A new method for early detection of mass concern about public health issues

During a public health crisis, risk communication professionals and other risk managers need timely and reliable information about the public reaction as soon as possible in order to effectively carry out their responsibilities. Based on a data-set of microblog news posts, this article presents a method that can forecast to what extent news about a public health issue will be disseminated. The study makes advances in rapidly tracking citizens’ reaction towards public health issues by monitoring news media on microblog sites. The findings show that the proposed method can detect early on the intensity of social reaction on a public health issue as well as provide alert signals. The method can also complement existing risk detection systems and help in the design of other powerful risk analytics tools.     

Examining inequities in children’s environmental health: results of a survey on the risk perceptions and protective actions of new mothers

Young children are more highly exposed and vulnerable to environmental health hazards than adults due to a variety of physiological and behavioural factors. Despite the significant responsibility mothers typically bear in managing their children’s health, little is known about how they perceive and negotiate these risks in their day-to-day lives. To better understand mothers’ environmental health risk perceptions and associated protective actions across socio-economic and geographic contexts, a telephone survey was conducted among new mothers (n = 606) recruited through two Public Health Units in Ontario, Canada. Analyses revealed that approximately half of the respondents were moderately or highly concerned about environmental health risks, ranging in nature from household products to outdoor air contaminants. Factors affecting the likelihood of experiencing concern included lower income and lower levels of perceived control. With regard to protective actions, 43% reported taking three or more actions to reduce environmental health risks to their children, with the likelihood of taking action being negatively affected by factors including low income and first language other than English or French, and positively affected by being a first-time parent (primiparous). This study contributes to our understanding of environmental health risk perceptions and associated protective behaviours among new mothers, and has implications for the development of more context-focused risk management and communication strategies.     

A proposed enterprise risk management model for health organizations

Health care organizations are environments with high management complexity and subject to a constant exposure to risks. Enterprise risk management (ERM) has been studied and applied in different economic environments with the aim of improving organizational performance. However, the health sector still suffers from a lack of attention in this context, in particular with regard to the need for a high degree of financial transparency and for the establishment of process-orientated management, and this provides the motivation for the study described in this paper. An ERM model for health organizations is proposed, based on a systematic literature review and on seven case studies in Brazilian hospitals. An approach to economic risk assessment using indicators such as the cash flow at risk and the variability of costs and receipts from the proposed model is suggested. The health organizations involved in the case studies all interpret ERM as a source of information contributing to corporate governance, and the indicators listed provide constructive data for improvement-driven decision-making. Given the interest expressed by the organizations involved, further application and validation of the proposed model in subsequent studies is suggested.     

Influences of individual-level characteristics on risk perceptions to various categories of environmental health and safety risks

Over the last five decades, social science researchers have examined how the public perceives the risks associated with a variety of environmental health and safety (EHS) hazards. The body of literature that has been emerged diverse both in the methodology employed to collect and analyze data and in the subject of study. The findings have confirmed that risk perceptions vary between groups of individuals as well as between categories of EHS risks. However, the extant literature on EHS risk perceptions has failed to provide empirical insights into how risk perceptions can be best explained according to the interplay of both (1) the category of EHS hazard appraised and (2) the prominent individual-level characteristics that best explain observed risk perception differences. This study addresses this deficiency in the literature by providing insights into the individual and cumulative roles that various individual-level variables play in characterizing risk perceptions to various categories of EHS risks including ‘agentic risks’ like street drug use and cigarette smoking, ‘emerging technological risks’ like nanoparticles and cloning, and ‘manufacturing risks’ like air and chemical pollution. Our data are drawn from the 2009 Citizens, Science, and Emerging Technologies national study of United States households that investigated public perceptions of EHS risks, traditional and emerging media use, and various individual characteristics like personal demographics, socioeconomic factors, and perceptual filters. The findings show that some categories of EHS risks like those associated with emerging technologies may be more easily predicted than other categories of risks and that individual-level characteristics vary in their explanative power between risk categories even among a single sample of respondents.     

