We may be hard-wired to panic about minor threats such as swine flu and ignore real dangers, writes John Watson.
THINK of each "threat", be it terrorism, asylum seekers, SARS, bird flu and now swine flu: how many deaths in Australia has each of these caused? None. Smoking, cars, ordinary flu — these cause thousands of preventable deaths every year and we shrug them off. The disparity between the impacts of threats and the panic they cause is remarkable. Even globally, with the exception of terrorism or, rather, the conflicts it has triggered, the tolls are strikingly small by comparison to the threats that are most likely to kill us.
SARS killed 9.6 per cent of those infected, but the threat that paralysed the world killed no more than 774 people, most of them in China, where authorities were slow to react. Then came bird flu, which since 2003 has caused 421 confirmed human cases with 257 deaths. Again, limited infectiousness meant the deaths were confined to a few countries. Now swine flu is thought to have killed 159 people out of a suspected 2498 cases in Mexico, although the World Health Organisation yesterday cautioned that only seven deaths and 79 cases were confirmed.
Mexico is a country of great inequality, with high rates of malnutrition and diabetes in a crowded population, making its people highly vulnerable. In the neighbouring US, which has 64 confirmed cases and hundreds suspected, no one has died yet. One cannot discount the risk of a pandemic, and people's fear of the unknown is powerful. Yet when Prime Minister Kevin Rudd talks about swine flu being a "serious international concern for public health" and vows to use all available resources to counter it, one has to wonder why the world's really big preventable killers barely register.
Each panic about relatively minor or remote risks diverts attention and resources from tackling threats that we know will kill millions year after year. According to the WHO, nearly 2 billion people — a third of the world's population — are infected with tuberculosis. About 5 to 10 per cent go on to develop full-blown TB, which kills about 2 million people a year. AIDS has infected more than 33 million people, including 2.5 million children, and killed about 2.1 million in 2007. In low to middle-income countries, fewer than one in three HIV-positive people receives antiviral therapy. Malaria causes about 250 million cases of fever and about 1 million deaths a year. Even the simple tragedy of diarrhoea as a result of poor sanitation and malnutrition kills about 1.8 million a year. Each day, about 25,000 children die of infectious disease and hunger.
These are not potential pandemics; they are happening now. Even run-of-the-mill flu infects 3-5 million people and kills 250,000 to 500,000 in a typical year, including about 2000 in Australia. Yet none of these threats causes alarm in Australia. Arguably, an assessment of the potential danger suggests they should. TB, for example, is highly infectious and strains have emerged that are resistant to all major drugs. From 2000 to 2004, 20 per cent of reported TB cases were resistant to standard treatments and 2 per cent were resistant to second-line drugs. If TB is not treated, the mortality rate is 50 per cent. The US reports 25,000 new TB cases each year. Of these, 40 per cent are immigrants from countries such as Mexico, where 2.4 per cent of TB cases involve multidrug-resistant strains.
The question, then, is why do the deaths of only some people from obscure diseases cause us to panic? And how can we be so unfeeling when we have the power to save the lives of millions by relatively simple, inexpensive precautions and treatments? The answer possibly lies in the profound hold that stereotypes have over our assessment of threats and our ability to empathise with others. Recent psychological research, including the mapping of brain activity, has established that stereotypes have a very powerful hold over us.
The world is a complex place, full of threats and opportunities. At its most primal level, we quickly need to make sense of these by sorting friend from foe. We are mentally wired to judge by appearances, to categorise on the basis of past experience or conditioning. On a very basic level, this means we almost instantly, automatically and unconsciously decide where people fit into our world. A New York Times article on stereotyping quotes assistant professor of psychology David Amodio, of New York University, as explaining: "People recruit stereotypes to kind of help them plan a world that's consistent with the goal they might have." Our brains rely on stereotypes because they can give us broadly accurate information, but even when contradictions arise we tend to ignore them and hold to the stereotype.
Princeton professor of psychology and neuroscience Susan Fiske offers an insight into why Australians couldn't help but rally to the aid of homeless bushfire victims — "people like us" — while remaining strikingly indifferent to the 100,000 or so people who are homeless on any given night. Her research suggests that people of low status register differently in the brain. "The part of the brain that normally activates when you are thinking about people is surprisingly silent when you're looking at homeless people. It's a kind of neural dehumanisation." The normal neural response is only restored, she said, when people are asked to think about what soup the homeless person might like to eat, which requires them to think about them as a person with human wants and needs. Similarly, when we are confronted by cases that break the conventions of the stereotype, such as the former executive who finds himself homeless, our empathy is engaged.
The power of stereotypes would also explain the irrational difference in our attitudes to asylum seekers who arrive by boat and those who arrive by air. Fewer than 40 per cent of "aeroplane people", who vastly outnumber "boat people", succeed in their asylum claims, but their arrival causes no great public concern or resentment. More than 90 per cent of boat people have proven to be genuine refugees, yet the Howard government's claim that the "threat" amounted to a "national emergency" was readily accepted. Boat people fit the stereotype.
As for swine flu, bird flu and SARS, it seems that only when we perceive that infectious diseases threaten "people like us" do we respond with real urgency. The millions killed by TB, AIDS, malaria and other mass killers are doomed to fit the stereotype of people who live and die like that. We can accept it as the way of the world. Aboriginal Australians are just as much victims of the indifference that flows from such stereotyping. Stereotypes matter, but not everyone is prisoner to the irrationality they can inspire. Being conscious of the power of stereotypes to sway the responses of individuals and governments is the first step to reducing them to a useful mental tool, rather than succumbing to a dangerously distorting trap of the mind.
John Watson is a senior writer.