For 30 years, Professor Deborah Lupton has been investigating the social, cultural and political dimensions of risk, in relation to health and communications. A third edition of her book, ‘Risk’, was recently released, prompting some reflections on how much has changed since the first edition in 1999.
She also explains the rationale behind her use of the hashtag, #MakeCOVIDVisible.
Deborah Lupton writes:
The third edition of my book ‘Risk‘ has just been published. In 1999, when the first edition came out, risk was a hot topic, both in the news media and academic scholarship in social theory and public health.
My initial interest was sparked by completing a Master of Public Health degree. Bringing my sociology training to bear, I noticed the social and political dimensions of the ways risks are identified and fingers of blame were pointed at some social groups for exposing themselves or others to risks. A few years later, after completing a doctorate focusing on the social aspects of HIV/AIDS, I decided to write a book on risk theory for Routledge’s Key Ideas in Sociology series.
This first edition of ‘Risk’ was published in 1999. At this time, cultures of blame and stigmatisation around risks groups related to HIV/AIDS was still a central focus for social researchers. Other key issues I covered in the book were risk cultures related to environmental despoilation, reproductive health, intimate relationships and sexuality, racism, violence and crime.
I and other social risk researchers paid close attention to the ways that risks were identified and framed in news media and other public forums, looking for who was singled out for blame for causing or spreading risks and who were portrayed as expert voices. While we identified political dimensions of risk communication, there was not a lot of emphasis on the vested interests who may be seeking to deliberately spread misinformation.
Thirteen years after ‘Risk’ was published, my publisher approached me to revise it for a second edition (this came out in 2013). Risk was still a popular topic of research in the social sciences and public health at this time. I updated the manuscript to include discussions of newly emerging or intensifying threats of the twenty-first century, such as climate change, extreme weather events, terrorism and global financial crises. Misinformation and disinformation were again not high on the agenda.
I began work last year on revising ‘Risk’ again for its third edition. This time, a decade had elapsed between the second and third edition.
The COVID-19 pandemic was in its third year and was continuing to kill and disable millions around the world. Climate change, loss of biodiversity and extreme weather events were increasing in scale, with governments and industry still failing to take effective action to mitigate these emergencies. Russia’s war against Ukraine had started earlier that year and was still causing devastation. There were global food and fuel shortages triggered by the war in Ukraine, other disruptions in supply chains due to the COVID emergency, and many nations face an economic recession and severe cost of living crises.
As I noted in the book’s preface: ‘Together, these emergencies appear so intractable and unsettling as to be labelled as constituting a ‘permacrisis’: a term chosen as Collins Dictionary’s word of the year for 2022.
As I was working on the third edition, what had becoming increasingly clear to me, especially in relation to the COVID crisis, was the sheer volume of misinformation, disinformation and outright denial or covering up risks that currently exists. For members of the public, understanding and making sense of risk was become increasingly difficult.
In the book, I paid close attention to the ways that COVID-19 risks have been publicised, managed, and in some cases, used for political advantage. I added a whole new chapter on misinformation and post-truth politics as they relate to both the COVID-19 crisis and the climate emergency.
The term ‘post-truth’ is employed to describe a public communication and information environment in which powerful individuals or organisations, particularly in the United States, have employed strategies designed to challenge expert knowledge and spread misinformation for political or corporate ends.
Their attempts to disseminate misinformation or conspiracy theories have existed for decades but have been ramped up in recent years, as outlined in ‘The Triumph of Doubt‘.
In the quarter-century since the first edition of Risk was published, anti-science sentiment, denial of risk and deliberate misinformation have been promoted by people and organisations wanting to halt or prevent government action to mitigate these crises. Social media and other online forums have allowed bad actors to spread misinformation and receive a large platform for their views. Conspiracy theories have quickly spread across online media, while vested interests have been able to harness popular opinion to challenge and undermine science.
There are many parallels between the anti-science tactics used to deny the seriousness of ecological devastation, loss of biodiversity, global warming and extreme weather events that have beset the planet over the past few decades and those recently employed to challenge medical and public health science to contain the spread of the novel coronavirus.