Book Review

This research examines two modes of assessment of environmental health risks and the transformation of these risks into public health issues while relying on the specific case of well‐water toxicity and mega dose of electromagnetic radiation found in one prosperous town in the center of Israel – Ramat ha‐Sharon. Based on official and scientific documentation and interviews conducted at three time periods with randomly selected town residents from contaminated neighborhoods (N = 169), this study shows the discrepancy between the ‘objective’ experts’ standards for assessing environmental health risks and the public’s subjective perception and evaluation of the impact of these risks on their health and well‐being. Even though, by experts’ standards, the well‐water toxicity remained constant over the three interview sessions, Ramat ha‐Sharon town residents’ subjective levels of concern and perception of risk fluctuated as a function of news media and municipality announcements and residents’ perceived ability to minimize the risk. This study also shows the complex and multidisciplinary nature of environmental health risk assessments and the need to relocate them into the broader socioeconomic and political context in which they are embedded.     

中国金融开放的外源性风险评估与预警机制

本文在构建金融开放的外源性风险指标体系的基础上,提出了评估金融开放外源性风险的“3δ”原理和风险的神经网络预警模型。利用中国金融开放的风险指标数据进行的分析结果显示,中国当前金融开放的风险级别处于安全状态。对26个发展中国家金融开放外源性风险的评估和预警表明,该原理和预警模型对金融开放的外源性风险的评估与预警具有一定的...     

GIRA: a general model for incident risk analysis

Most existing risk analysis methods focus on analysing risks that a system might face throughout its life. However, there is no explicit method for risk analysis during incidents. Approaches such as bow-ties and attack trees provide reliable information about triggers and escalation of incidents, but do not cover risk evaluation. Risk matrices include the entire risk analysis process; however, their risk evaluation approach is oversimplified. This paper presents a General Model for Incident Risk Analysis, which formalises the incident risk analysis process through an influence diagram. Our aim is to provide a decision support model that generates reliable risk information and enhances incident risk evaluation.     

我国健康保险业的健康管理运行模式构建

健康管理是健康保险转移财务风险、控制成本、解决信息不对称、道德危害等问题的成功策略之一。积极借鉴国外保险业健康管理的成功运行模式(如HMO,PPO,POS等),构建我国健康保险的健康管理运行模式对于我国健康保险业的可持续发展有着重大意义。本文重点研究了健康管理运行模式的重要组成部分:服务人群、服务方式、服务内容、支付机制、成本控制与医疗服务管理机制、利益协调机制、反馈机制等,并探讨了健康管理当前在我国面临的问题,指出必须结合国情构建健康管理运行模式,从而促进我国健康保险业务稳定、持续、健康的发展。     

Influence of perceived risk on entrepreneurial desirability and feasibility: multidimensional approach for nascent entrepreneurs

This study examines the influence of perceived risk on entrepreneurial desirability and feasibility as determining factors in the intention to start a self-owned business. Specifically, a multidimensional approach is taken to examine the different types of risks associated with entrepreneurship: economic, social, time, health and personal risks. The results obtained from a sample of 376 new entrepreneurs in Mexico confirm the fact that the perceived desirability and feasibility have a significant and positive effect on the intentions to start their own company. On one hand, the empirical evidence obtained shows a heterogenic effect of the risk dimensions associated with entrepreneurship on the perceived desirability and feasibility in their behaviour. Therefore, it was found that the economic risk associated with entrepreneurship has a negative effect on the feasibility to start a business, but does not significantly influence the desirability of that behaviour. On the other hand, a significant effect from the risk related to health is not seen on desirability and feasibility, but the negative influence of personal risk is empirically supported for both variables. Finally, the results obtained related to social and time risk are contradictory. Social risk negatively influences entrepreneurship desirability, but a positive effect is observed on the feasibility to create a business. For its part, the empirical evidence obtained does not support any effect of the time risk on the perceived feasibility of starting a business, but there is a positive on entrepreneurship desirability. These results, which are contrary to the traditional concept of risk as a barrier to entrepreneurship, are justified by the vocational nature of this behaviour and by the social sacrifices that are sometimes necessary to be able to make a business work.     

Travelling risks: How did nanotechnology become a risk in India and South Africa?

