“Misfearing” — Culture, Identity, and Our Perceptions of Health Risks

““Misfearing” — Culture, Identity, and Our Perceptions of Health Risks,” by Lisa Rosenbaum MD, New England Journal of Medicine.

“Misfearing,” the term Cass Sunstein uses to describe the human tendency to fear instinctively rather than factually, is not unique to women’s perceived health threats. Decades of research on risk perception have revealed the many factors feeding our misfears and associated perceptions. Tornadoes. Terrorist attacks. Homicides. The big, the dramatic, and the memorable occupy far more of our worry budget than the things that kill with far greater frequency: strokes, diabetes, heart disease. But interacting with many of these fear factors is another force we rarely associate with our individual health perceptions: our commitment to our cultural groups.

The ongoing controversy surrounding mammography screening highlights the clash of identity and data at the social level. In 2009, the U.S. Preventive Services Task Force recommended decreased frequency of mammography for most women younger than 50 years old, noting that the potential harms outweighed the benefits. Although the recommendations were based on an unbiased review of decades’ worth of data, a public outcry ensued. The recommendations were criticized as an assault on women’s health, and a 2009 USA Today poll found that 84% of women 35 to 49 years of age planned to ignore them.

Have pink ribbons and Races for the Cure so permeated our culture that the resulting female solidarity lends mammography a sacred status?

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