Fear sells healthcare
In our predominately for-profit healthcare system, fear sells products.
Every day I read an article or listen to a news story about cancer. Breast cancer, prostate cancer, colon cancer, skin cancer, liver cancer, mouth cancer, ovarian cancer…I often feel like a ticking time bomb!
It’s so easy to get overwhelmed by the grim statistics being tossed around by marketers. Then we live in fear, become anxious and depressed, willing to buy anything if it will decrease our chance of getting the Big C.
Americans spend billions every year on over-the-counter supplements, herbal remedies, and screening exams to prevent cancer, or at least find it early.
Many of these products and tests don’t help. At best they’re a waste of money; at worse, they can cause harm.
But how likely is each of us to get cancer or die from cancer? How do we know which interventions, such as screening tests and lifestyle changes, are best?
Understanding health statistics not only lessens our fears and saves us money, but helps us work with our doctors to make more appropriate health care decisions.
Know Your Chances
Statistics are numbers, and they can be intimidating if you’ve never studied them before. Marketers take advantage of our ignorance.
But there is help!
Looking through my past posts, I can’t believe I haven’t shared this amazing ebook, Know Your Chances: Understanding Health Statistics, by Drs. Lisa Schwartz, Steven Woloshin, and H. Gilbert Welch. (It’s free to download from the National Library of Medicine.)
It was brought to my mind by the recent death of one of its authors, Lisa Schwartz. She was a passionate advocate for better healthcare, and worked to educate patients, journalists and physicians about the harms of overdiagnosis and overtreatment. She will be missed.
Related post: Be informed—Informulary
Anyway, she and her co-authors wrote Know Your Chances about 10 years ago, but it’s still very relevant today. It’s a beautiful little primer that teaches how to critically read or view a health-related news story or a commercial ad.
The goal of this book is to help you better understand health information by teaching you about the numbers behind the messages—the medical statistics on which the claims are based.
The book will also familiarize you with risk charts, which are designed to help you put your health concerns in perspective.
By learning to understand the numbers and knowing what questions to ask, you’ll be able to see through the hype and find the credible information—if any—that remains.
The first part of the book talks about risk. Risk of cancer or any disease has to be seen in context.
Ask these questions:
- Risk of what, exactly? Getting a disease or dying of a disease?
- How big is the risk? One number by itself means nothing. The authors use the example of 150,000 Americans will get colon cancer. But you need to know out of how many total Americans. The number seems big until you put it against 300,000,000 Americans. Then the risk reads 5 out of 10,000 Americans will get colon cancer.
- What is the time frame of the risk? A year, a lifetime? Many health statistics use a 10-year time period. Using the colon cancer example, 5 out of 10,000 Americans will get colon cancer in a year; 5 out of 1,000 will get colon cancer over 10 years; and 53 out of 1,000 will develop colon cancer over their lifetime. The chance of getting most cancers and diseases increases as we age, after all, so lifetime risk will be greater than annual or 10-year time frames.
Using easy-to-understand tables, charts, and quizzes the authors show how to critically analyze healthcare numbers, and be more aware of missing information.
Understanding risk reduction
The second part of the book focuses on ads that talk about risk reduction (supplements, prescription drugs, screening tests, etc.). Again, the risk must be seen in context or perspective.
Ask these questions:
- This (test, drug, whatever) reduces the risk of what, exactly? Of dying? Of experiencing unpleasant symptoms? Or does it just change a test result, such as cholesterol or bone density?
- How big is the risk reduction? Some ads will say “This reduces your risk by 45%.” 45% of what? You need to know the starting risk before you can understand the overall risk reduction. Ads generally leave this information out, or put it in very tiny print.
- Does the risk reduction information reasonably apply to me? Are the studies based on others like you: similar gender, age, race, health history? The more similar you are to the study participants, the more likely the results will apply to you.
There is so much more information in the book. Feed your inner skeptic and take a look!
By the way, the authors note that many physicians don’t know how to accurately calculate and communicate risk, either. You may be able to teach your doctor a thing or two 😉
There are two other online risk tools that I like to use:
- Know Your Chances from the National Cancer Institute, and
- Breast Cancer Risk Assessment Tool, also from the National Cancer Institute
Overall, Know Your Chances is an extremely useful reference book, especially in today’s overpriced and commercially-driven healthcare market.
I highly recommend it to anyone who wants to take more control of their health and save money, too.
And here are some other great books by these same authors!