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Sunday, March 29, 2020

A Rant on Risk.

Apologies for a long delay in posting. I'm busy researching a book: "The story of food and dining"

Risk is an abstract concept and the perception that a risk exists, or the degree of that risk, is determined by an individual’s worldview. Pail Slovik at the University of Oregon has written many research papers on the topic. For the general public, risk is determined by three factors. First a high level risk is associated with dread. Everyone knows an obese person and would have seen overweight friends lead long, happy and healthy lives into old age. Thus, obesity and overweight is not dreaded. However, motor neuron disease is dreaded, seen as a fatal disease with a slow decline in wellbeing and with a growing dependence on others. A second factor is familiarity. These days, most of us know someone who was diagnosed with cancers. Decades ago cancer was, in effect,  a death sentence. However, many cancers are now manageable and allow those who contract cancer to enjoy a long and happy life. So, cancer is seen as a risk which is familiar and something not to be feared as it once was. The third factor is control. Those who smoke know the risk but they retain the belief that at any point, they can quit smoking. But, during the height of the BSE crisis, Variant Creutzfeldt–Jakob disease (vCJD), was a condition which was outside our personal control. We might be a vegetarian but who’s to say that your vegetable curry wasn’t contaminated with gelatin. You might avoid a T-bone steak but could you be sure that the minced beef you just bought is BSE free. In fact, vCJD hits all the buttons: it is dreaded, it is unfamiliar and it is totally outside your control.
One would imagine that toxicologists, whose speciality involves all manners of risk analysis would have a clear and objective understanding of risk, independent of their worldview. Thus it shouldn’t matter if you are Christian, Jew, or Muslim when, as a toxicologist you consider the scientific data on the hazards to human health of some chemical or biological risk. But Slovik’s study challenges that. When presented with several scenarios, toxicologists were asked to rate the risk. In the US, male toxicologists had a higher risk tolerance than their female counterpart. The same was true in Europe except that European toxicologists had a much lower tolerance of any given  of risk compared to their US counterparts. Right now, in the midst of this Covid 19 pandemic, we can see geographic or cultural variation of risk perception and thus differing strategies of risk management. In some countries, economic issues hold a higher ranking than societal issues leading to quite different messaging to the general population (Obrador, Trump, Bolsonaro).

Risk assessment is purely scientific while risk management is tainted with the politics of the problem. It follows the seat belt rule. When research showed that seat belts would save lives, car manufacturers were asked to install them in new cars. Then the were obliged to do so by law and drivers were asked to use them. In turn, drivers were legally required to wear them. In the realm of risk managements there are vested interest which either promote or downplay the risk according to their interests. And there are rogue scientists who exploit the scare to self-promote themselves[1],[2],[3], [4]  There are also very eminent scientists, experts in the field of epidemiology,  who query and challenge scientific opinion[5]. Where true debate can be held, we should remember that dissent is the oxygen of science.
In an environment where all hazards to human health are properly managed, there is no reason for people to go beyond that system and take a risk. But around half the global population don’t enjoy such sanitized existence and they have to take risks. Hunger, they say, is the best sauce and the those who suffer hunger will take risks to meet their nutritional needs. They have no choice. And it a world which favours the privileged societies, social distancing in the current Covid 19 pandemic is easy to comply with, albeit annoying to endure. But in the slums of the great cities of the world, the townships of Johannesburg, the Favelas of Sao Paulo or among the 18 million US citizens who live in trailer parks, social distancing is challenging and the risks that it seeks to mitigate can’t easily be avoided. But its not just among the world’s disadvantage that risk is tolerated.
Opioids and obesity, each account for 40,000 deaths annually in the US[6]. When populations find risk acceptable, politicians are slow to act. Herein the rant ends and I feel better-cheaper than therapy!!

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