India and South Africa have invested in nanotechnology since the early 2000s and have identified risks to human health and the environment as an important issue for governance. This is exemplary for a wider trend in which ‘developing countries’ play an increasingly prominent role in the development, production and use of emerging technologies. This validates the claim of the world risk society thesis that countries around the world are now confronted with the risks of emerging technologies. Little is known, however, about the way developing countries deal with the potential risks of emerging technologies. Starting from the observation that the risk colonization of nanotechnology in developing countries cannot be taken for granted, this article draws upon the relational theory of risk in order to investigate how nanotechnology became understood as an object of risk in South Africa and India. The article shows that nanotechnology was constituted as an object of risk in rather different ways in India and South Africa, demonstrating that the spread of risk discourses – and the emergence of a world risk society – cannot be understood without attending to the local context. The article shows that way risk is understood and dealt with changes as risk discourses travel around the world, giving many different faces to the world risk society.     

Citizen views about public meetings

The current study seeks to demonstrate that a citizen views about public meeting structure and related groups matter in predicting satisfaction with public engagement and willingness to attend future meetings. Public health agencies frequently use public meetings to communicate risk information, but relatively little social science research has examined how potential meeting participants view them. Using survey data (N?=?866) collected in seven US communities where health agencies were investigating possible local cancer clusters and holding public meetings to communicate with local residents, the current study replicates and extends an earlier inquiry related to citizens satisfaction with public meetings used for risk communication. Whereas previous research found that expectations, health agency credibility, and risk perceptions predicted satisfaction with public meetings, the current results did not show a significant relationship between agency credibility, risk perceptions, and satisfaction. Further, the results suggest it may make sense to consider ‘views about public meetings’ as a single measure that includes citizens’ structural expectations for meetings. Finally, the current study finds that views about public officials and views about meetings relate to individuals’ willingness to attend future meetings. Additional variable development and modeling research is suggested.     

中国商业健康保险的现状与发展战略

中国确立了走向全民医保的医疗保障发展战略,商业健康保险在全民医保的制度框架中占有重要的地位。目前,商业健康保险依然处在初期发展阶段,在卫生筹资体系中的作用很低,其分摊民众医药费用风险的功能尚未发挥出来。因此,商业健康保险在未来的发展空间巨大。制约其发展的外部因素主要在于政府支持的力度和方式都有所不足,内部因素主要在于专业化程度不高。在国家推进新医改的背景下,商业健康保险在近期内的战略发展领域包括公共医疗保障基金的第三方管理,大病统筹保险和补充性医疗保险。商业健康保险与公共医疗保障体系建立互利互惠的公私合作伙伴关系,至关重要。     

Shifting reactions to risks: a case study

Social science research in the field of risk analysis has emphasised evaluating the magnitude of individuals’ reactions to risks (e.g. strength and salience of concerns, frequency and forcefulness of behaviours that respond to risks). Fewer studies assess the factors that contribute to risk reactions or the types of risks to which reactions are directed (e.g. human health, wildlife health or ecosystem health risks; economic or aesthetic concerns). Theoretical and empirical research on amplification and attenuation of risk (e.g. the Social Amplification of Risk Framework) reveals that the strength of people’s reaction to risks can change markedly over time, as a function of new stimuli. We expand on this foundation to consider here how the types of risks members of the public react to may also shift over the course of their exposure to a hazard, particularly as more information about the hazard becomes available. This case study of risk reactions related to an outbreak of type E botulism in north-western Michigan, USA, demonstrates that the types of risks people react to can change substantially over time. We identify factors that contributed to changes in types of risk reactions, and then consider how these factors potentially distinguish the botulism outbreak from other outbreaks. This case study suggests that, under certain conditions, risk communication can meaningfully alter the types of risks that people react to in response to an environmental hazard. We discuss implications of these findings for risk research, risk communication and environmental conservation.     

The interplay between risk adjustment and risk rating in voluntary health insurance

Many regulated health insurance markets include risk adjustment (aka risk equalization) to mitigate selection incentives for insurers. Empirical studies on the design and evaluation of risk-adjustment algorithms typically focus on mandatory health insurance schemes. This paper considers risk adjustment in the context of voluntary health insurance, as found in Chile, Ireland, and Australia. In addition to the challenge of mitigating selection by insurers, regulators of these voluntary schemes have to deal with selection by consumers in and out of the market. A strategy for mitigating selection by consumers is to apply some form of risk rating. Our paper shows how risk adjustment and risk rating interact: (1) risk rating reduces the need for risk adjustment and (2) risk adjustment reduces premium variation across rating factors, thereby increasing incentives for consumers to select in and out of the market.     

