[-empyre-] Rigging the Risk Odds

Stewart Auyash auyash at ithaca.edu
Tue Nov 13 00:04:08 EST 2012

Rigging the Risk Odds

Schools closed, concerts and public events cancelled, travel down to a
drizzle of people and no one with a fever allowed in or out, quarantines
(forced and self-imposed), shops nearly empty, N95 masks and anti-microbial
products sold out, a large hospital devoted only to the diseased,
temperature checks in malls, schools, and at borders. Friends, family, and
colleagues back home begged, pleaded, and prayed for the expats to leave.
“Fear has a mind of its own,” declares the newspaper.  All in the effort to
decrease risk.

So how far would you be willing to go to avoid risk in a pandemic that
proved fatal to about 10% of all those infected and 50% for those over 65?
Would you be willing to voluntarily quarantine yourself and your family if
you thought you might have been exposed? Would you accept a forced
quarantine if someone you recently met had the symptoms? Or how would your
react if you were not allowed to leave the country if you had a fever? (1)

Be it making choices in a pandemic, avoiding an oncoming storm, becoming
more  physically active, or driving old gas guzzlers paying no heed to
climate change, why don’t we make better decisions about our health and
those around us? Can’t we just do the right thing?

As Bill Leiss said in his plenary talk during Risk at Humanities, we make
choices about risks every day. But not all of us have the ability to make
the “right” choices to avoid the risks we know. When contemplating future
health risks, we are playing a game comparable to lottery as Dan Beauchamp
explains in his editorial, *Lottery Justice *(2)*.* Not everyone has the
equal ability to avoid a pandemic, outrun a hurricane, or change our
“lifestyle” to lower risks to our health. The lottery is rigged. Geography,
for example, is destiny.  Born near the equator or sub-Saharan Africa, we
can expect high risk of poverty and illness.  Living in an inner city with
no safe recreation areas and lousy schools for your kids, what would you
expect? Not everyone can pack up and move.  But live in a clean suburb with
playgrounds and good schools and your kids will have a head start.  No need
to move, is there?

However, we can change the lottery odds for others to reduce risk. We can
make the air healthier to inhabit, quarantine during a pandemic, restrict
guns, design safer highways, restrict the size of soft drinks, and provide
better primary education to all.  Beauchamp calls these policies “gifts to

One could look at the election last week as a way to change the odds of
risk in the American lottery. One candidate clearly cared about rigging the
odds for the wealthy while the other candidate argued the opposite
approach.  As Bhaskar indicated last week, risk does not exist in a vacuum.
By changing the odds, we can rig the risk in favor of all.

(1) All these events took place in Singapore and elsewhere in 2003 during
the SARS pandemic.

(2) Beauchamp, D. (1981) Lottery justice. *Journal of Public Health Policy*,
2:3, 201-3.

*Thanks to Renee and Tim for inviting me to participate in this forum.
Stewart Auyash, MPH PhD
Associate Professor and Dept Chair
Dept of Health Promotion and Physical Education
Hill Center 7

Ithaca College
953 Danby Rd |  Ithaca, NY 14850
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