[We always suspected it was true metaphorically and metapsychologically. It might actually be literally true.]
http://www.nytimes.com/2008/01/15/science/15tier.html
The New York Times
January 15, 2008
Findings
Living in Fear and Paying a High Cost in Heart Risk
By JOHN TIERNEY
Which is more of a threat to your health: Al Qaeda or the Department of
Homeland Security?
An intriguing new study suggests the answer is not so clear-cut.
Although it's impossible to calculate the pain that terrorist attacks
inflict on victims and society, when statisticians look at cold
numbers, they have variously estimated the chances of the average
person dying in America at the hands of international terrorists to be
comparable to the risk of dying from eating peanuts, being struck by an
asteroid or drowning in a toilet.
But worrying about terrorism could be taking a toll on the hearts of
millions of Americans. The evidence, published last week in the
Archives of General Psychiatry, comes from researchers who began
tracking the health of a representative sample of more than 2,700
Americans before September 2001. After the attacks of Sept. 11, the
scientists monitored people's fears of terrorism over the next several
years and found that the most fearful people were three to five times
more likely than the rest to receive diagnoses of new cardiovascular
ailments.
Almost all the people in the study lived outside New York or Washington
and didn't know any victims of the Sept. 11 attacks. But more than a
10th of them reported acute stress symptoms (like insomnia or
nightmares) right after the attacks, and over the next three years more
than 40 percent said they kept worrying about a terrorist attack
affecting themselves or a family member.
Their worries were understandable, given the continual warnings from
Washington. Officials repeatedly raised the color-coded level of the
National Threat Advisory and sometimes explicitly warned of imminent
attacks from terrorist cells supposedly operating in America. The alert
level has never dropped below yellow (the third of the five levels).
About a third to a half of Americans have continued to tell pollsters
that they're personally worried about being victims of a terrorist
attack, and that an attack is somewhat or very likely within several
months.
"It's amazing how enduring these feelings of fear are, but look at
what's been going on," said Alison Holman, a professor of nursing
science at the University of California, Irvine, the lead author of the
study. "I'd be surprised if those terrorist alerts didn't contribute in
some way to the ongoing worry about terrorism in our sample."
Another of the authors, Roxane Cohen Silver, also at U.C. Irvine, is a
psychologist who is on an advisory council to the Homeland Security
Department.
"I've regularly pointed out to the department that there are
psychological consequences to the raising of the alert," Dr. Silver
said. "Now we're demonstrating that it may have physical consequences."
The researchers caution that they're not sure how serious the physical
consequences are, because they're relying on people reporting that
their doctors have diagnosed new cardiovascular ailments. Also, studies
like this show correlations, rather than an identifiable cause and
effect. But since the researchers have taken into account reports of
people's health problems and anxiety that were collected before Sept.
11, and the levels of lifetime and continuing stress, they're confident
they've identified a worrisome increase in heart disease.
After controlling for various factors (age, obesity, smoking, other
ailments and stressful life events), the researchers found that the
people who were acutely stressed after the 9/11 attacks and continued
to worry about terrorism -- about 6 percent of the sample -- were at
least three times more likely than the others in the study to be given
diagnoses of new heart problems.
If you extrapolate that percentage to the adult population of America,
it works out to more than 10 million people. No one knows what fraction
of them might consequently die of a stroke or heart attack -- plenty of
other factors affect heart disease -- but if it were merely 0.0003
percent, that would be higher than the 9/11 death toll.
Of course, statistics of any sort, even when the numbers are rock
solid, don't mean much to people when they're assessing threats. Risk
researchers have found that even when people know the numbers, they're
less worried about death tolls than about how the deaths occur. They
have good reasons -- called "rival rationalities" -- for fearing
catastrophes that kill large numbers at once because these events
affect the whole community and damage the social fabric.
But continual fear of terrorism is a strain on the social fabric, too.
People become reluctant to even get together when public spaces are
turned into fortified zones. Civil liberties erode and mistrust
increases when the authorities keep warning of lurking terrorists and
urging people to report "suspicious" activity, as in the ubiquitous
advertisements in the New York subways exhorting people to call in tips
to a counterterrorism hot line.
The sponsors of the New York campaign were so pleased with the results
that they papered the subways with congratulations to the riders: "Last
year, 1,944 New Yorkers saw something and said something." But as
William Neuman reported in The Times, the ads neglected to mention the
number of terrorists arrested as a result of the tips: zero.
Meanwhile, how many subway riders were given diagnoses of new heart
problems after riding to work every morning looking at ads reminding
them that they might be blown to bits any second? Not zero, if you
believe the new study.
Even before this study, some doctors were arguing that terrorism wasn't
nearly as dangerous as the related "epidemic of fear," as Marc Siegel
called it in a 2005 book, "False Alarm." Dr. Siegel, of the New York
University School of Medicine, pointed to studies linking fear of
terrorism with increased risk of heart arrhythmias and elevated levels
of an enzyme that correlates with heart disease.
"The fear response causes the heart to pump harder and faster, the
nerves to fire more quickly," Dr. Siegel said. "Excess triggering of
this system of response causes the organs to wear down. For a person
who is always on the alert, the result is a burned out body."
It's not fair to blame public officials alone for this fear epidemic.
We in the news media have done our part to scare people. (More on how
the "terrorism industry" distorts risks can be found at
tierneylab.blogs.nytimes.com.) But since there hasn't been an attack in
America for six years, for domestic drama we've had to rely on dire
predictions of politicians and security officials.
What if the alerts stopped? What if the security officials looked at
this new medical evidence -- or at their own perfect record of false
alarms -- and decided that the nation did not need to be in a perpetual
state of yellow alert? What if they even decided that Americans could
survive without any color at all?
I guess that's a hopeless fantasy. No politician wants to be blamed for
failing to anticipate a terrorist attack. No bureaucrats willingly
abandon a system that keeps them employed.
But maybe these officials could be induced to take one more precaution.
The next time they raise the threat level to orange or red, they could
add, "Warning: Heeding this alert may be hazardous to your health."