Let's start with a quiz. Presuming you have to die tomorrow (relax, it's only a quiz), would you rather die being eaten alive by a shark, or from heart disease?

Most people vote for heart disease. A few vote for death by shark. ‘Quicker," they say. (A journalist friend once voted for death by shark, because his obit would run on the front page.)
      Here's another choice about how to go. Burning to death, or heart disease? Nobody ever votes for going out in a literal ball of fire.
      And a third choice. Cancer, or heart disease? Overwhelmingly people vote for heart disease.
      All three questions are the same. They compare two ways of dying, and the first choice involves more pain and suffering. If you voted for heart disease over any of the other three you were ‘irrational'. Heart disease is more likely to kill you. (632,000 U.S. deaths in 2006, compared with 550,000 from cancer.) You should be most worried about what is most likely to get you, right?
      Nope. That's not how risk perception works. Powerful as our cognitive thinking cortex may be, it's only one of a suite of mental tools we use to detect and respond to danger. Most of these tools operate before and below consciousness, and they are less concerned with the facts, and more with how those facts feel. With this post we'll start a series of pieces that describe these tools, the hidden forces that shape our fears.

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      Most definitions of risk say something like "The chance of injury or loss". The concept of risk includes the element of likelihood (the chance, the odds), and the probability of something bad happening. (You wouldn't say "My risk of winning the lottery is...".) Well, probability can be calculated, but bad is in the eye of the beholder. Economists and policy makers hate this, but risk is actually a subjective concept. Still the subjective way we perceive risk has some predictable patterns. Most of us are afraid of similar things, for similar affective reasons.
 A big one is, how much pain and suffering is involved. The greater the pain and suffering, the more afraid we are likely to be, no matter how likely or unlikely the threat may be. So cancer scares people more than heart disease, and the thought of dying in a plane crash scares people more than dying in "regular" accidents (car and otherwise, like falls and drownings and electrocutions, etc., which are cumulatively the 5th leading cause of death in the U.S. and the leading cause of death for people under 39), and the idea of a terrifying fall to your death from the roof of a tall building is scarier than the idea of falling off a chair in your kitchen and hitting your head and dying.
     There are more than a dozen of these psychological risk perception factors, identified by psychology research pioneers like Paul Slovic and Baruch Fischhoff. They have a powerful influence on how scary something feels. In fact, these underlying emotional factors probably play a bigger role in our perceptions of most risks than does our conscious rational analysis of the facts. And that can become a risk in and of itself.
     Sometimes we're more afraid of something than the facts say we need to be. And often we're not as afraid as the facts suggest we ought to be. In my book "How Risky Is It, Really?" I call this The Perception Gap, the gap between our fears and the facts. And the Gap itself can be dangerous. We are so much more afraid of cancer than heart disease that, in the U.S., the federal government spends three times as much researching cancer as heart disease, even though both have deep unanswered questions that need to be researched, and even though heart disease is a far greater killer. (In 2008 The National Institutes of Health spent $10,000 per death on cancer research, and $2,500 per death on heart disease research.)
     But cancer is scarier, not only because it is perceived to involve more pain and suffering, but because we think heart disease is to some degree a matter of choice, and when we take a risk voluntarily it's less scary than when the risk is imposed on us. (More on the "choice" risk perception factor in a future post.) For now, let's just say that Franklin Roosevelt was only half right when he said "the only thing we have to fear is fear itself." We have to fear too much, or too little. Getting risk wrong is risky. So understanding why we perceive risks the way we do is one of the most important things we can do for our well-being and survival, because it can help us make healthier choices.
     Talk to you again soon.

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