The parameters of risk

Since risk, and attempts at risk assessment, are so fundamental to the colonising of the future, the study of risk can tell us much about core elements of modernity. Several factors are involved here: a reduction in life-threatening risks for the individual, consequent on large tracts of security in daily activity purchased by abstract systems; the construction of institutionally bordered risk environments; the monitoring of risk as a key aspect of modernity's reflexivity; the creation of high-consequence risks resulting from globalisation; and the operation of all this against the backdrop of an inherently unstable `climate of risk'.

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Preoccupation with risk in modern social life has nothing directly to do with the actual prevalence of life-threatening dangers. On the level of the individual lifespan, in terms of life expectation and degree of freedom from serious disease, people in the developed societies are in a much more secure position than most were in previous ages. In the late eighteenth century in Britain, at that time the most economically advanced society in the world, deadly epidemics which killed hundreds of thousands of people were still commonplace. A proliferation of endemic illnesses had to be endured, even when they were not necessarily fatal. Many had cause to observe: ⁸

The weariness, the fever and the fret,
Here, where men sit and hear each other groan,
Where palsy shakes a few sad last grey hairs,
Where youth grows pale, and spectre-thin, and dies.

Only since the early twentieth century have sufficient statistics been available to chart out with any precision the changes which have affected life-threatening outcomes. A study which took the year 1907 as its point of departure showed that at that time newborn infants `stepped into a minefield' ⁹ (although rates of infant mortality had been vastly reduced as compared to a century before). On a chart for 1907, about one in seven died in the first year of life, as contrasted to one in sixty-seven on a 1977 chart taken as a basis for comparison. The list given below records some of the most important risk-reducing advances relevant to health which occurred during the years 1907-77 - that is, the years spanning the life of a seventy-year-old in 1977:

Safe drinking water
Sanitary sewage disposal
Hygienic food preparation
Pasteurised milk
Refrigeration
Central heating
Scientific principles of nutrition widely applied
Scientific prinicples of personal hygiene widely applied
Eradication of major parasitic diseases, including malaria
Rodent and insect control
Continually improved prenatal and postnatal care

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Continually improved care of babies and infants
Continually improved care of infectious diseases
Continually improved surgical treatment
Continually improved anaesthesia and intensive care
Scientific principles of immunisation widely applied
Blood transfusion made practical
Organisation of intensive care units in hospitals
Continually expanded and improved diagnostic procedures
Continually improved treatment of cancer
Continually improved treatment of occlusive arterial disease
Planned parenthood made feasible and practical
Improved and legalised methods for interrupting pregnancy
Safety in the workplace widely accepted
Safety belts in cars
Continually improved methods for preserving teeth, vision and hearing
Smoking, obesity, high blood pressure and sedentary life recognized as damaging to health. ¹⁰

We cannot tell in full how far each of the items on this list has affected the changes highlighted in the 1907-77 comparison, since the full impact of some, or even many, of them may only be felt by subsequent generations. Against such risk-reducing changes, moreover, we have to place a considerable number of negative influences. Two world wars, involving massive destruction of life, have occurred during the lifetime of the 1907 generation. Risk of death or serious injury from car crashes has increased steadily over most of this period. From the 1930s to the late 1960s, this generation consumed many drugs that, by current standards, were inadequately tested before being made available. The members of this generation drank a great deal of alcohol, and smoked millions of tobacco goods, before the toxic effects of these were fully realised; environmental pollution, believed by many medical specialists to increase susceptibility to major diseases of various sorts, has sharply increased; and for much of their lives they have eaten food containing many additives and treated by chemical fertilisers, with consequences for health that are at best unknown and at worst may help produce some of the leading killer diseases.

In terms of basic life security, nonetheless, the risk-reducing elements seem substantially to outweigh the new array of risks.

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There are various ways in which this can be tentatively assessed. One is by calculating how the 1907 cohort actually fared with how it would have fared if the major known life-threatening risks pertaining in 1907 had continued to prevail through the lifetimes of those born in that year -- a speculative calculation, but one that can be undertaken with a reasonable degree of statistical backing. Such a calculation indicates no differential, in terms of survival percentages, up to age twenty. After this age, the curve of actual survival begins to rise above the curve given by the newly constructed data in a progressive way, the more so in the later period.

