Political partisanship and mobility restriction during the COVID-19 pandemic.

OBJECTIVES: Non-pharmaceutical interventions (NPIs) are effective in curbing the spread of severe acute respiratory syndrome coronavirus 2. All US states have adopted NPI policies, but the compliance to these measures and influence of sociopolitical factors on NPI adherence is unknown. NPI adherence may be approximated by personal mobility in a population that is tracked by anonymous mobile phone data. STUDY DESIGN: This is a cross-sectional study of state-level mobility changes across the US. METHODS: State-level mobility was based on anonymous mobile phone data from multiple participating carriers collected by the University of Washington's Institute for Health Metrics and Evaluation (http://www.healthdata.org). Pearson's correlation coefficient was used to examine the strength and direction of the relationship between political affiliations and mobility restriction across states. Multivariable linear regression analyses were used to assess other factors that may impact personal travel. RESULTS: All states experienced a decline in personal mobility but had varying nadirs ranging from a 34% to a 69% reduction in mobility, which was not temporally related to the timing of state-level NPI measures. There was a statistically significant linear and negative correlation (r = -0.79) between the proportion of Republicans/leaning Republicans and NPI adherence across US states. The negative association between Republicans and NPI adherence was significant even when adjusting for urbanization, proportion of essential workers, population, Gini index, and poverty rates. CONCLUSIONS: Political orientation affects risk perception, which may contribute to the unwillingness of some individuals to perceive the coronavirus disease 2019 pandemic as a risk and to comply with NPIs. Our results highlight the importance of sociopolitical factors in disease control and emphasize the importance of bipartisan efforts in fighting the pandemic. These results may have implications for the development, dissemination, and communication of public health policies.

Protective measures, personal experience, and the affective psychology of time.

We examined the role of time and affect in intentions to purchase a risk-protective measure (Studies 1 and 2) and explored participant abilities to factor time into the likelihood judgments that presumably underlie such intentions (Study 3). Participants worried more about losing their possessions and were more likely to purchase a protective measure given a longer term lease than a short-term lease, but only if their belongings were described in affect-poor terms. If described instead as being particularly special and affect-rich, participants neglected time and were about equally likely to purchase a risk-protective measure for shorter and longer term leases. However, and consistent with prior literature, the cognitive mechanism underlying this time-neglect-with-affect-richness effect seemed to be the greater use of the affect heuristic in the shorter term than the longer term. Study 2 results demonstrated that prior experience with having been burglarized amplified the interactive effect of time and affect. Greater deliberation did not attenuate this effect as hypothesized whether deliberation was measured through numeracy or manipulated through instructions. The results of Study 3 indicated that few participants are able to calculate correctly the risk numbers necessary to take time into account. Two possible solutions to encourage more purchases of protective measures in the long term are discussed.

Assessment of the regional economic impacts of catastrophic events: CGE analysis of resource loss and behavioral effects of an RDD attack scenario.

We investigate the regional economic consequences of a hypothetical catastrophic event-attack via radiological dispersal device (RDD)-centered on the downtown Los Angeles area. We distinguish two routes via which such an event might affect regional economic activity: (i) reduction in effective resource supply (the resource loss effect) and (ii) shifts in the perceptions of economic agents (the behavioral effect). The resource loss effect relates to the physical destructiveness of the event, while the behavioral effect relates to changes in fear and risk perception. Both affect the size of the regional economy. RDD detonation causes little capital damage and few casualties, but generates substantial short-run resource loss via business interruption. Changes in fear and risk perception increase the supply cost of resources to the affected region, while simultaneously reducing demand for goods produced in the region. We use results from a nationwide survey, tailored to our RDD scenario, to inform our model values for behavioral effects. Survey results, supplemented by findings from previous research on stigmatized asset values, suggest that in the region affected by the RDD, households may require higher wages, investors may require higher returns, and customers may require price discounts. We show that because behavioral effects may have lingering long-term deleterious impacts on both the supply-cost of resources to a region and willingness to pay for regional output, they can generate changes in regional gross domestic product (GDP) much greater than those generated by resource loss effects. Implications for policies that have the potential to mitigate these effects are discussed.

Making health care quality reports easier to use.

BACKGROUND: Although there is evidence that consumers want comparative quality information, most studies indicate that consumers make limited use of the data in decision making. The reasons for the limited use appear to be the complexity of the information and the difficulty of processing and using the amount of information in reports. The purpose of this investigation was to determine whether there are approaches to reporting comparative information that make it easier for consumers to comprehend the information. Further, the degree to which consumers who have a low level of skill can accurately use that information when it is presented in a format that is easier to use was examined. METHODS: The study used an experimental design to examine how different presentation approaches affect the use of information. Participants were randomly assigned to different conditions and were asked to review information and complete a decision task related to using comparative information and making health plan selections. Two separate convenience samples were used in the study: an elderly Medicare sample (N = 253), and a nonelderly sample (N = 239). RESULTS: The findings indicate that there are data presentation approaches that help consumers who have lower skills use information more accurately. Some of these presentation strategies (for example, relative stars) improve comprehension among the lower skilled, and other strategies (for example, evaluative labels) appear to aid those in the midrange of comprehension skill. CONCLUSIONS: Using these approaches in reporting would likely increase the use of the comparative information and increase the efficacy of reporting efforts.

