Understanding Health Risks
Improve Your Chances for Good Health
\n ![\"Illustration](\"https://newsinhealth.nih.gov/files/oct2016/images/feature1.jpg\")
\n Risks are all around us. A nearby sneeze may raise your risk for catching the flu. Obesity boosts the odds you\u2019ll get diabetes. Smoking increases your risk for many cancers. And if you pay attention to news headlines, you may worry that you\u2019re at risk for food poisoning, Zika infection, shark attacks, and more. How can you know which health risks apply to you?
\nHealth risks can sometimes be confusing, but they\u2019re important to understand. Knowing the risks you and your family may face can help you find ways to avoid health problems. It can also keep you from fretting over unlikely threats. Knowing the risks and benefits of a medical treatment can help you and your doctor make informed decisions.
\n\u201cUnderstanding health risks is key to making your own health care decisions,\u201d says Dr. William Elwood, a psychologist and behavioral scientist at NIH. \u201cIt gives you perspective on potential harms and benefits, so you can make smart choices based on facts and not fears.\u201d
\nA health risk is the chance or likelihood that something will harm or otherwise affect your health. Risk doesn\u2019t mean that something bad will definitely happen. It\u2019s just a possibility. Several characteristics, called risk factors, affect whether your health risks are high or low.
\nYour personal health risk factors include your age, sex, family health history, lifestyle, and more. Some risks factors can\u2019t be changed, such as your genes or ethnicity. Others are within your control, like your diet, physical activity, and whether you wear a seatbelt.
\nWhen you see health statistics, consider the types of people being described. If they\u2019re not similar to you, or if the category is very broad, then your risks may be different. A general statement like \u201cMore than half of Americans over age 45 will develop heart disease at some point\u201d is based on statistical averages across the entire U.S. population. If you\u2019re younger than 45, your heart disease risk will generally be much lower. The more risk factors you have\u2014such as smoking, high blood pressure, or diabetes\u2014the greater your risk. Exercise and a healthy diet, on the other hand, can make your chance of developing heart disease lower than for most other people.
\n\u201cIn many ways, our perception of risk is irrational,\u201d says Elwood. \u201cWe sometimes worry over something that\u2019s extremely unlikely, like Ebola in the U.S. And we ignore steps we can take to prevent what\u2019s much more likely to harm us, like heart disease or colon cancer.\u201d
\nTalking about health risks can seem intimidating. Even doctors sometimes have trouble with risk concepts. That\u2019s why NIH supports research to improve how medical staff and others communicate health risks and prevention strategies to patients and the public.
\n\u201cMath in general is hard for a lot of people. Yet math is often hidden in everyday activities that affect our health,\u201d says Dr. Russell Rothman, a physician and scientist at Vanderbilt University in Nashville. Rothman\u2019s research focuses on helping people understand and work with numbers, so they can reduce their risks for diabetes and excess weight, including childhood obesity.
\nStudies show that the way we hear and understand health statistics can be influenced by how the numbers are described, or how they\u2019re \u201cframed.\u201d Different descriptions can affect how clear the information is and also what emotions it stirs. For example, the statement: \u201cMore than 20% of Americans will eventually die of cancer\u201d might sound less scary from a different perspective: \u201cNearly 80% of Americans will not die of cancer.\u201d The same information might seem clearer described as a ratio: \u201cMore than 1 in 5 Americans will eventually die of cancer.\u201d Research shows that pictures or diagrams are often the most understandable\u2014for instance, showing 5 human figures with 1 in a different color.
\nTo understand the potential risks or benefits of a medical treatment or behavior change, it helps to focus on a math concept called \u201cabsolute risk.\u201d Absolute risk is the chance of something happening, such as a health problem that might arise over a period of time. For example, a disease might affect 2 in 100 middle-aged men over their lifetimes. If a certain drug lowers their risk for the disease to 1 in 100, the drug has reduced their absolute risk by 1 person in 100, or 1%. Another way to think of it is that you\u2019d need to treat 100 people with this medicine to prevent just 1 additional person from getting the disease.
\nOften, however, you might hear numbers that use a related concept called \u201crelative risk.\u201d Relative risk compares the absolute risks of one group to another. In the example above, you could also say that the drug reduced the risk of disease by 50%, since 1 is half of 2. Looking at relative risk alone, you may mistakenly think that the drug is highly effective.
\n\u201cMany times, the relative risk sounds much greater than the absolute risk, which can be confusing,\u201d Rothman explains. When you hear numbers about risk, it\u2019s best to focus on the absolute risk.
\nHealth risks can be especially hard to grasp when emotions run high, such as when people are faced with a serious illness. One recent NIH-funded study found that people with advanced cancer tended to expect better outcomes and longer survival times from treatment than their doctors did. Most patients didn\u2019t realize that their outlook differed from their doctors. Such misunderstandings might affect whether patients choose to undergo harsh treatments.
\n\u201cCommunication is a 2-way street,\u201d says the study\u2019s lead researcher, Dr. Ronald M. Epstein of the University of Rochester Medical Center in New York. \u201cFor effective discussions to occur, doctors must provide encouragement and answers. And patients have to ask important questions.\u201d Epstein and colleagues are developing methods to help doctors and patients have realistic discussions about topics such as emotions, treatment choices, and likely outcomes.
\n\u201cWe\u2019ve shown it\u2019s possible to improve the conversations. It helps if patients come prepared with 3 or 4 big-picture questions to ask their doctors,\u201d Epstein says. For people with advanced cancer, questions might include: How will treatment affect my quality of life? What\u2019s the average survival time for this type of cancer?
\n\u201cIt can feel scary to ask those kinds of questions. Sometimes you don\u2019t really want to know the answers, or you have mixed feelings,\u201d Epstein says. \u201cDoctors can help by opening the door to conversation. They can say, \u2018Tell me what\u2019s on your mind. Do you have any questions?\u2019\u201d Such open conversations can help patients and their families make more informed health decisions.
\nStart by talking with your doctor about your health risks. Ask how you can reduce your risks. And look to trustworthy websites\u2014like NIH\u2019s health.nih.gov\u2014for reliable health information.
\n\n
References:
\nEffect of a Patient-Centered Communication Intervention on Oncologist-Patient Communication, Quality of Life, and Health Care Utilization in Advanced Cancer: The VOICE Randomized Clinical Trial. Epstein RM, Duberstein PR, Fenton JJ, et al. JAMA Oncol. 2016 Sep 9. doi: 10.1001/jamaoncol.2016.4373. [Epub ahead of print]. PMID: 27612178.
\nDeterminants of Patient-Oncologist Prognostic Discordance in Advanced Cancer. Gramling R, Fiscella K, Xing G, et al. JAMA Oncol. 2016 Jul 14. doi: 10.1001/jamaoncol.2016.1861. [Epub ahead of print]. PMID: 27415765.
\n\"Greenlight Study\": A Controlled Trial of Low-Literacy, Early Childhood Obesity Prevention. Sanders LM, Perrin EM, Yin HS, et al. Pediatrics. 2014 Jun;133(6):e1724-37. doi: 10.1542/peds.2013-3867. Epub 2014 May 12. PMID: 24819570.
\nPatient numeracy, perceptions of provider communication, and colorectal cancer screening utilization. Ciampa PJ, Osborn CY, Peterson NB, Rothman RL. J Health Commun. 2010;15 Suppl 3:157-68. doi: 10.1080/10810730.2010.522699. PMID: 21154091.
\n\n \n