Comparisons can also be made between the 1907 chart and that of 1977 by contrasting life expectancies of the 1907 group with those predicted for the 1977 generation. These show a substantial divergence, starting from the very first year of life and up to old age, in favour of the 1977 cohort (although, of course, we have no way of knowing fully what additional factors might influence life- threatening risks for that generation in years to come).

Risk concerns future happenings -- as related to present practices -- and the colonising of the future therefore opens up new settings of risk, some of which are institutionally organised. In relatively minor contexts such settings have always existed, for instance in the culturally widespread case of gambling. Occasionally there have been organised risk environments in non-modern cultures where no equivalent institutionalised forms are found in modern social life. Thus Firth describes an institutionalised type of attempted suicide in Tikopia. ¹¹ It is accepted practice for a person with a grievance to put out to sea in a canoe. Since the waters are treacherous, there is a substantial chance that the individual will not survive the experience; chances of survival are also affected by how quickly others in the community notice and respond to the person's absence. While this risk-taking endeavour clearly bears some affinities with risk-taking in suicide attempts in modern settings, in the second of these the institutionalized element is lacking. ¹²

For the most part, however, institutionally structured risk environments are much more prominent in modern than pre- modern societies. Such institutionalised systems of risk affect virtually everyone, regardless of whether or not they are `players' within them -- competitive markets in products, labour power,

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investments or money provide the most significant example. The difference between such institutionalised systems and other risk parameters is that they are constituted through risk, rather than certain risks being incidental to them. Institutionalised risk environments link individual and collective risks in many ways -- individual life chances, for instance, are now directly tied to the global capitalistic economy. But in relation to the present discussion they are most important for what they reveal about how the future is colonised.

Take the stock exchange as an example. The stock exchange is a regulated market which provides a range of securities (an interesting term in itself) that borrowers issue and savers hold, creating a choice of ways of structuring the risks of both borrowers and savers in their objective of achieving financial gain. It also has the effect of valuing securities in relation to their expected returns, taking into account investors' risks. ¹³ Savers and borrowers have a variety of financial desiderata. Some savers want to accumulate money in the long term, while others are looking for more short-term gains and may be prepared to take considerable risks with their capital with this end in view. Borrowers normally want money for the long term, but a certain risk of loss on the part of lenders is unavoidable. In the stock market, investors can choose from a range of risks and modes of hedging against them, while borrowers can seek to adjust the terms of their received capital against the risks of the business endeavours for which they utilise it. The stock market is a theorised domain of sophisticated reflexivity -- a phenomenon which directly influences the nature of the hazards of saving and borrowing. Thus studies indicate that price-earnings ratios seem to be poor predictors of subsequent earnings or dividend growth. Some theories applied in stock market investment take this as evidence that the stock market cannot identify which companies will utilise scarce financial resources most satisfactorily, and calculate risk strategies accordingly. Others hold that retention of earnings, plus other specifiable factors, account for this finding, and adopt correspondingly different strategies. A measure of the reflexive complexity of such a situation is provided by the fact that retention policies themselves are likely to be influenced by the type of theory adopted. ¹⁴

Stock markets, like other institutionalised risk environments, use risk actively to create the `future' that is then colonised. This

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is well understood by participants. One of the best illustrations of this is the specific existence of futures markets. All savings and borrowings create possible future worlds through the mobilising of risk. But futures markets mortgage the future in a direct fashion, securing a bridgehead in time that offers a peculiar security for certain types of borrowers.

The reflexive monitoring of risk is intrinsic to institutionalised risk systems. In respect of other risk parameters it is extrinsic, but no less fundamental for life chances and life-planning. A significant part of expert thinking and public discourse today is made up of risk profiling -- analysing what, in the current state of knowledge and in current conditions, is the distribution of risks in given milieux of action. Since what is `current' in each of these respects is constantly subject to change, such profiles have to be chronically revised and updated.

Consider `what we die of' -- representing the major risks associated with mortality. <sup>15</sup> Risk profiling of the main life- threatening illnesses shows major differences between the turn of the century and the present-day in the developed countries. By 1940 infectious diseases like tuberculosis, nephritis or diphtheria had dropped out of the top ten causes of death. Deaths attributed to heart disease and cancer moved into first and second place after 1940, where they have stayed. The main reason for this change is thought to be the greater proportion of people living to age fifty or more, but this view is challenged by some who hold dietary and environmental factors responsible. One should note that the concepts used to identify the major causes of death have changed substantially since 1900. What was first generally termed `intracranial lesions of vascular origin' at the turn of the century became `vascular lesions affecting the central nervous system' in the 1960s, and has since altered to `cerebrovascular diseases'. Such changes are more than fads: they reflect alterations in medical outlook towards the pathologies in question.

