s is “intentional self-harm”, that is, suicide. About 400 people aged 35-44 killed themselves in 2007, more than three quarters of them males. Another 245 in the same category died of heart diseases and 221 of cancers of the digestive organs (stomach cancer and the like). In the next category along, those aged 55-64 years, “chronic lower respiratory diseases” - a category which may include flu - carried off 429 souls. That toll is, in turn, a fraction of the 1,850 or so in that age bracket who died of cancers of the digestive organs.

Causes of death vary from age group to age group. As you might expect, in the 15-24 age group, death from car accident - either as a pedestrian, car occupant or motorcyle driver - just trumps the suicide total of 245 persons.

The figures also show that despite the popular perception that suicide is something young people do, it remains a significant problem up to the 45-54 age category with 354 people in that category killing themselves. The difference is that for people in that age group it ranks well below heart disease and cancer as a cause of death.

As those figures show, the fuss over swine flu is meaningless and perhaps even counter productive. Anyone predisposed to self-harm, for example, may well have their mood darkened by the “end is nigh” style of media coverage given to swine flu.

Media scares are not confined to diseases, of course. As the shark attack scares of the summer showed, any risk will do. Yet the risk of a shark attack is almost as remote as the risk of an encounter with swine flu, as a glance at the figures show that the most deadly animals in Australia are not sharks or crocodiles. A count of deaths involving animals between 2000 and 2006 collated by the National Coroners Information System (PDF 411KB) show that the real problem animal is the horse, followed by that terrible animal the cow.

Horses and cows do not lurk in the undergrowth then leap out an attack people, of course. Instead people riding horses fall off them; and motorists swerving to avoid cows on the road late at night crash their cars. Of the 128 deaths involving animals counted by the coroner’s system, 40 were caused by horses, cows (and bulls) were linked to 20 and dogs were involved in 12 including a number resulting from tripping over the poor animals. Dog attacks featured in seven deaths, compared to 11 caused by sharks and eight by snakes.

As can be seen from these statistics in public health terms much of the debate over shark attacks last summer, such as calls for nets off beaches, and the berating of state governments for not doing more about the menace (it was never clear what) was simply froth and foam. The death toll from horse riding is far greater than anything sharks do - and the injury toll probably greater - yet no one has suggested closing riding stables or forbidding gymkhanas. All these figures are, incidentally, tiny compared to those for suicide, heart disease or road accidents.

This almost constant misperception of risk leads to bad decisions, both by individuals and governments. Individuals may, say, avoid swimming for fear of sharks without realising that the resulting lack of exercise puts them at greater risk of a heart attack. Governments may put far more money than can be usefully spent into countering terrorism, but neglect research into diabetes.

As noted earlier, the problem seems to be getting worse. Part of the problem with the likes of swine flue and SARS is that outbreaks of new diseases can be identified very quickly and tracked, with information available hourly, so there is something to write about. The diseases are not more deadly, just more visible. However, mainstream media is arguably also becoming more desperate for readers, and so more willing to whip up hysteria. Last but certainly not least, people seem to be more willing to listen to this sort of alarmism. They are becoming more fearful, and their fear has nothing to do with the actual risks involved.

Better education in the causes of death may help, but I doubt it. If people want to be scared then they are quite capable of ignoring statistics. The real problem is to avoid letting this fearfulness affect policy.