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Preventable Deaths and the Need for Data-Driven Journalism

In the wake of the recent mass shootings in Texas and Ohio that claimed the lives of more than 30 people, Neil deGrasse Tyson drew significant controversy by posting a tweet which compared the death toll from the shootings to the (larger) numbers of people who died from other preventable causes over a 48-hour time period. Dr. Tyson concluded his message with a warning: “Often our emotions respond more to spectacle than to data.”

The negative responses to his tweet were swift and numerous, with many users voicing outrage, disappointment, and disgust. The next morning, he issued an apology on his Facebook page and acknowledged that he “got this one wrong.” But did he? I don’t disagree that his timing could have been better, but I think his point is important: We shouldn’t let our emotional reaction to shootings inflate our perception of their impact or their probability. Sounds straightforward, right? Well, it’s not as easy as it seems, and one of the primary reasons for the difficulty is a cognitive bias known as the zero-risk bias.

Zero-risk bias is the tendency to prefer the complete elimination of a single risk even when alternative risk reduction strategies lead to a greater decrease in overall risk. People tend to feel better when a given risk is eliminated rather than mitigated. Imagine the following scenario: I present you with two magic buttons. One of them will reduce mass shooting deaths by 100 percent for an entire year, the other will reduce drug overdose deaths by five percent. If you could only press one, which would it be? If you’re like me, your first impulse will be to end mass shooting deaths. It seems more consequential; that impulsive preference is the zero-risk bias in action.

Let’s go over that thought experiment again, only this time imagine that the buttons have numbers on them instead of proportions. The first button will save 372 people from being killed in mass shootings; the second will save 3,425 people from being killed by drug overdoses. This time, I immediately gravitate towards the second option. The numbers are the same in both situations, but they feel very different. They also reflect approximate mortality statistics for mass shootings and drug overdoses from 2018. Several other causes of death could stand in for overdose deaths to illustrate a similar difference in magnitude, but this specific comparison goes deeper than a simple comparison of number of deaths. Both mass shooting and overdose deaths are multiplicative at the societal level in a way that dying in an elevator accident is not.

Mass shooting deaths are also well suited to zero-risk thinking due to how much more preventable they seem to be compared to other types of premature death (which is partially a result of relative rarity). This form of reasoning can lead us to endorse statements such as “We can’t possibly stop people from overdosing on drugs, so let’s focus on something we can stop.” But, as outlined above, this sort of logic doesn’t appropriately engage with societal risk factors. It also ignores the significant progress being made on the overdose front, and the potential for future intervention.

Recognizing this bias, and its effect on how we understand preventable death statistics, contextualizes the conversation around mass shootings, both societally and in the realm of debate. Many contend that such comparisons are faulty, but they are helpful when it comes to combatting these problems. Every dollar, minute, or ounce of energy spent addressing a specific problem is one that, almost by definition, cannot be spent on one of the others. Resources, including time, are zero-sum; when we allocate those resources, we should endeavor to place them where they will achieve the most good. These considerations become even more important when we consider that average life expectancy in the US has been in decline1 for the past three years—the longest sustained period of decrease since WWI. Preventable deaths, specifically those related to drug overdose and suicide, are central drivers of our life expectancy problems, and that should alarm us.

Does this mean that we should ignore mass shootings? Certainly not. I do not mean this comparison to trivialize mass shootings or to diminish efforts to curb the risk of future violence. Updating the laws surrounding firearms and their use is a worthwhile goal that could help to decrease violence more generally and put a dent in the suicide epidemic. There are also important reasons to focus on mass shootings that extend beyond the death toll, or actual level of risk, and this analysis should not detract from those considerations. Ideological factors, such as white nationalism, that have driven a significant portion of recent mass shootings have the potential to damage our system in ways that are not properly reflected by the death toll alone. They should be a central part of the public conversation. But that conversation needs to maintain a sense of perspective.

