During my years as a daily TV journalist in Boston, I covered a seemingly endless string of risks: from the run-of the mill threats like car crashes and plane crashes and fires and crime, to artificial sweeteners (yes, I’m that old) and air bags and silicone breast implants and the “new” epidemic of child abductions, to a depressingly rich litany of environmental risks. I tried to do it well, and won a bunch of awards. Then I left TV news and joined the Harvard School of Public Health, and discovered a lot of details about risk that would have made me a better reporter had I known about them back when I was reporting.
Risk is more than just a number one in a million. It’s more than just saying some scary thing is out there “Suspected Carcinogen in Coffee”. There are important aspects to risk that I never provided my viewers because I never knew what questions to ask. The people who depended on me for the information that would help them make healthy choices were disserved, and possibly even harmed, by my failure. I wasn’t alone, of course. Plenty of my colleagues in broadcast and print—the best of them—did the same thing. Our reporting was inherently deficient because we just didn’t know that there are important details without which a story about a risk is simply incomplete. This still happens all the time, even at the very best news organizations.
So in the hope of contributing to better journalism, here are some basic “Who, What, When, Where, Why, and How” questions to answer about risk that will help journalists cover these stories more thoroughly and give readers/viewers/listeners all the information they need to know just how risky something may actually be. (And, by the way, none of the details described below are complicated, hard to understand, or take more than a sentence or so to squeeze into any story.)
For something to actually be a risk, you need two elements: a hazard and exposure to the hazard. Either component creates the potential for risk and is therefore a story by itself, but an actual risk to people only exists if there is some hazard and exposure to it. A poisonous snake is hazardous, but not a risk if it’s in a cage and we’re not exposed. A snake on the loose to which we are exposed is not a risk unless it’s poisonous. That something is a hazard is a story, of course. That we are exposed to some worrisome thing is, too. But for there to be an actual risk, you have to have both. If you are reporting on just the hazard (“Substance X May Cause Cancer”) or just the exposure (“Trace Amounts of Human-made Chemicals in our Blood”), readers won’t know whether they are actually at risk.
Hazard and exposure both have critical details. Here are the biggies regarding hazard:
Hazard - How much? Dose matters, yet you’d be astonished how often that information never shows up in risk stories. Stories often say something like “Substance X causes Y,” but they fail to say how much of substance X it takes. Sometimes there is no bright line—a specific dose above which there is hazard and below which there isn’t—and the best science can come up with are frustratingly vague “guidelines.” Sometimes there’s a threshold dose below which the hazard isn’t hazardous, and in most cases the greater the dose above that threshold, the greater the risk. But not always. Sometimes small doses are believed to be the riskiest (endocrine disruptors), and with things that cause cancer, the standard scientific assumption is that any dose is potentially hazardous. Then there’s the new toxicology that has found that sometimes things that are hazardous at high doses may actually be good for you at low ones (even carcinogens!). In any event, a story without information about dose is missing a basic fact the reader needs.
Hazard - What does it do, and when? It’s amazing how many stories on risky things don’t include these basic facts. Is it fatal? How? If it’s not fatal, does it cause severe or minimal harm (food poisoning stories often fail to include this), treatable damage (exposure to TB) or untreatable (birth defects)? Even some carcinogens produce treatable harms (a frequent outcome of radiation exposure is thyroid cancer, highly treatable, but an important fact that rarely showed up in stories about the radiation risk from Chernobyl). If the hazard is fatal, does it kill you right away or later? (Asbestos causes lung cancer or mesothelioma, but it’s usually decades before those diseases show up.) These are important details the reader needs in order to judge the risk.