HAZA RD SEQUENCES:SOCIAL PROCESSES AMPLIFYING ANDATTENUATING HEALTH RISK SCARES
SOCIAL PSYCHOLOGY EUROP EAN RESEARCH INSTITUTE
A series of h azard notificat ion s, wh ich may ( but need no t) betechn ically related
Occu rrin g in specifiable temp oral sequen ce
1995: third gen erat ion O C pills (i.e. co ntaining gestoden e anddesogestrel) and ven ous th romboembolism
18 Oct 199 5: Comm ittee of the Safety of Med icines and Med icinesControl Age ncy issue d 190,000 le tters to GP’s an d pharmacistsstating that so-called th ird gene ration O Cs (those containingdesogestrel an d gestodene ) were associated with arou nd a twofoldincrease in the risk of t hromboe mbolism, compare d to t hosecontaining o ther progestog ens
19 Oct: Press reported sto ry p rior to m any doctors getting th eir letter,resu lting in users seeking m edical advice from doctors before t heywere properly informed
20 O ct: CSM interpretation of research results ch allen ged by m ainrese archer - CSM reiterate s its interpretation
20 O ct: Dru g companies producing th ese p ills claim CSM actionprem ature
Decrease in pill use (15% dro p o verall ‘94-98; third gen erat ionpills dropping share of th e market from 55% in ‘9 4 to 15% in ‘98)
govern ment agencies risk communicatio n ch anges
Debate about th e a ccu racy a nd reliability of t he scientificevide nce
Criticism of th e co ntent of the CSM comm un ication
Criticism of timing of CSM com munication
CSM acted when other agencies in U S and Europe did not
Meta-an alysis by Berol linked pill to breast can ce r
CSM warned GPs of upcoming statem ent - req uired no ch angein prescribing pra ct ice
Med ical establishm ent con demned media coverage assensationalist and re-itera ted original statem ent
W omen 2.9 tim es more likely to have ischaem ic stroke if takin goral con tracep tives
Med ia hyped story “Pill raises risk of stroke four t imes” (Mirror)
May and Augu st 199 7 HRT linked to th rombosis risk
Octo ber 1997 Sunda y Times leaked meta-analy sis results (2.3times high er risk o f breast cancer)
CSM sta tes results do not provide a reason for women to stoptheir treatm ent
No vember 1997 Lancet corrects figu re (1.02) - st ill no publicreaction
Most reactive stop using at time of first scare, n ot a vaila ble toreact to sub seq uent;
Som e con tinue to use but have d etermined cost-ben efits anddo not react to la ter notifications
Hence all pu blic re actio n that wo uld b e visible has been seen.
• coordinated CSM output - doctors informed - s tatem ent
• intri ns ic differences in the stor y
– less nov elt y - red uced infotainment
– relat ion to o ther hazard storie s (e.g. bomb)
MEDIA AS LEA RNING ORGANISATIONS V IZ RISK
The media (like oth er stations o f amplification) act as lea rningorganisations when faced with a nove l hazard
• Re-broadcast with amendm ent bas ed on learning
In effect each hazard in the sequen ce is gre eted
CRITICAL HAZA RD NOTIFICATION IN ASEQUENCE
1995 Pill sca re repre sen ted a turn in g point in therepre sen tation of O C he alth hazards - th e critical hazardnotification
Shift from being possibly a hazard to full h azard stat us
Shifted social representation of OC p ill from medically safe tomedically risky though possibly necessary
People faced wit h novel information seek to in terpret (anch or)itin terms of th eir ex isting belief sy stem s (social rep resentat ion s)- creating illusory certainty
Informat ion or even ts which shift a hazard from o ne socialrepre sen tational anchor t o an other are critical points in th eprocess of social am plification of risk
Individu als act in this way but so do the m edia - media shiftbetween social representational ancho rs
The so cial re present atio n use d determines how theamplification station acts an d the way it transm its
HAZA RD SEQUENCES PREDISPOSE CHOICE OFSOCIAL REPRESENTATION
Am plification stations a re constrain ed in their choice of hazardrepre sen tation by what has pre viously happe ned
Most particu larly they are con strained by very memorable,rela ted haza rd notifications
Na ture of constrain ts require fu rth er ex p loration
Strongly sug gests nee d for ex amining hazard sequ ences
Strongly sug gests nee d t o d etermine what makes a hazardnotification achieve status of a critical point in the choice ofsocial represen tation
VERNON B. WILLIAMS, M.D. 6801 Park Terrace. Los Angeles, CA 90045 EDUCATION University of Michigan, Ann Arbor, MI Inteflex Accelerated Pre-Medical/Medical Program POST-GRADUATE TRAINING 1996 - 1997 Johns Hopkins Hospital, Baltimore, MD Department of Anesthesiology and Critical Care 1993 - 1996 University of Maryland Medical Center, Baltimore, MD 1
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