The risk game.

In the context of health, safety, and environmental decisions, the concept of risk involves value judgments that reflect much more than just the probability and consequences of the occurrence of an event. This article conceptualizes the act of defining and assessing risk as a game in which the rules must be socially negotiated within the context of a specific problem. This contextualist view of risk provides insight into why technical approaches to risk management often fail with problems such as those involving radiation and chemicals, where scientific experts and the public disagree on the nature of the risks. It also highlights the need for allowing the interested and affected parties to define and play the game, thus emphasizing the importance of institutional, procedural, and societal processes in risk management decisions.

Public perception of the risk of blood transfusion.

BACKGROUND: Health policymakers are concerned about the proportion of people who say they are unwilling to receive a blood transfusion. This article examines how social, cultural, and political factors affect the perceived risk of transfusions. STUDY DESIGN AND METHODS: Data were collected as part of a large national telephone survey of 1204 people conducted in the United States in 1997 and 1998. The survey elicited images associated with blood transfusions and contained questions about the perceived risk of the blood supply, sensitivity to stigma, world views, trust, and demographics. RESULTS: The results showed that a substantial proportion of people do not consider the US blood supply to be safe and say they would not accept blood if hospitalized. The images evoked most frequently by the stimulus phrase "blood transfusions" were related to AIDS or HIV. The people who tend to perceive the greatest personal and public risk from blood transfusions are female, nonwhite, and less educated, and they have not previously received a transfusion. Sensitivity to stigma, mistrust, one's perceived inability to control hazardous activities and technologies, and fatalistic and egalitarian world views tend to be associated with heightened concern about the risk of blood transfusions. CONCLUSION: Risk perceptions need to be monitored to anticipate and deal with problems of public acceptance. Risk management strategies should be tailored to the specific characteristics of individuals that are important determinants of the perceived risk of transfusions.

Violence risk assessment and risk communication: the effects of using actual cases, providing instruction, and employing probability versus frequency formats.

This article describes studies designed to inform policy makers and practitioners about factors influencing the validity of violence risk assessment and risk communication. Forensic psychologists and psychiatrists were shown case summaries of patients hospitalized with mental disorder and were asked to judge the likelihood that the patient would harm someone within six months after discharge from the hospital. They also judged whether the patient posed a high risk, medium risk, or low risk of harming someone after discharge. Studies 1 and 2 replicated, with real case summaries as stimuli, the response-scale effects found by Slovic and Monahan (1995). Providing clinicians with response scales allowing more discriminability among smaller probabilities led patients to be judged as posing lower probabilities of committing harmful acts. This format effect was not eliminated by having clinicians judge relative frequencies rather than probabilities or by providing them with instruction in how to make these types of judgments. In addition, frequency scales led to lower mean likelihood judgments than did probability scales, but, at any given level of likelihood, a patient was judged as posing higher risk if that likelihood was derived from a frequency scale (e.g., 10 out of 100) than if it was derived from a probability scale (e.g., 10%). Similarly, communicating a patient's dangerousness as a relative frequency (e.g., 2 out of 10) led to much higher perceived risk than did communicating a comparable probability (e.g., 20%). The different reactions to probability and frequency formats appear to be attributable to the more frightening images evoked by frequencies. Implications for risk assessment and risk communication are discussed.

Perceived risks and reported behaviors associated with osteoporosis and its treatment.

This study investigates older American women's knowledge and risk perceptions about osteoporosis and its treatment. Our results indicate that older U.S. women undervalue the health impact of osteoporosis; they consider it controllable, and neither life threatening nor dreaded relative to other possible diseases or conditions. At least 1/3 of older women in a diagnosed and general sample also confused osteoporosis with arthritis. Women scored highest on osteoporosis knowledge questions related to items under their personal control, such as diet or exercise. Further, women who understood the effects of a particular behavior on osteoporosis were more likely to act in accordance with that knowledge than were women who did not understand those effects.

"How exposed is exposed enough?" Lay inferences about chemical exposure.

