You're not alone. Advances in science and technology continue to increase the amount of health information available to the media and public. This guide seeks to help consumers evaluate health and scientific information and consider how the information can be used to improve their lives in the Age of Risk Management. Check out this online Consumer's Guide to Health Information or print it (PDF). If you enjoy this guide, then get more insight and humor from Dr. Thompson's book Risk in Perspective: Insight and Humor in the Age of Risk Management.
A Consumer's Guide to Taking Charge
Most people are on their own as they evaluate health information, put it into context, and make important health care decisions for themselves and their families. This requires an understanding of the concept of risk. Risk is important because it implies that there is some chance that something bad might happen. The uncertainty can be frustrating and frightening, but it also means that your attitude and choices can play a major role in your future health. The best advice you might get when it comes to making sense of health information is ASK QUESTIONS! Check out a list of 10 questions designed to help you turn health information into clues and to get you started on becoming your own health risk detective.
|© 4/27/97 Jim Borgman, Cincinnati Enquirer. Reprinted with special permission of King Features Syndicate.|
10 Questions & Reasons for Asking (Click here for PDF file of the guide)
What is the message?
Get past the presentation and to the facts. Consider that:
|© 5/20/98, Jim Borgman, Cincinnati Enquirer. Reprinted with special permission of King Features Syndicate.|
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Information comes from many sources, good and bad. Think about the information's quality. Consider that:
|It is important to read between the
lines. Look for the assumptions that make the observations relevant to other
members of the population. For example, do you have to assume that the same
effects occur in humans as in rats? in women as in men? in children as in
adults? These types of assumptions raise questions about how well the conclusions
from the sample apply to the larger population. They do not necessarily
mean that the conclusions are wrong or that more studies are needed.
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Understand how this information fits in with other evidence. Some sources generally strive to provide unbiased coverage, while others may be intentionally biased. Consider how many sides of the story you hear and whether your source tells you about all of the possibilities, and the weight of the evidence.
Remember that extensive coverage of a story can be misleading if it does
not reflect the amount of evidence that supports the claim. In particular,
the results of early studies can turn out to be right or wrong after time.
Americans have mistakenly rejected results that later proved true, and
accepted results that later proved false.
Determine whether the information changes your thinking and leads
you to respond. Just because information appears in the media does
not mean that it affects you or someone you care about. Some newsworthy
risks (like accidents and homicide) may be overreported in the news media,
while other, less newsworthy risks (like heart disease and stroke) may
be underreported. The result is that you might be led to worry about small
risks that appear to be big and to ignore big risks that appear to be
Remember that understanding the importance of a risk requires that you understand the numbers. Information about health risks gives the chances of an outcome occurring. To avoid confusion, put the numbers into a format that you can understand. Remember that you can also write 1 in 100 as 1%, ten thousand out of a million, 0.01, 1x10-2, one penny out of a dollar, or 10 in 1,000.
Researchers report their findings as expected values within a range. The breadth of the range shows how confident they are about the results. When only one number is reported, it is probably pulled out of a range and it does not inform you about the researcher's confidence in the result. In such cases, it is important to understand whether the number reflects the worst case, the best case, or something in the middle.
Remember that risks change with time, and that some people have higher or lower risk numbers than other people. Think about any habits or behaviors you have that put you at a higher or lower risk for a particular outcome.
|© 7/19/98 Jim Borgman, Cincinnati Enquirer. Reprinted with special permission of King Features Syndicate.|
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Put the risk into context. One important skill for comparing risks
is making sure that comparisons all involve the chances of the same outcome,
like death. For example, the following numbers of U.S. deaths per year
per 10 million people all compare deaths per year:
Since numbers about risk can be presented in many forms (like the chances of dying from a cause over a lifetime, during a year, or during an event), make sure you compare similar forms. Consider that reporting different parts of a range for different risks (best case for one vs. worst case for another) can be very misleading.
Finally, in making comparisons, other factors may be important to you.
For example, consider the extent to which you
These factors might mislead you sometimes. For example, an unfamiliar chemical like dihydrogen monoxide might sound threatening, even though it is simply another name for water.
Remember that science can not answer the question "Is it safe?" for anyone.
You must decide what is an acceptable risk and make health decisions based
on your personal judgment.
Identify the ways that you can improve your health. Be creative.
Think about actions that can reduce your risk. For risks that are new
to you, take the time to think about them before forming an opinion. Keep
in mind that just because someone you know picks one action does not mean
that the same action will be right for you.
Make sure you can live with the trade-offs associated with different actions. Every decision involves trade-offs. When talking about medications, trade-offs are often called side effects, like when the medicine you take to get rid of your headache upsets your stomach. Ignoring potential trade-offs when considering an action to reduce or eliminate a risk might ultimately put you (or someone else) at greater risk.
Taking action can also lead to trade-offs of other important resources,
particularly time and money. Some people object to the idea that they
might be asked to trade between health and money or other factors. Most
people make these choices automatically, however, by driving slower at
the cost of a few extra minutes or spending money to buy a bicycle helmet
for their child or a smoke detector for their home. Remember that resources
spent to reduce one type of risk are not available for other activities.
Focus on identifying the information that would help you make a better
decision. Remember that scientific information is always somewhat
uncertain even if it is not reported that way. Think about what information
is missing and how you would use more information if you had it. Keep
in mind that if you rely on the headlines as a basis for managing your
health, you are likely to overlook the well-established (and consequently
not newsworthy) strategies for improving your health.
Find the information that you want. Try:
· Manufacturers and manuals or labels that come with their products (my recommendation is that
you actually take the time to read these!)
· Your original source
· Your local Department of Health
· Government agencies (many linked from www.consumer.gov)
Consumer Product Safety Commission
Department of Agriculture
Department of Health and Human Services
Department of Transportation
Environmental Protection Agency
Occupational Safety and Health Administration
· Consumer groups
· The Internet.
Harvard School of Public Health, 677 Huntington Ave., 3rd Floor, Boston, MA 02115
For more information about this completed project, please e-mail Dr. Thompson.
© 1999, 2004 Kimberly M. Thompson. This guide provides an excerpt from the book Risk In Perspective: Insight and Humor in the Age of Risk Management by Dr. Kimberly M. Thompson, which is also available from www.AORM.com or Amazon.com. Development of this guide was funded in part through an educational grant to the Harvard School of Public Health from the Chlorine Chemistry Council.