Many have noted that the effect that a mass shooting has on a community (and wider society) goes well beyond the number of people killed. The same, however, is true of other forms of preventable death, such as suicide.2 Overdose deaths, and the opioid crisis in particular (47,600 overdose deaths involved opioids in 2017), have had a dramatic effect on communities which also extends well beyond the number of people who overdose—those who die likely represent a small proportion of those affected. Considering estimates that as few as one in 10 of those with a substance use disorder can access the treatment that they need, this seems like an area which merits additional attention.

It is also worth noting that these arguments address preventable death from a societal perspective and are aimed at those whose concern is to save lives in a general sense. There are rational, from a personal risk perspective, reasons that someone may be more concerned with mass shootings than the other types of preventable death mentioned here. If you feel that you, and the people in your social group, are not at risk of falling victim to a drug overdose or suicide, then you might want the government to focus on risks that you cannot mitigate yourself, rather than on strategies designed to halt the maximum number of preventable deaths, even when those risks are extremely low (as is true of mass shootings).

My primary goal—and Dr. Tyson’s if I read his tweet correctly—is to provide context. It is perhaps inevitable that our biases will continue to inform the responses of the general public on social media. But responsible journalism could do a better job of marshaling the available data so that we can keep the threats to public welfare and safety in proportion and allocate our resources most effectively. I agree with those who have pointed out that we are facing a crisis in the United States. But that crisis has multiple fronts, and facts, rather than feelings, should inform our response. So, give Dr. Tyson a break, he was only trying to help us keep things in perspective.

 

Evan Balkcom is originally from the US and currently a PhD candidate in psychology and science communication at the University of Otago in Dunedin, New Zealand. You can follow him on Twitter @EvanBalkcom

References:

1 Dyer, Owen. “US Life Expectancy Falls for Third Year in a Row” BMJ (December 2018);363:k5118 https://doi.org/10.1136/bmj.k5118
2 Cerel, Julie, Myfanwy Maple, Judy van de Venne, Melinda Moore, Chris Flaherty, and Margaret Brown. “Exposure to Suicide in the Community: Prevalence and Correlates in One U.S. State.” Public Health Reports 131, no. 1 (January 2016): 100–107. doi: 10.1177/003335491613100116.

Comments

  1. I’d rather prevent mass shooting deaths entirely than reduce overdose deaths because I presume that overdose deaths are self-inflicted consequences of bad judgment whereas mass shooting victims are chosen at random (and could be me!). And yes, I realize some overdoses happen in hospitals.

    Nevertheless, most of us know that the policies sponsored by people clamoring to “do something!” after El Paso will not reduce mass shooting deaths much at all, and will increase other types of pain by more than a corresponding amount.

    Moreover, if El Paso were an Islamic terrorist attack, the same people condemning Tyson for his Tweet would be applauding him.

  2. Edit) Because society tends to emotionally respond to either mass shootings or drug overdose by reaching for a non existent magic button, these problems rarely get addressed properly or with the nuance and foresight that are required. If your hand is on that magic button, (same with anti abortion activists) you’re about 10 steps behind in the game and both games look more and more alike in their causes the earlier you get to them.

    Meaning, fatherlessness, familial dysfunction, social isolation/loneliness, mental health, lack of opportunity… are all highly relevant factors in both issues. Dealing with these plethora of issues at an earlier stage and in a more proactive manner will pay more dividends than passing out narcan, opening a crisis hotline, or banning guns.

  3. Many, of not most, of these mass shootings seem to be perpetrated by men with histories of mental illness and associated violence.

    Relatives and neighbors frequently come forward in the immediate aftermath and say they had been trying to get get schools and the police to do something about them for years.

    But schools, police and other government agencies do not do anything, very much, about them. What government does do, and what mental health professionals do, is hide and conceal from the public as much as they can about the dangerously mentally ill in the name of privacy.

    It’s only when they go on a killing spree that the community learns just how dangerous they were, and that it was known by a surprisingly large number of people who hid it.