The concept of exposure is central to chemical risk assessment and plays an important role in communicating to the public about the potential health risks of chemicals. Research on chemical risk perception has found some indication that the model lay people use to judge chemical exposure differs from that of toxicologists, thereby leading to different conclusions about chemical safety. This paper presents the results of a series of studies directed toward developing a model for understanding how lay people interpret the concept of chemical exposure. The results indicate that people's beliefs about chemical exposure (and its risks) are based on two broad categories of inferences. One category of inferences relates to the nature in which contact with a chemical has taken place, including the amount of a chemical involved and its potential health consequences. A second category of inferences about chemical exposure relates to the pragmatics of language interpretation, leading to beliefs about the motives and purposes behind chemical risk communication. Risk communicators are encouraged to consider how alternative models of exposure and language interpretation can lead to conflicting conclusions on the part of the public about chemical safety.

Trust, emotion, sex, politics, and science: surveying the risk-assessment battlefield.

Risk management has become increasingly politicized and contentious. Polarized views, controversy, and conflict have become pervasive. Research has begun to provide a new perspective on this problem by demonstrating the complexity of the concept "risk" and the inadequacies of the traditional view of risk assessment as a purely scientific enterprise. This paper argues that danger is real, but risk is socially constructed. Risk assessment is inherently subjective and represents a blending of science and judgment with important psychological, social, cultural, and political factors. In addition, our social and democratic institutions, remarkable as they are in many respects, breed distrust in the risk arena. Whoever controls the definition of risk controls the rational solution to the problem at hand. If risk is defined one way, then one option will rise to the top as the most cost-effective or the safest or the best. If it is defined another way, perhaps incorporating qualitative characteristics and other contextual factors, one will likely get a different ordering of action solutions. Defining risk is thus an exercise in power. Scientific literacy and public education are important, but they are not central to risk controversies. The public is not irrational. Their judgments about risk are influenced by emotion and affect in a way that is both simple and sophisticated. The same holds true for scientists. Public views are also influenced by worldviews, ideologies, and values; so are scientists' views, particularly when they are working at the limits of their expertise. The limitations of risk science, the importance and difficulty of maintaining trust, and the complex, sociopolitical nature of risk point to the need for a new approach--one that focuses upon introducing more public participation into both risk assessment and risk decision making in order to make the decision process more democratic, improve the relevance and quality of technical analysis, and increase the legitimacy and public acceptance of the resulting decisions.

Judgments of chemical risks: comparisons among senior managers, toxicologists, and the public.

Nineteen Senior Managers of a major chemical company in the United Kingdom participated in a survey to determine their attitudes, beliefs, and perceptions regarding risks from chemicals. Similar surveys had previously been conducted with toxicologists and members of the general public in the United States and Canada. In general, the Senior Managers tended to judge risks to be quite small for most chemicals. Moreover, they had lower risk perceptions than did members of the British Toxicological Society and even far lower perceptions of risk than a comparison group of members of the Canadian public. The managers held views that were similar to British toxicologists working in industry and government and dissimilar to the views of toxicologists working in academia. The observed differences between views of managers, toxicologists, and the public must be recognized and understood in order to facilitate communication and constructive efforts to manage chemical risks.

Do adolescent smokers know the risks?

Professor Slovic challenges Professor Viscusi by suggesting that "risk" is a term with varying meanings and the potential for misinterpretation by study participants. He distinguishes between the probability and severity of a risk, and suggests that teens who know the probability of smoking causing cancer are not aware of the severity of the experience of cancer. He goes on to note that people often perceive themselves as being less at risk than others, and observes that Professor Viscusi's study posed questions about others, instead of asking teens to assess their own risks. Thirdly, he argues that teens perceive each individual cigarette as posing a small risk even if they seem to be aware of the larger risk of smoking. Finally, since many teen smokers intend to quit, he contends, they do not see smoking as hazardous to themselves. He argues that Professor Viscusi underrates the misperception of the risks of personal addiction. Professor Slovic augments his argument with original research demonstrating that smoking teens are more likely than nonsmoking teens to perceive the short term risks of smoking as trivial.

Perception of ecological risk to water environments.

This paper examines lay and expert perceptions of the ecological risks associated with a range of human activities that could adversely affect water resource environments. It employs the psychometric paradigm pioneered in characterizing perceptions of human health risks, which involves surveys to obtain judgments from subjects about risk items in terms of several important characteristics of the risks. The paper builds on a previous study that introduced ecological risk perception. This second study employs a larger, more diverse sample, a more focused topic area, and comparisons between lay and expert judgments. The results confirm that a small set of underlying factors explain a great deal of variability in lay judgments about ecological risks. These have been termed Ecological Impact, Human Benefits, Controllability, and Knowledge. The results are useful in explaining subjects' judgments of the general riskiness of, and need for regulation of, various risk items. The results also indicate several differences and areas of agreement among the lay and expert samples that point to potential key issues in future ecological risk management efforts for water resources.

Evaluating chemical risks: results of a survey of the British Toxicology Society.

