Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / Understanding Risk, Living With Uncertainty

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Understanding Risk, Living With Uncertainty · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:01
  Speaker 1: This is parent data. I'm Emily Oster. Welcome back to
• 0:09
  Speaker 1: another parent data article read aloud. In the last month,
• 0:13
  Speaker 1: I've recorded podcasts with both doctor Bapu Jetta and doctor
• 0:17
  Speaker 1: Nate Fox, two people who I consider my good friends
• 0:20
  Speaker 1: and also excellent sources of risk management. Even though those
• 0:24
  Speaker 1: conversations centered around specific things like how research studies make
• 0:28
  Speaker 1: get into the news in the case of Bapu, or
• 0:31
  Speaker 1: questions about pregnancy and postpartum in the case of Nate,
• 0:34
  Speaker 1: there's an underlying thread that connects them both. What it
• 0:37
  Speaker 1: means to deal with risk and with uncertainty and not
• 0:41
  Speaker 1: lose your mind while doing it. Economists deal with this constantly,
• 0:45
  Speaker 1: and so to parents, but not in the same way.
• 0:48
  Speaker 1: Economists learn not to panic in ways that parents understandably
• 0:52
  Speaker 1: have a really hard time with. We're trained to read
• 0:54
  Speaker 1: the studies and spot their holes or their aims, their impacts,
• 0:59
  Speaker 1: and that's what today's articles about it. Yes, we live
• 1:02
  Speaker 1: in a world with scary things like trace amounts of
• 1:05
  Speaker 1: lead in cheerios, and sometimes we just feel like we
• 1:08
  Speaker 1: can't leave the house. But things that are low risk
• 1:11
  Speaker 1: are low risk no matter how scary they feel. So
• 1:14
  Speaker 1: today we're going to think about risk like an economist,
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  Speaker 1: so that we can, I hope, try to internalize it
• 1:20
  Speaker 1: as a sane parent after the break, Understanding risk, living
• 1:26
  Speaker 1: with uncertainty and what I actually worry about as a parent.
• 1:37
  Speaker 1: Understanding risk, living with uncertainty and what I actually worry
• 1:41
  Speaker 1: about as a parent. The core of my job is
• 1:45
  Speaker 1: communication about what I call panic headlines. These are headlines
• 1:50
  Speaker 1: in newspapers on Instagram that provoke panic in parents. Often
• 1:55
  Speaker 1: it's along the lines of new study says or experts claim,
• 2:00
  Speaker 1: followed by a terrifying claim screens cause developmental delays, hot
• 2:04
  Speaker 1: dogs linked with cancer. In a very large number of cases,
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  Speaker 1: the panic these produce is misplaced, and I spend a
• 2:12
  Speaker 1: lot of time talking people down. A result of this
• 2:16
  Speaker 1: is that people often ask me if there is anything
• 2:18
  Speaker 1: I do worry about. The answer is yes. My two
• 2:22
  Speaker 1: big safety worries with kids are cars and swimming pools.
• 2:26
  Speaker 1: These are both sources of sizable risk for kids, but
• 2:29
  Speaker 1: neither of them gets much panic headline coverage, likely because
• 2:33
  Speaker 1: they aren't new and surprising. Panic headlines instead tend to
• 2:39
  Speaker 1: focus on things that you aren't currently thinking about, but,
• 2:43
  Speaker 1: according to the headlines anyway should be When processing new
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  Speaker 1: panic headlines, I end up pulling heavily on my communication
• 2:52
  Speaker 1: about one of two things, risk or uncertainty. In my experience,
• 2:58
  Speaker 1: much of the panic comes from our difficulty in understanding
• 3:01
  Speaker 1: small risks and from the challenge of living with uncertainty. Today,
• 3:06
  Speaker 1: I want to flesh out both of those ideas with
• 3:09
  Speaker 1: some tools to discipline our thinking understanding risk. People are
• 3:16
  Speaker 1: extremely bad at understanding probabilities. This is especially true for
• 3:21
  Speaker 1: very small or very large probabilities. Research and economics and
• 3:25
  Speaker 1: psychology has shown us that people overestimate small probabilities and
• 3:30
  Speaker 1: underestimate large ones. Take the small probability case. Let's say
• 3:36
  Speaker 1: I tell you there is a chance that something happens
• 3:39
  Speaker 1: one in a thousand times and a chance that some
• 3:42
  Speaker 1: other event happens one in five thousand times. These are
• 3:46
  Speaker 1: actually quite different. One happens five times as often as
• 3:51
  Speaker 1: the other, but for most of us they feel similar.
• 3:55
  Speaker 1: They're both small, but they aren't zero that one. It's
• 4:01
  Speaker 1: why we play the lottery, even a chance of one
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  Speaker 1: in eighty million. You're telling me there's a chance. This
• 4:09
  Speaker 1: internal psychology causes us to process even really unlikely events
• 4:13
  Speaker 1: like the lottery as similarly likely to an event that happens,
• 4:18
  Speaker 1: say one in a thousand times. This confusion about small
• 4:22
  Speaker 1: probabilities can push us to give attention to risks that
• 4:25
  Speaker 1: may not be worth our time. I've talked in the
• 4:28
  Speaker 1: past about the risk of injury for children on airplanes.