    When we as a society stopped believing that the dangerously mentally ill should be locked up, and kept locked up, we guaranteed that this kind of thing would happen more and more often.

  4. I am sympathetic with your point that fatherlessness, familial dysfunction, and other factors are the root cause of many social problems. But it would take fundamental cultural change to address them, which is very daunting (and probably not popular in our individualistic culture). Handing out narcan seems like a fairly low-cost way to deal with one of the specific symptoms.

  5. My take away from this article was that the highly respected Mr. Tyson was placed in the mob’s iron maiden and forced to apologize for exercising his freedom of speech by stating totally verifiable facts in the context of a very unfortunate event. Yes, it happened yet, yet again. Enough. It is time for all free speech loving people to put a stop to this intimidation and call out these lynch mobs for what they are: weak, pusillanimous, small minded little piss ants. No more intimidation, no more apologies. I should add F’ em and few more fitting expletives, but I won’t because this is Quillette wherein people actually try to show a bit of decorum to other complete strangers within this otherwise cultural cesspool we are currently living.

  6. For sure Narcan is a cheap and easy end run solution and a good lifesaving tool to boot. There will always be opiate addicts and always a need for such tools. (I was 10 years a heroin addict and personally had my life saved twice by emt administered narcan).

    Concerning the factors I mentioned earlier, I don’t believe fixing these issues (besides public safety in mental health) is much within the purview of the government. It IS a monumental task, with highly personal and social aspects that 1. The government has no business in 2. They would colossally flub if they tried. (IMO the government sucks at everything they do but the garbage service)

    Rather, I think these issues should be addressed by men and women, neighborhoods and towns, churches, charities, synagogues, and mosques.

    The people to whom it most matters. The people with skin in the game. A call to brotherhood, love, accountability, family. This is mostly high minded rhetoric on my part, I know, but I think as far as solutions go, people will always respond better to personal action than to government program or decree. Finding ways to encourage and facilitate engagement in fixing our ills isn’t as hard as it seems. Nearly everyone is affected personally by one if not multiples of these problems.

  7. How does government’s central planning fix fatherlessness, familial dysfunction, social isolation/loneliness, mental health and lack of opportunity.
    And what data to you have to support that such mass shooters did so for those reasons?

  8. True, but accidents, errors, natural disasters and illness can reach anybody. And they are the often the biggest actual threat to shorten your lifespan. Of course, in the end, we all die, so there’s no such thing as ‘saving a life,’ just not letting them die at a particular moment.
    If you have a way to stop bad actors, let us know. These actions are already criminal; fully prohibited.
    Life is risky, and you do want to reduce risks you can control. But many have no controls, hence the risk.
    And you state you won’t be a victim of suicide or drug overdose as you have a magical mind that cannot go awry, which is not the case. Depression can reach anybody. You can become addicted due to bad luck, like many of the opioid sufferers. That you life is good now does not mean it will be in the future.

    A simple “nice example” is government recycling programs. Turns out that some things recycle pretty well, like plastic water bottles (though recycling is not as clean as reusing needed containers) and aluminum cans. We used to sort it all. Then came the idea that we can just put everything in one recycle can, which basically made it a mess for recyclers to process, causing many cities to simply toss their recycling into landfills, and even China and Vietnam said they no longer wanted our soiled recycleds. No recycling plant would make that mistake, not implement it across all households and businesses, etc.

  9. Here’s a list of mass shooters and descriptions of their home life.

    This information is highly relevant and correlates directly to what I mentioned about fatherlessness and family dysfunction.

    Here’s a breakdown on the effects of fatherlessness on children.

    As for central government planning to deal with said issues? I wrote in my second comment that I don’t think they should or are capable of doing so. Edit) But there is clamor for somebody, (the government) anybody, (a self appointed spotlight seeking politician) to come and save us with a feel-good, reactive reaction instead of a thought through, proactive action.

