An introduction to risk
communication in health
In 1995 the Committee on Safety of Medicines (CSM) issued a warning that third generation oral contraceptives were associated with 'around twice the risk' compared with second generation preparations. This relatively simple and straightforward risk communication had unexpected and farreaching effects. In particular, it led to considerable anxiety in many women, and resulted in a dramatic decrease in use of the pill and a steep rise in pregnancies and terminations. The situation was greatly exacerbated by intensive (and unbalanced) media coverage. What was not explained to women at the time was that the absolute level of risk was actually very low, and that the risk of thrombosis in pregnancy was several times higher.
The 'pill scare', as it has become known, clearly illustrates how failure to interpret risk information in the way intended by advisory bodies can have significant and unanticipated detrimental effects on health behaviour. The UK Chief Medical Officer, in his 1996 report, said that a key issue highlighted by the scare was the importance of the distinction between absolute and relative risk (see Chapter 3). However, as Adams (1998: 150) pointed out, 'the more important lesson is that scientists, by combining uncertainty with dire consequences, can frighten large numbers of people'. This is particularly the case when such matters attract media attention and become subject to sensationalized and unbalanced reporting.
Many of the issues touched on above are reflected in subsequent chapters in the present book. We will see how risk communication can have significant effects on health behaviours, and how the particular way in which the information is presented can influence those behaviours. We will also look at how emotions interact with cognitive processes when interpreting health messages. Finally, we will consider the potentially far-reaching effects that communications can have in the present day (particularly with the 'aid' of new technology and media reporting), as well as some of the wider ethical concerns that arise in relation to risk and health communication.