May 28th, 2015
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Misfearing Culture, Identity, and Our Perceptions of Health RisksDuring my cardiology fellowship, I worked at a women's cardiovascular clinic where we asked every new patient the same question: What do you think is the number-one killer of women? Most women said either breast cancer or heart disease. But Ms. S., a middle-aged woman with high blood pressure and hyperlipidemia, answered in a way that sticks with me: I know the right answer is heart disease, she said, eyeing me as if facing an irresistible temptation, but I'm still going to say `breast cancer.'If helping women understand their cardiovascular risk were about right answers, I would simply have reiterated the facts about heart disease that it takes more women's lives each year than all types of cancer combined (seegraphs)Prevalence of Breast Cancer and Heart Disease among Female Americans (Panel A) and Related Mortality (Panel B).), that it is in many ways preventable, and that, despite what many women believe, multivitamins and antioxidants do not reduce the risk. But Ms. S.'s response short-circuited my statistical litany. Her sense of risk was clearly less about fact than about feeling. Would more facts really address those feelings?Data on campaigns to educate women about heart disease reinforced my sense that our efforts to provide women with the facts about heart disease were missing something critical. Although the first decade of educational campaigns led to a near d

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