Communicating risk for issues that involve ‘uncertainty bias’: what can the Israeli case of water fluoridation teach us?

Water fluoridation is a controversial issue in public health. Despite the uncertainty regarding its efficacy and safety, health officials continue to communicate it as ‘unequivocally’ safe and effective. Our focus is on how health officials and policy-makers in Israel frame the issue of water fluoridation in terms of certainty while promoting a mandatory fluoridation policy. According to van Asselt and Vos, the uncertainty paradox describes situations in which uncertainty is acknowledged, but the role of science is framed as providing certainty. Our study is an analysis of documents and media articles emphasizing the paradoxical language used by official representatives on the controversial topic of fluoridation. A central contribution of this study is that we coin the term ‘uncertainty bias,’ in which policy-makers do exactly what they accuse laypeople of doing, framing uncertainty in biased terms. We found that in order to establish mandatory regulation, health ministry officials expressed information in an unbalanced format, promoting the topic of fluoridation by framing it in exclusively positive terms. This study does not focus on the practice of water fluoridation per se, and is not intended to decide for or against it, but rather, to explore how the debate regarding it is communicated. Understanding this particular case can shed light on how other controversial topics are transformed into health policy that is characterized in equivocal terms.     

A Note on Deductible Insurance and Production

This paper examines the optimal production decision of a firm facing revenue risk. We show that the purchase of actuarially fair deductible insurance unambiguously induces the firm to produce more if the firm is not only risk averse but also prudent. If the firm's perferences satisfy constant absolute risk aversion, buying actuarially unfair deductible insurance unambiguously enhances production should the positive loading factor be sufficiently small. When there are moral hazard problems in that the firm's output cannot be contracted upon, we show that the purchase of actuarially fair deductible insurance unambiguously induces the firm to produce more if the firm's utility function is quadratic.     

Science vs. fear: the Ebola quarantine debate as a case study that reveals how the public perceives risk

This study focuses on newspaper coverage of the Hickox quarantine incident, using it as a case study to examine how the media characterized the spread of disease in an ongoing crisis situation characterized by uncertainty. The study builds on Slovic et al.’s research, who argue that risk perception is comprised of both emotional and analytical aspects. We employed a qualitative approach, first examining articles on Hickox’s story in The New York Times and New York Daily News between October 25 and 31, 2014; and second, readers’ comments in response to these articles. The findings from the newspaper articles show that in their treatment of the quarantine debate, the media did not address the issue of uncertainty, and thus continued the health authorities’ neglect of this issue. Although the media gave expression to various sides of the debate, it emphasized those who objected to the quarantine policy, thus raising the claim that the conflict was between ‘science’ and the public’s ‘irrational fears,’ and that the governors decided on quarantine in response to the public’s panic and fears. From our analysis of readers’ comments, it appears that these claims are unjustified. First, we found that the public did not speak in a single unified voice, but rather, was divided into supporters and opponents of quarantine. Both sides used scientific arguments and resorted to similar terminology, and tended to cite and present studies backing their arguments. As for irrational fears, although quarantine supporters expressed emotions, they indicated mainly concerns, not panic or hysteria.     

Why do parents who usually vaccinate their children hesitate or refuse? General good vs. individual risk

This study examines vaccination hesitancy or refusal following the 2013 polio outbreak in Israel, based on two theoretical models. The first is Sandman’s theoretical model, which holds that risk perception is comprised of hazard plus outrage. The second model is the affect heuristic that explains the risk/benefit confounding. It aims to expose the barriers that inhibited parental compliance with OPV vaccination for their children. The study employed mixed methods – a questionnaire survey (n = 197) and content analysis of parents’ discussions in blogs, Internet sites, and Facebook pages (n = 2499). The findings indicate that some parents who normally give their children routine vaccinations decided not to give them OPV due to lack of faith in the health system, concerns about vaccine safety and reasons specific to the polio outbreak in Israel. Some vaccinated due to a misunderstanding, namely, they believed that OPV was supposed to protect their children, when it was actually for overall societal well-being. This study highlights the difficulty of framing the subject of vaccinations as a preventive measure, especially when the prevention is for society at large and not to protect the children themselves. The findings of this study are important because they provide a glimpse into a situation that can recur in different places in the world where a disease considered to have been ‘eradicated’ returns, and the public is required to take measures which protect the public but which might put individuals at risk. The conclusions from the analysis of the findings of this study are that the public’s risk perception is based on a context-dependent analysis, which the communicating body must understand and respect.     

Stochastic Dominance of Pension Plans

We compare different possibilities to reform a funded pension plan, whose balance is threatened by a decrease in mortality rates. Since the plan is mandatory, the welfare of employees might be reduced if contributions increase or if the retirement age is raised. An empirical study of Israeli data shows that a reform which decreases the pension benefits is the optimal strategy, compared with the options of increasing the retirement age or increasing pension fund contributions. We also show that giving employees freedom to choose their retirement age and induced pension benefits is the optimal policy and increases the welfare of employees.