Contents
Preface 11
Foreword by Neil Shulman, M.D. 13
Introduction 15
1. Science and technology 35
2. It's all in the numbers 57
3. Variability 71
4. Uncertainty 83
5. Errors 101
6. Choices and risk trade-offs 115
7. Effectiveness, benefits, and costs 135
8. Values and preferences 159
9. Risk in the media 181
10. Risks meet law and policy 217
11. Health care in the U.S. 241
12. Signs of the times 259
Epilogue 295
Index of quotes 297
Index of cartoon artists and reprint permission contacts 305
Extras 307
Introduction
Many people already appreciate that we're living in the Age of Risk Management - a time in human history where we recognize that life is full of risks, choices often involve tough trade-offs, and good data and risk analysis play a critical role in the decisions we make as individuals and collectively. The Age of Risk Management brings with it a requirement for everyone to understand risks, deal with uncertainty, and remain ready, willing, and committed to making good choices.
I'm just not talking about professionals. I really mean everyone.
In my job as Associate Professor of Risk Analysis and Decision Science at the Harvard School of Public Health, I identify and assess all types of health risks, look for ways to deal with them, and find strategies to talk to people effectively about what they mean. Of course I realize that effectively managing health risks is a requirement for survival of all humans. Yet, in daily life our roles as children, parents, students, teachers, employers, policy makers, works, and so on, the dizzying array of risks that we face can be somewhat overwhelming if we don't keep the risk in perspective. Understanding the risks and keeping them in perspective for me makes the world much bigger, smaller, more manageable, and funnier, all at the same time. No matter who you are or what you do, take a minute to think about the risks in your daily life.
Consider some questions to help you think abut your daily risks...
1. What risks do you face associated with everyday activities like eating, sleeping, and moving around? Balance this by remembering the benefits of these activities!
2. How have the risks that you've faced changed with time given choices that you've made? For example, consider risks you've experienced when you were younger compared to your risks now.
3. How have your risks changed with time given the evolution of science and technology and the choices made by others (both individual and societal)?
4. What health-protective behaviors reduce your risks (like eating a balanced and nutritious diet, exercising regularly, and managing a chronic illness well)?
5. What health-threatening behaviors increase your risks (like eating too much, smoking, drinking excessively, abusing substances, or working in a high-stress job)?
6. What risks might you face if you stop working or significantly change where you spend your time? Remember the financial impacts and where you spend time both affect your identity.
7. What specific risks might you face on the job? Consider your understanding about these and whether you choose to actively take the opportunities that exist to reduce them.
For more excerpt and cartoons, please visit http://www.health-insight.harvard.edu/
What do people say about Risk in Perspective?
"Empowering..."
J. Thomas Zender, President, Unity
"...this book will equip you with a new sophistication and skepticism about how to judge the 'health risk de jour' regularly reported on the nightly news."
Dr. Elizabeth M . Whelan, President, American Council on Science and Health
"Kim Thompson has captured, along with the cartoonists, the essence of how medical care is delivered and the choices we, as lay consumers, are required to make...."
June Walker, President, Hadassah, Women's Zionist Organization of America, Inc.
"...enlightening for everyone... destined to become a must-read for all involved in generating, providing, and consuming health information"
Sylvia Rowe, President and CEO, International Food Information Council
"...this collection of superbly selected cartoons and verbal nuggets is sheer delight."
Howard Raiffa, Professor Emeritus, Harvard Business School
"Read this book, laugh and learn."
George Lundberg, MD, Editor, MedGenMed and Special Healthcare Advisor to the Chairman and CEO of WebMD
"A creative and humorous approach to the ways we respond to risk."
U.S. Senator Joe Lieberman (D-Connecticut)
"An insightful, enlightening, educational and entertaining approach to contemporary risk taking behaviors."
Carden Johnston, MD, FAACP, President, American Academy of Pediatrics
"Imagine, quotes from Twain, Einstein, and Jefferson - and hundreds of cartoons. You can't beat that!"
Sidney Harris, Cartoon Artist, ScienceCartoonsPlus.com
"...a wonderful catalyst for learning...."
Sharon Dunwoody, Evjue-Bascom Professor of Journalism, University of Wisconsin-Madison
"...You'll laugh, be provoked, humbled, find rapport, think about a cartoon's message, reread a helpful quote, and find it absolutely impossible to put this book down."
Bill Deane, News Editor, CBS News
"...At last someone understands and has articulated this!"
U.S. Senator Sam Brownback (R-Kansas)
"... a highly favorable benefit/risk ratio"
Dennis M. Bier, M.D., Director, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine
"This book will be invaluable for anyone who teaches risk analysis... "
John F. Ahearne, PhD, Sigma Xi and Past President of the Society for Risk Analysis