Some two-thirds of the population over thirty-five years of age in countries with high rates of coronary heart disease, like Britain or the United States, are believed to have some degree of narrowing in their coronary arteries, although not enough to bring about distinct pathological symptoms or changes in an electrocardiogram. Each year, about one person in eighty over the age of thirty-five has a heart attack, although only a certain

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proportion of these are fatal. Heart disease is more common in men than women, although the gap is closing. In the United States and one or two other countries, after a steady increase for many years, the rate of deaths due to coronary heart disease has begun to drop. There is much debate as to why this is so; it may be due to changes in diet, improved emergency care, a decrease in smoking or greater adult participation in regular exercise. It is generally agreed that lifestyle factors of one kind or another strongly influence the risk of contracting heart disease. There is a good deal of comparative evidence on the issue. Thus Japan has the lowest rate of coronary heart disease of any of the industrialized societies. The children and grandchildren of Japanese immigrants to the United States, however, have rates of the disease comparable to that of the US, not Japan. Yet it is not at all clear what influence diet, as compared to other aspects of lifestyle, has in the aetiology of heart illnesses. France, for example, reports low rates of death from coronary heart disease, although the French diet is high in the substances thought to produce it.

Cancer is not a single disease entity, at least in respect of the risks of death associated with it. From the turn of the century, the different forms of the disease have followed divergent paths. For instance, there has been a steady increase in rates of death from lung cancer since about 1930, the continuation of that increase presumably being due to the delayed effects of the widespread popularity of smoking until about the late 1960s. On the other hand, there has been a steady drop in some other types of cancer. The experts disagree about why this is so. They also disagree about whether or not, or to what degree, diet and environmental factors play a part in the onset of the disease.

The regular and detailed monitoring of health risks, in relation to information such as that just described, provides an excellent example, not just of routine reflexivity in relation to extrinsic risk, but of the interaction between expert systems and lay behaviour in relation to risk. Medical specialists and other researchers produce the materials from which risk profiling is carried out. Yet risk profiles do not remain the special preserve of the experts. The general population is aware of them, even if it is often only in a rough and ready way, and indeed the medical profession and other agencies are concerned to make their findings widely available to laypeople. The lifestyles followed by

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the population at large are influenced by the reception of those findings, although there are normally class differences in the altering of behaviour patterns, with professional and more highly educated groups in the lead. Yet the consensus of expert opinion -- if there is any such consensus -- may switch even as the changes in lifestyle they called for previously become adopted. We might recall that smoking was once advocated by some sectors of the medical profession as a relaxant; while red meat, butter and cream were said to build healthy bodies.

Medical concepts and terminologies change as theories are revised or discarded. Moreover, at any one time, there is substantial, sometimes radical, disagreement within the medical profession about risk factors as well as about the aetiology of major health hazards. Even with illnesses as serious as coronary heart disease and cancer, there are many practitioners of alternative medicine -- some of whom are now taken much more seriously by orthodox medical specialists than used to be the case -- who dispute the more mainline positions. The assessment of health risks is very much bound up with `who is right' in these disputes. For although a risk profile drawn up at any one point in time looks objective, the interpretation of risk for an individual or category of individuals depends on whether or not lifestyle changes are introduced, and how far these are in fact based on valid presumptions. Once set up, a lifestyle sector -- say, the following of a particular diet -- may be quite difficult to break, because it is likely to be integrated with other aspects of a person's behaviour. All these considerations influence the reflexive adoption by laypeople of risk parameters as filtered through abstract systems. In the face of such complexity, it is not surprising that some people withdraw trust from virtually all medical practitioners, perhaps consulting them only in times of desperation, and stick doggedly to whatever established habits they have formed for themselves.

In contrast to health dangers, high-consequence risks by definition are remote from the individual agent, although -- again, by definition -- they impinge directly on each individual's life chances. It would clearly be a mistake to suppose that people living in modern social conditions are the first to fear that terrible catastrophes might befall the world. Eschatological visions were quite common in the Middle Ages, and there have been other

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cultures in which the world has been seen as fraught with massive hazards. Yet both the experience and nature of such hazardous visions are in some respects quite distinct from the awareness of high-consequence risks today. Such risks are the result of burgeoning processes of globalisation, and even half a century ago humanity did not suffer from the same kind of threat.

