Sorry, Mr. Roosevelt. We ARE Afraid

A new Gallup poll asked people to name the most urgent health problem facing the country, and instead of any single disease, a majority named the cost of health care or lack of access to it.

The American people are not too swift when assessing real risk, because a few years ago AIDS was thought to be the No. 1 health problem. And this year, as in the past, only 3 percent listed heart disease as the major problem, even though we know it is by far the largest killer.

Yet the Gallup findings mirror those of last month’s USA Today poll finding that most Americans are fearful about paying for their future health.

Compounding the dilemma is a finding by Harvard’s Robert Blendon that although a majority of Americans are dissatisfied with the health care system, they remain unlikely to accept comprehensive reform legislation.

What people feel, as opposed to what they know, is an increasingly important factor for providers to understand as they try to help consumers make the best personal health decisions. And previous years of this survey have shown that the news media play a significant role in framing the top health problems simply by paying attention to “hot” topics like AIDS, anthrax and obesity.

But in the case of health policy, the average American knows better than the news media and the political parties, because it is he and she in this “open season” for health insurance decisions who have to figure out just how much health they can afford.

2 thoughts on “Sorry, Mr. Roosevelt. We ARE Afraid”

  1. [A]lthough a majority of Americans are dissatisfied with the health care system, they remain unlikely to accept comprehensive reform legislation.

    It seems to me that the age-old principle of “the devil you know is better than the devil you don’t know” is working overtime here, as in just about every other major issue of the day.

    Heart disease, cancer, the flu (except for bird flu, which is a “new” thing) – we don’t think that much about those. They’re common, we’ve lived with them for centuries. Obesity? So we’re getting fat. Ho hum.

    AIDS? Bird flu? SARS? (Remember SARS?) Those are relatively new, and mostly they happen to “other people” (face it, most people think the GLBT population constitutes “other people”) – but what if they come here and affect us? Horrors!

    A similar dynamic is going on with terrorism. According to one estimate (from 2004), an American’s chance of dying in an automobile accident in a given year is about 1 in 18,800. The same person’s chance of dying in a terrorist attack is 1 in 9.2 million.

    Which are we more worried about, driving to work or getting on a plane (chance of dying in a crash: 1 in 8.4 million; you’re about twice as likely to die of a lightning strike)? How many hundreds of billions of dollars have we spent on “Homeland Security” and two wars in the last five years? For that kind of money, we could have had the world’s safest highways and vehicles, a phenomenal public transportation system, and a national health care system that would turn every other country in the world green with envy.

    But we’d rather not take a look at the real dangers. That would involve stepping into the unknown, and that’s always a scary thing. Yes, it seems FDR called it exactly right: we truly are afraid of fear. And maybe that’s the greatest danger of all.

  2. “The American people are not too swift when assessing real risk, because a few years ago AIDS was thought to be the No. 1 health problem.”

    The concept of “real” risk is loaded with assumptions. Medical professionals are liable to apply a narrow set of criteria in quantitating risk that they then use to evaluate subjective perceptions of risk.

    Calculating the number of deaths associated with, say, AIDS is only the first step in understanding the public concern with this disease. There are many other reasonable concerns that differentiate between AIDS and heart disease. The later is largely a personal risk (assuming there are no dependents), whereas the former involves either severe restictions on pleasure or the possibility of passing the virus on to others.

    The point is that social and personal factors are just as legitimate criteria for assessing the risk associated with medical problems.

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