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Understanding Risk with Professor Andrew Maynard

By: 
Renee Despres

How much does eating red meat really increase your risk of cancer? Will having a glass of red wine with dinner every night really reduce your risk of heart disease? Should you get a flu shot this year? Will BPA in can linings make you sick? Which health screening tests should you have, and when? Will taking a multivitamin every day help you live longer? Should you have a baby past 35? 40? 45? What’s the risk of drinking alcohol while you’re pregnant?

If you’ve ever asked yourself questions like these, you’re not alone. News media often contribute to the confusion. Health news headlines proclaim one day that “Food X” or “Activity Y” is good for you and the next day that the same food or activity leads to a Deadly Chronic Disease.

So what’s a person to do? Start by learning some basic concepts about the science of risk.

We make choices every day that affect our risk of developing a disease or getting seriously hurt. Yet humans are notoriously bad at understanding risk – especially if the risk isn’t immediate and frightening. Bacon and eggs doesn’t appear terrifying, but if you’ve got heart problems, it might be riskier for you to eat a big home-style breakfast than it would be for you to bungee jump.

To answer to some of our questions about risk, ehealthMD spoke with Andrew Maynard, professor of risk science at the University of Michigan School of Public Health. Maynard is the author risk videos, designed to help anyone (and we mean anyone) understand the formal concept of risk – and the processes to make good decisions.

You’ll find a direct link to Maynard’s whimsical, humorous videos on risk on ehealthMD.com. We hope you enjoy these brief, delightful segments as much as we did. The videos, also available at riskbites.org, offer a smorgasbord of topics. You’ll find vocabulary lessons (do you know the difference between a hazard and a risk?), quirky explanations (Is there a relationship between chocolate, cats, and Nobel Prize winners?), and more.  


Here’s the transcript of our talk with Professor Maynard. Read on… but be sure to fasten your seatbelt before you begin!

ehealthMD: Who is your audience for these videos?

Maynard: The audience really has multiple levels. To understand my audience, you really need to know something about the genesis of the whole project.

I was taken by my kids to VidCon, the annual YouTube convention. At the conference, I was struck by the rapid rise of YouTube as an informal educational medium. People are hungry for educational content online, but pitched in a friendly, inviting way.

Established educational organizations are doing a really poor job of taking advantage of these tools. The grassroots community is the force behind this. Science videos with deep content are getting millions of views. So I began to wonder: Can we translate between the two?

My kids have been drawing me into the YouTube community, which consists of younger people in their 20 and 30s. I’m intrigued by the way people are using YouTube not only for trivial stuff, but for serious content, with millions of views and subscribers. That growing community of young people is my primary audience. My secondary audience is people who are interested in the topic of risk.

The videos are aimed at young people who are interested in science and health and also want to be entertained – and who are used to watching short videos. But they are also deep enough to be worth watching for people with a serious interest in health risk.

I don’t want the videos to be too professional and polished – putting aside the limitations that I can’t draw and don’t have much time, there’s something fresh about their simplicity I think.

ehealthMD: What has been the hardest part of getting these videos out to the public?

Maynard: My biggest challenge is within the professional community. Many are worried about putting out snippets of information. But the traditional approach – a full college course or at minimum a lengthy lecture – doesn’t satisfy people searching for information for themselves.

ehealthMD: Why is it important for people to understand risk?

Maynard: There are two aspects to the importance of understanding risk. First, everybody has to make decisions that have some elements of risk in them. When you’re choosing food, shampoo, medicine, or anything else, what information do you use to make decisions? For instance, in the outbreak of fungal meningitis – how do you make sense of the information that you hear? Is there a significant danger to you, or is it something you shouldn’t be worried about?

Our understanding of risk affects important day-to-day decisions we make about our health. Those decisions often extend to risk factors – like age and sex, or even events that happened early in life – that we cannot control or change. As medicine is becoming ever more personalized, scientists are getting better at identifying factors that increase the risk of diseases from heart disease to cancers to Alzheimer’s.

When people understand risk, they are better equipped to make decisions and make sense of the information they get. But in general, we don’t have the language we need to understand and talk about risk. It’s sometimes a lottery whether people make a decision that’s good or bad for them.

So it makes sense to give people the tools, language, and understanding they need to make those decisions.

Second, there’s some really cool science associated with risk. Just as people get excited about biology, physics, or other topics, some people are at least potentially equally excited about the science of risk. And they ought to be given the opportunity to be introduced to that science.

ehealthMD:  How do you approach risk in your own life?

Maynard: First, I don’t see myself as being any different than anyone else. I’m notoriously bad at handling big numbers or small numbers. Say I go and have a medical procedure, and my doctor tells me that there’s a one in a million chance that a problem will occur. I haven’t got the foggiest idea of what that really means. I know there’s a potential benefit, but those numbers can’t tell me what the magnitude of that benefit is.

Or say there’s 10 parts per billion of some substance in my water supply. Should I be filtering my water? Drinking bottled water? I struggle with things like that – just like everyone else.

I work in this area. Yet I find it very hard to make decisions – and that’s knowing about relationships between exposure, risk, and toxicity. How do people without that knowledge make decisions?

ehealthMD:  Are there any areas in which we’re especially bad at understanding risk?

Vaccines are one example. Vaccines are controversial because there are no right and wrong answers. But if we’re asking people to make decisions that affect both their lives and lives of their communities, we need to work far better in enabling people to understand the consequences of their actions.

Looking at vaccines, there are two arguments to be made. There is a strong argument that, as part of a community, everyone should be vaccinated; at same time, we are each an autonomous human and have the right to make our own decisions. I don’t think science can dictate whether or not vaccines are mandated. What is indefensible is people making decisions without understanding the consequences.

Another topic of dispute is BPA in bottles or can liners: We know something about the science of BPA, and we know it could cause problems. But how do you make sense of the information that’s coming out?

ehealthMD: What tools are available to for people who want to assess their personal risk?

There are very few tools out there, although there are a growing number of resources to help people put risk in perspective.

The Risk Bites videos are designed to help people understand what questions they should be asking about risk. What is relevant? What are credible sources of information?

Hopefully, through Risk Bites, we can put the right language and fundamental ideas together, so people can have access to better sources on how to understand risk.

ehealthMD: What are some of the fundamental things people need to know to understand risk?

First, you need to know what risk is. To be at risk, you need exposure to something. Just finding out that there is a harmful agent isn’t enough to say that agent poses a risk. That’s where you get to the difference between hazard and risk. A hazard is the potential, the possibility of something causing harm. But you have to do something to that hazard for it to actually cause harm.

The example I use in one video is bleach. Bleach is nasty stuff. It’s hazardous, whether it’s locked in a cabinet, sitting in front of the cabinet, or in an unlocked cupboard. But sitting there in the bottle, it’s just a hazard. You have to do something like drink the stuff for it to cause harm. Risk is a combination of the potential of something to be harmful and exposure to that substance.  

 

 

ehealthMD: What do you hope people gain from the videos?

There’s a strong aspect of literacy to this: giving people the chance to get to understand new concepts and develop a new language for exploring those concepts. But it’s not entirely a literacy project – that seems presumptive, even paternalistic. I see the videos more as a way of empowering people to understand the world they’re in.

This is very much an experiment – I’m trying to tap into this desire for knowledge and understanding beyond the usual way in which academics approach it. I’m hoping to help viewers build understanding bit by bit. So rather than take the conventional perspective of creating and targeting content toward learning objectives, I see Risk Bites as a way of forming a tapestry of understanding over time.


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