Such risks are part of the dark side of modernity, and they, or comparable risk factors, will be there so long as modernity endures -- so long as the rapidity of social and technological change continues, throwing off unanticipated consequences. High-consequence risks have a distinctive quality. The more calamitous the hazards they involve, the less we have any real experience of what we risk: for if things `go wrong', it is already too late. Certain disasters give a taste of what could happen -- such as the nuclear accident at Chernobyl. As with many such issues, experts are not fully in agreement about what the long- term effects of the escaped radiation from that accident might be on the populations of the countries it affected. It is generally thought to have increased the risks of certain types of disease in the future, and of course has had devastating consequences for the people most immediately affected in the Soviet Union. But it is inevitably counterfactual guesswork to estimate what the out- come of a larger nuclear disaster might be -- let alone a nuclear conflict, even a relatively small-scale one.

Risk assessment endeavours in the case of high-consequence risks have to be correspondingly different from those concerned with risks where outcomes can be regularly observed and monitored -- although these interpretations have to be constantly revised and updated in the light of new theories and information. The thesis that risk assessment itself is inherently risky is nowhere better borne out than in the area of high-consequence risks. A common method used in the attempted calculation of risks of nuclear reactor accidents is the design of a fault tree. A fault tree is drawn up by listing all known pathways to possible reactor failure, then specifying the possible pathways to those pathways, and so on. The end result, supposedly, is a fairly precise designation of risk. The method has been used in studies of reactor safety in the United States and several European countries. Yet it leaves various imponderables. ¹⁶ It is impossible to make a confident calculation of the risk of human error or sabotage. The Chernobyl

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disaster was the result of human error, as was, at an earlier period, the fire at one of the world's largest nuclear stations at Brown's Ferry in the United States. The fire first started because a technician used a candle to check for an air leak, in direct contravention of established procedures. Some pathways to potential disaster might not be noticed at all. They have been missed on many occasions in more minor risk settings, and for high-consequence risks dangers have sometimes been spotted only by retroactive revisions of data and assumptions. This happened in a hypothetical setting when a study by the American National Academy of Sciences was convened to determine the risks to the food supply given an exchange of nuclear warfare of a certain intensity. The panel carrying out the study concluded that the resulting reduction in the earth's ozone layer would not threaten the survivors' food resources, as many crops that would survive in the atmosphere of increased ultraviolet radiation would continue to be cultivated. No one among the panel noticed, however, that the raised radiation level would make it virtually impossible to work in the fields to grow these crops. ¹⁷

High-consequence risks form one particular segment of the generalised `climate of risk' characteristic of late modernity -- one characterised by regular shifts in knowledge-claims as mediated by expert systems. As Rabinowitch observes: `One day we hear about the danger of mercury, and run to throw out cans of tuna fish from our shelves; the next day the food to shun may be butter, which our grandparents considered the acme of wholesomeness; then we have to scrub the lead paint from the walls. Today, the danger lurks in the phosphates in our favourite detergent; tomorrow the finger points to insecticides, which were hailed a few years ago as saviours of millions from hunger and disease. The threats of death, insanity and -- somehow even more fearsome -- cancer lurk in all we eat or touch.' ¹⁸ That was written some twenty years ago: since then, further contaminated traces have been found in tuna fish, some types of detergent believed safe in the early 1970s have been banned, while some doctors now say that it is more healthy to eat butter than the low-fat margarines which were previously widely recommended as preferable.

The point, to repeat, is not that day-to-day life is inherently more risky than was the case in prior eras. It is rather that, in conditions of modernity, for lay actors as well as for experts in

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specific fields, thinking in terms of risk and risk assessment is a more or less ever-present exercise, of a partly imponderable character. It should be remembered that we are all laypeople in respect of the vast majority of the expert systems which intrude on our daily activities. The proliferation of specialisms goes together with the advance of modern institutions, and the further narrowing of specialist areas seems an inevitable upshot of technical development. The more specialisms become concentrated, the smaller the field in which any given individual can claim expertise; in other areas of life she or he will be in the same situation as everyone else. Even in fields in which experts are in a consensus, because of the shifting and developing nature of modern knowledge, the `filter-back' effects on lay thought and practice will be ambiguous and complicated. The risk climate of modernity is thus unsettling for everyone; no one escapes.

Date: 2016-04-22; view: 644