1. Members of the British Toxicology Society participated in a survey to determine their attitudes, beliefs, and perceptions regarding risks from chemicals. Similar surveys had previously been conducted with toxicologists and members of the general public in the United States and Canada. Data from 312 completed questionnaires were analyzed. 2. In general, the British toxicologists judged risks to be quite low for most hazards, with the exception of cigarette smoking and asbestos. They tended to have quite favorable attitudes toward the use of chemicals and were confident about the adequacy of chemical regulations. 3. As in previous studies of toxicologists, women expressed higher perceptions of risk than did men and had consistently stronger anti-chemical attitudes. 4. Toxicologists working in industry had more favorable attitudes towards chemicals and their use than did those working in academic settings. 5. When asked to evaluate chemical technical summaries of various animals studies there was considerable disagreement among the respondents about the toxicity of the chemicals involved. 6. In general, British toxicologists were equivocal about the reliability of animal studies in predicting human effects (particularly carcinogenicity) probably because of the belief that animal studies overestimate risk. However, they were rather confident that human health risks could be assessed reasonably accurately.

Informing consumer decisions in health care: implications from decision-making research.

Despite the wider dissemination of health plan report cards, little is known about whether consumers will use this information in making plan and provider choices. Studies of human judgment and decision making are reviewed, as are their implications for devising strategies to inform consumers. The limitations of human information processing suggest that many consumers will not use performance information in making choices. Strategies are needed to support consumers who prefer to rely on intermediaries as well as those who wish to apply the information for their own use. Many current strategies are based on assumptions not supported by existing decision-making research. Although there is much to learn about assisting consumers in making informed choices, a great deal is known from decision-making research. Our approaches and our research agenda must be based on this existing foundation of knowledge.

Characterizing perception of ecological risk.

Relatively little attention has been paid to the role of human perception and judgment in ecological risk management. This paper attempts to characterize perceived ecological risk, using the psychometric paradigm developed in the domain of human health risk perception. The research began by eliciting a set of scale characteristics and risk items (e.g., technologies, actions, events, beliefs) from focus group participants. Participants in the main study were 68 university students who completed a survey instrument that elicited ratings for each of 65 items on 30 characteristic scales and one scale regarding general risk to natural environments. The results are presented in terms of mean responses over individuals for each scale and item combination. Factor analyses show that five factors characterize the judgment data. These have been termed: impact on species, human benefits, impact on humans, avoidability, and knowledge of impacts. The factor results correspond with initial expectations and provide a plausible characterization of judgments regarding ecological risk. Some comparisons of mean responses for selected individual items are also presented.

Adolescent health-threatening and health-enhancing behaviors: a study of word association and imagery.

PURPOSE: To examine the ways in which perceived risks and benefits relate to health-threatening and health-enhancing behaviors by adolescents. METHOD: The study used a word association methodology to explore adolescents' thoughts and affective feelings associated with five health-threatening behaviors (e.g., drinking beer, smoking cigarettes) and three health-enhancing behaviors (e.g., exercising, using a seat belt). RESULTS: Each behavior elicited a mix of positive and negative associations. Health-threatening behaviors had many positive associations in common, such as having fun, social facilitation, and physiological arousal. Health-enhancing behaviors had much less commonality in their positive associations. Patterns of negative associations were not highly similar across behaviors. The content and affective tone of the associations were closely linked to participation in health-threatening behaviors and health-enhancing behaviors. Participants in an activity were far more likely than nonparticipants to associate that activity with positive outcomes, concepts, and affect and less likely to produce outcomes, concepts, and affect and less likely to produce negative associations. CONCLUSIONS: The word association methodology provides a useful technique for exploring adolescents' cognitions and affective reactions with regard to health-related behaviors. The data provided by this method have implications for prevention and intervention programs, as well as for future research.

Presenting uncertainty in health risk assessment: initial studies of its effects on risk perception and trust.

Some analysts suggest that discussing uncertainties in health risk assessments might reduce citizens' perceptions of risk and increase their respect for the risk-assessing agency. We tested this assumption with simulated news stories varying simple displays of uncertainty (e.g., a range of risk estimates, with and without graphics). Subjects from Eugene, Oregon, read one story each, and then answered a questionnaire. Three studies tested between 180 and 272 subjects each. Two focus groups obtained more detailed responses to these stories. The results suggested that (1) people are unfamiliar with uncertainty in risk assessments and in science; (2) people may recognize uncertainty when it is presented simply; (3) graphics may help people recognize uncertainty; (4) reactions to the environmental problems in the stories seemed affected less by presentation of uncertainty than by general risk attitudes and perceptions; (5) agency discussion of uncertainty in risk estimates may signal agency honesty and agency incompetence for some people; and (6) people seem to see lower risk estimates (10(-6), as opposed to 10(-3)) as less credible. These findings, if confirmed, would have important implications for risk communication.