• 4:32
  Speaker 1: A comprehensive paper estimated the risk of injury to a
• 4:36
  Speaker 1: child under two at about one in two hundred and
• 4:39
  Speaker 1: fifty thousand. Some of these injuries likely would have been
• 4:43
  Speaker 1: prevented if the child was in a car seat in
• 4:45
  Speaker 1: their own airplane seat, So purchasing a seat could lower
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  Speaker 1: the injury risk by as much as one in two
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  Speaker 1: hundred and fifty thousand, assuming all injuries would have been prevented.
• 4:58
  Speaker 1: A gut reaction to this one I got on Instagram
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  Speaker 1: is to say any risk reduction is worth it for
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  Speaker 1: your child. I can see the logic here, but the
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  Speaker 1: reality is that this risk is just extremely small. The
• 5:12
  Speaker 1: annual risk of car accident injury for a child under
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  Speaker 1: fourteen is about one in five hundred. The annual risk
• 5:19
  Speaker 1: of a cancer diagnosis for a child under five is
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  Speaker 1: about one in four thy five hundred. Does this mean
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  Speaker 1: you shouldn't use a car seat on an airplane. No.
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  Speaker 1: If you want to go ahead, and there may be
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  Speaker 1: other reasons to do so, but making a good decision
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  Speaker 1: about trade offs here does require actually understanding the size
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  Speaker 1: of the risk. How to conceptualize risk. Risk is not
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  Speaker 1: intuitive to people, even for people who do this as
• 5:50
  Speaker 1: their job. It's not something our brains naturally get, which
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  Speaker 1: means you need to actively find approaches that work for
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  Speaker 1: you to turn probably into something concrete that you can understand.
• 6:04
  Speaker 1: The two approaches I like the best other common comparisons
• 6:08
  Speaker 1: and a conversion to time. First other comparisons. A simple
• 6:14
  Speaker 1: way to think about risk is to ask what other
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  Speaker 1: events occur with this probability. It's not an exact science,
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  Speaker 1: but we can often get some context for probabilities. For example,
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  Speaker 1: one in two hundred and fifty thousand is on the
• 6:29
  Speaker 1: lower end of the estimated risk of being killed by
• 6:32
  Speaker 1: a meteorite. A related form of this comparison is to
• 6:36
  Speaker 1: take some risk that you do feel comfortable understanding, like
• 6:40
  Speaker 1: the risk of car accidents, and use it as a benchmark.
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  Speaker 1: A second option time. This is my go to convert
• 6:49
  Speaker 1: risks into time, as in, if I took this risk
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  Speaker 1: every single day, how long would it take before I
• 6:56
  Speaker 1: would expect the event to happen once. For something with
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  Speaker 1: a risk of one in ten, you'd expect it about
• 7:02
  Speaker 1: every ten days. For a risk of one in one hundreds,
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  Speaker 1: more like every three months, one in a thousand, every
• 7:08
  Speaker 1: three years. For comparisons like one in one thousand versus
• 7:13
  Speaker 1: one in five thousand, that's every three years versus every
• 7:17
  Speaker 1: fifteen years, and those feel, at least to me very different.
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  Speaker 1: Note a daily risk of one in two hundred and
• 7:26
  Speaker 1: fifty thousand translates to once every six hundred and eighty
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  Speaker 1: four years. Bottom line on risk. A lot of panic
• 7:34
  Speaker 1: ensues when we do not correctly conceptualize risks, especially when
• 7:39
  Speaker 1: they are small. The first step is to discipline your
• 7:42
  Speaker 1: risk thinking living with uncertainty. Although we often use them interchangeably,
• 7:56
  Speaker 1: risk and uncertainty are different. Risk means a defined chance
• 8:02
  Speaker 1: of something happening or not. You may be uncertain about
• 8:05
  Speaker 1: which outcome will occur, but you are certain about the
• 8:09
  Speaker 1: possible outcomes and their probabilities of happening. Uncertainty, at least
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  Speaker 1: formally to an economist, means we do not even know
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  Speaker 1: the probabilities that we're facing, and sometimes we don't know
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  Speaker 1: what the possible outcomes are. With uncertainty, we often cannot
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  Speaker 1: even get our heads around what we are facing, and
• 8:29
  Speaker 1: that's a bigger challenge than understanding probabilities. A great example
• 8:34
  Speaker 1: of a panic headline driven by uncertainty was Costco sued
• 8:38
  Speaker 1: for toxic chemicals in its baby wipes. The story behind
• 8:43
  Speaker 1: this is a class action suit that claims two high
• 8:46
  Speaker 1: levels of the forever chemical p fas were found in
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  Speaker 1: a widely used Costco brand of baby wipes. This headline
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  Speaker 1: has uncertainty on many levels. It's not clear to what
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  Speaker 1: degree we should be worried about pfas in general, what
• 9:00
  Speaker 1: the risks are, how large they are. It's not clear
• 9:03
  Speaker 1: what the levels are in the wipes. It's not clear
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  Speaker 1: how much the wipes would actually transfer p fast to
• 9:09
  Speaker 1: a baby. In the absence of these answers, we fill
• 9:13
  Speaker 1: in with often worst case scenarios. It's easy to think
• 9:17
  Speaker 1: this must be serious. It's a lawsuit, though it's worth
• 9:20
  Speaker 1: remembering that there are a lot of reasons to file
• 9:23
  Speaker 1: class action lawsuits, and these same filers have other ongoing
• 9:26
  Speaker 1: lawsuits against Costco. Precisely because there is so much uncertainty,
• 9:32
  Speaker 1: we cannot put these fears to rest with facts or logic.
