The side effects of health warnings
Shock-tactics in health-promotion campaigns have backfired: new analysis from the Social Issues Research Centre in Oxford indicates that health warnings may have hidden psychological side effects.
SIRC has monitored media coverage of health issues and public responses over the past three years, and identified three types of adverse reaction to the high 'doses' of health-scares and warnings received by the British public:
The most common effect, in which people become habituated and de-sensitised to health-promotion campaigns, exhibiting a diminishing response and eventually paying no attention at all. Constant exhortations on healthy eating and exercise, for example, have had little effect on obesity, which continues to rise.
Warning-fatigue is highly dangerous because sufferers from this effect are likely to ignore important health-related information as well as unfounded scares. "That is the danger of crying wolf," said a SIRC Director. "When there really is a wolf, you come up against warning-fatigue: your audience has simply switched off."
While some become habituated and de-sensitised to health campaigns, others develop hyper-sensitivity to scares and warnings, becoming increasingly fearful and anxious about the hazards and 'risk factors' in their diet, lifestyle and environment.
Riskfactorphobics tend to be avid readers of health pages and health magazines, often over-reacting to each new scare and attempting to follow contradictory advice.
This reaction is just as dangerous as warning-fatigue, say SIRC. In 1995, riskfactorphobics stopped taking the contraceptive pill as soon as they read reports of possible health risks, resulting in many unwanted pregnancies and a sudden 9% rise in the abortion rate – which translates as 29,291 additional abortions. The Committee on the Safety of Medicines has recently reversed its advice, declaring that the pill is in fact safe and expressing "regret" over the unnecessary abortions. But the British Pregnancy Advisory Service called the scare "a disaster that should never have happened. It caused a massive hike in the rate of unintended pregnancies.It undermined general confidence in the pill. We still see women requesting abortion who wrongly believe the pill is dangerous."
Another very common response to authoritarian warnings is increased desire for the 'forbidden' substance or activity. In many cases, the constant stream of warnings, scares and bans has led to deliberate defiance.
This effect was evident in initial public responses to the beef-on-the-bone scare, when there was a scramble to 'beat the ban' and sales of rib-of-beef increased dramatically.
Rebellious teenagers seem particularly susceptible to the forbidden-fruit effect: extensive anti-smoking campaigns in recent years, for example, coincide with reported significant increases in teenage smoking. Heavy-handed warnings about the dangers of drugs and alcohol have been equally ineffective.
The SIRC research indicates that a more socially responsible approach to health promotion could reduce these adverse effects.
"The main problem seems to be that health promotion has become a cut-throat competitive industry, with ever-increasing numbers of agencies, charities, politicians and academics vying for media attention and funding," said a SIRC Director.
"The result of all these competing vested interests is that people are bombarded with scary headlines, warnings and often conflicting advice, much of it based on very flimsy or dubious scientific evidence. This is clearly not in the public interest, and if the agencies and individuals involved cannot exercise greater restraint, there may be a need for regulation."
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