A meta‐level analysis of major trends in environmental health risk governance

Internationally but also within countries, large differences exist regarding how environmental health risks (EHRs) are governed. Despite these differences, at a meta‐level some general trends can be discerned that may point to a convergence of EHR governance regimes. One, EHR governance regimes are increasingly taking into account cost‐benefit considerations, sectoral goals outside the health risk domain, public concerns and stakeholder interests in early stages of decision‐making. Two, EHR objectives are increasingly integrated in other, sectoral policies such as land use planning. Three, an increased differentiation of EHR standards is observed (partly as a consequence of the former characteristic). Still little systematic empirical research has been conducted on the dynamics in EHR governance regimes and their causes, on what EHR governance regimes have produced in terms of (perceived) risk reduction and on how these results can be explained. This paper proposes a systematic framework for analysing, explaining and evaluating shifts in EHR governance regimes. The framework in turn is applied to examine and understand the shift towards more integrated and differentiated EHR governance regimes.     

Risk management within the cannabis industry: Building a framework for the cannabis industry

Thirty states and the District of Columbia have legalized the use of cannabis for medicinal and/or recreational use by either formally or informally de‐criminalizing its use. However, cannabis remains a Schedule 1 drug under the Federal Controlled Substances Act (21 U.S.C. Sections 801 through 812), leaving federal law in conflict with the laws of over half of the states. As a result, market participants in legal cannabis businesses face risks due to the industry's unique legal status within the United States. We examine the risks and challenges deemed by the cannabis industry as the top risks facing the industry's continued future growth and its sustainability. In addition to general risks inherent in a nascent industry, a legal cannabis business faces additional risks, such as risks in its banking and finance activity, placement of insurance, payment of taxes, and managing its supply chain. These legal businesses also face true legal risk from the possibility of being shut down by the federal government and seizure of assets and product under the CSA. This paper also examines whether the cannabis industry would benefit from a futures market to mitigate price risk.     

Genetic risk information

Risk information and communication of health risks play a large role in medicine. With the growing importance of genetics and genomics in medicine, the importance of risk communication will even increase in the future. This paper starts with a discussion on the concept of medical risk information and then focusses on genetic risk information. Three examples of genetic risk information are discussed (carrier testing, susceptibility testing and pharmacogenomics testing) in order to exemplify the broad variety of types of risk information and their specific challenges for medical counselling.     

重大公共卫生危机下的健康保险应对研究

公共卫生危机对经济的影响较大,21世纪以来,面对频发的重大公共卫生危机,健康保险业如何通过科技赋能,有效参与到公共卫生安全体系建设中亟待研究对策。通过数据比较分析法、模型构建法,分析了我国商业健康保险业在防控重大疫情期间的作为、短板、机遇和挑战,并基于健康保险参与公共卫生安全体系建设的国际经验和保险科技的发展,提出了我国健康保险业应对重大公共卫生危机的一系列政策建议,以便完善现有公共卫生安全体系,助推"健康中国战略"和"可持续发展战略"的实现。     

Genetic risk and value

A conceptual truth about risks is that they involve a possible and future adverse effect or a negative value of some kind. The genetic risks that individuals may face in the health care setting differ in some crucial respects to other kind of risks. The aims of this paper are to analyse the notion of value in the context of genetic risk in the setting of health care, and to suggest a conception of the evaluative aspect of genetic risk that is fruitful for genetic risk information. Two influential and relevant approaches to value, preferentialism and the capability approach, are discussed in the light of certain distinctive features of genetic risk and a third, a sensibility theory of value is suggested. According to this view, the concept of risk is a so-called ‘thick’ evaluative concept that has both a world-guiding function as well as an action-guiding or normative function. It is argued that this provides a more promising way to think about genetic risks in the clinical setting.