• 9:36
  Speaker 1: Thinking about it more will not help. A similar case
• 9:42
  Speaker 1: can be made for many of the headlines we see
• 9:43
  Speaker 1: about screen time for little kids. You read something like
• 9:47
  Speaker 1: screen time linked to developmental delays, and there are a
• 9:51
  Speaker 1: million questions what kind of delays? There's no clear way
• 9:55
  Speaker 1: to translate many of the metrics in these papers into
• 9:57
  Speaker 1: real world outcomes, for which chill. Most of these studies
• 10:01
  Speaker 1: have heterogeneity across kids, what kind of screens? That's almost
• 10:05
  Speaker 1: never measured, And then people like me come along and
• 10:09
  Speaker 1: tell you, hey, actually, those studies just show correlation, not causation.
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  Speaker 1: It's entirely possible that there's literally no effect at all
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  Speaker 1: at anyone, but we can't know for sure because the
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  Speaker 1: study is enabled to show us. It's uncertainty piled on uncertainty.
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  Speaker 1: Unlike with risk, there aren't good tools for unpacking uncertainty.
• 10:33
  Speaker 1: As noted, thinking more will not help. What we may
• 10:36
  Speaker 1: have are tools for disciplining our interactions with these problems.
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  Speaker 1: A first tool. Remember that in nearly all of these cases,
• 10:46
  Speaker 1: all of the ones that come to mind, like ultra
• 10:48
  Speaker 1: processed foods, microplastics, p fast screen time, the risks we
• 10:52
  Speaker 1: are talking about are definitely small if screen time caused
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  Speaker 1: enormous developmental delays in most children, or even a small share,
• 11:01
  Speaker 1: we would likely know it small is than a number.
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  Speaker 1: But I do think it's useful to keep in perspective
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  Speaker 1: that a bag of Dorito's, or an Apple sauce pouch,
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  Speaker 1: or a brand of wipes, or even an hour a
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  Speaker 1: day of television is extremely unlikely to matter much in
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  Speaker 1: the grand scheme of things. A second tool ask yourself, what,
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  Speaker 1: if anything, can I do about this, and how hard
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  Speaker 1: would it be to do it? Sometimes there is an
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  Speaker 1: easy change that can remove the fears. If there is
• 11:31
  Speaker 1: another equal priced brand of wipes that you're indifferent about,
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  Speaker 1: you may as well switch. Often though there really isn't
• 11:38
  Speaker 1: anything realistic you can do. Think of et panic headlines about, say,
• 11:42
  Speaker 1: microplastics in the water supply. Moving away from the municipal
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  Speaker 1: water supply is not a feasible option for most of us.
• 11:50
  Speaker 1: We can advocate and vote for more water supply regulations,
• 11:54
  Speaker 1: but at the end of the day, we have to
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  Speaker 1: realize that right now, this is a risk we have
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  Speaker 1: to live with. Understand that this may sound callous and defeatist,
• 12:03
  Speaker 1: but spiraling anxiety doesn't actually help fix any problems. The
• 12:08
  Speaker 1: hardest cases are ones where there is something you could
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  Speaker 1: change but it would make other things worse. You could
• 12:14
  Speaker 1: quit screen time cold turkey, but it would make your
• 12:16
  Speaker 1: life much harder and mean more frustration with your kids.
• 12:19
  Speaker 1: You could switch wipes, but it would cost more and
• 12:21
  Speaker 1: your kid would like them less, making diaper changes less fun,
• 12:25
  Speaker 1: and eating into funds they could be used for other things.
• 12:28
  Speaker 1: I would offer you the mantra. People face trade offs.
• 12:32
  Speaker 1: No option is perfect or without downsides. You have to
• 12:36
  Speaker 1: pick one and move forward. Ultimately, this is about living
• 12:41
  Speaker 1: with uncertainty. You will almost certainly never know whether you
• 12:45
  Speaker 1: made the right choice in any of these many many situations.
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  Speaker 1: Often all we can do is embrace the uncertainty and
• 12:52
  Speaker 1: try to move on.