    Also, I think you may have misunderstood what I was originally saying. I was saying I believe there is significant overlap from those issues to those outcomes (drug overdose/mass shootings). There is an extreme hopelessness in both results. Is it that hard to believe there are similarities in the starting points? AND, I’m not a researcher or social scientist. I do my best to check what I believe against prevailing studies and researched articles, but like everyone else here…this shit is just opinion.

  10. Mass shootings vs drug overdoses is a poor choice of choices. Since I can easily avoid a drug overdose by not doing drugs whereas an innocent trip to the mall could get me killed by an idiot with a gun I’m going to have to go with mass shootings as top priority.

  11. Great comment as usual. Where did you pick up this only 20% of heroin users are addicts statistic? As someone who was addicted myself for many years, everyone I knew that used had a physical addiction to the substance…everyone.

    Might be that I was insulated within a rougher circle of users and never met the majority of more leisurely users. But god, I was physically addicted within the first 48 hours of use and can’t imagine anyone who could use that substance on a purely recreational basis.

    Let me know.

  12. Agreed. We don’t actually “prevent” death; we simply delay the inevitable. But that’s not to say we should just be nihilists about the whole thing. Simply delaying it is not a bad objective, or a bad outcome.

    Indeed, the “actions” are already criminal. But that’s the point, isn’t it. By the time the act occurs, you’re a little late to the game. With every crazed mass gun murderer, you need 3 things. (1) crazy person; (2) gun; (3) bunch of victims. So we can’t do anything about (2) because of 2a. But can we do something about how often (1) and (2) get together? You would think so. But even that’s too much logic for the 2a nuts. With current laws, even if their families reported them as being “a bit off”, what can be legally done? They haven’t committed a crime, so what can cops do? And because there is no record, they pass the rudimentary background checks currently in place. Which is the other point. These guys came by their guns legally. Which means the law as currently construed was unable to stop it. So assuming you want to stop the next one, logic tells me you need to change the law, so that background checks have more teeth, and bite. Logic also tells me the status quo merely guarantees more of the same.

    Fair enough, I might become suicidal and do crack tomorrow. But not today. Yet even today, I’m at risk for a crazed mass gun murderer in a way that I am not with those other dangers.

  13. I got the stat from a JRE (Joe Rogan) interview with Johann Hari:

    The statistics cited in the interview were actually 10-20% addiction rates, with higher rates for the more physiologically addictive drugs- and it doesn’t get much more addictive than heroin. The drinks industry stats, came from a Ted Talk, in which the speaker was sounding alarm bells over the corporatisation of marijuana in the US, with some companies producing extremely high THC content weed.

    I couldn’t find my original fact check source for the addiction stats, but found this instead, that estimates total addiction rates for those who abuse heroin at around 25%:

  14. Thanks. I actually found the same research in the exact same piece earlier today while on an internet statistics hunt.

    It kind of blows my mind. That statistic seems so counterintuitive to me and my experience. Although to be more specific, the stats weren’t entirely clear about the type of ingestion. If smoked or snorted, heroin is a much less powerful experience than if injected IV. I was anecdotally assuming heroin users as exclusively IV (as I was) when that isn’t the case and taking that into consideration makes the 25% number seem a lot more sensible.

  15. This is an interesting point. Earlier this year here in Portland we had an incident downtown at around 230 am where an African American (Patrick Kimmons)fired multiple shots in a crowded area, shot two people and was running around on the streets. The police showed up, he failed to surrender or put down his weapon and was shot and killed.

    All that to say this: I left a comment on the Portland mercury blog page to the effect that this was a description of a mass shooting. Multiple wounded, gunman armed and on the loose, but the comment was almost instantly erased as was my account and the responses were fully in denial that this was anything other than another racist cop murder. BLM showed up, dragged the family downtown, blocked streets and traffic…in defense of a mass shooter.

    It was surreal as are most political theatrics in my city within the last 15-20 years.

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