These crises are intertwined, as humans’ actions in devastating ecosystems and habitats, leading to closer contact with wild animals, together with intensive livestock farming practices, have caused regular outbreaks of zoonotic diseases.
COVID-19 is merely the most recent: other major pandemics involving vertebrate animals as hosts of pathogens transmissible to humans include Zika disease, swine influenza, Ebola disease, MERS, SARS and avian influenza.
For decades, libertarian for-profit organisations have used a variety of strategies to minimise or deny medical and public health professionals’ attempts to reduce such harms as tobacco consumption, exposure to respirable silica in the workplace, persistent chemicals in waterways released by industrial processes, and air pollution, as well as challenging climate science.
A common strategy employed by well-funded organisations with corporate connections is to contribute to ‘think-tanks’ and lobby groups to counter environment, medical and public health science (here). Some parts of the mainstream media with connections to major right-wing news corporations have contributed to amplifying the anti-science rhetoric disseminated by these organisations. Emotive language appealing to fear, resentment and suspicion is frequently employed as part of these attempts to discredit science.
Strategies from the corporate and libertarian playbook are now also being deployed to promote economic interests over public health in relation to COVID-19 management.
These strategies include establishing think-tanks, research institutes and public relations and lobby group to support such activities. The US Brownstone Institute is a well-known example of a think-tank established to counter COVID public health policy responses and promote libertarian viewpoints. It has close links to Australia: two Australian-based academics hold the role of ‘Senior Scholar’ in this Institute.
Among the most recent articles published on its website are those referring to the ‘COVID coup’ of government protections, describing prevention and vaccine science as ‘propaganda’ and claiming that government policy ‘has poisoned American minds’, comparing COVID mitigations to the effects of radiation poisoning.
Medical practitioners are unfortunately among the ranks of the most well-known proponents of disinformation. A recent analysis of the types of COVID misinformation propagated online by US physicians found that they spread misinformation about vaccines, unapproved treatments for COVID and mask efficacy as well as supporting conspiracy theories.
Many of these physicians, who were from a range of subspecialities, had very large followers on platforms such as Twitter, Instagram and YouTube. They also received a high level of attention in mainstream news outlets. Nearly one third of these physicians were affiliated with medical groups that have sought to deliberately mislead the public, such as America’s Frontline Doctors. There are similar groups here in Australia, including the Australian Medical Professionals society, a group which recently promoted a visit by a British doctor who is known for his anti-vaccination stance.
Remarkably, some national leaders have even sought to promote fallacies about COVID-19 mitigations and treatments or have been slow to act to introduce preventive strategies.
Prominent examples include former British Prime Minister Boris Johnson’s statements encouraging the ‘herd immunity’ approach early in the pandemic and former US President Donald Trump’s initial refusal to support mass vaccination campaigns and promoting consuming bleach as a remedy for COVID-19. Former Brazilian President Jair Bolsonaro promoted hydroxychloroquine as a COVID cure despite no medical evidence.
The pandemic has also surfaced strong emotions and rousing debates about the level of risk to which people are exposed from the novel coronavirus SARS-CoV-2 itself and to what extent the mitigation strategies implemented by governments and health agencies have been reasonable, effective or even harmful.
The word ‘infodemic’ has been frequently employed to suggest that alongside the risks posed by the novel coronavirus itself were those related to wrong or misleading information about how best to manage the threat posed by COVID.
Misinformation and deliberate attempts to shape what is ‘the truth’ of the science behind COVID-19 and public health measures such as quarantine, border closures, vaccination and face masks/respirators have received high levels of attention in the news media, social media outlets and academic journals.
Several studies have demonstrated that misinformation and conspiracy theory views have been taken up by many members of the public, influencing their attitudes towards COVID preventive measures such as face mask wearing and vaccination.
Acceptance of conspiracy theories concerning denial of COVID risk and challenging the safety of COVID vaccines have been shown to be strongly associated with hesitancy to accept COVID vaccination in surveys based in the UK, US, and Jordan, Kuwait and other Arabic countries.
A Pew Center study found that Americans who relied on President Trump for their COVID-related news were among the least likely to have received a COVID vaccine compared with other groups.
People who are younger, male, have a lower education level and speak a language other than English at home are at increased risk from misinformation.
However, in this fourth year of the pandemic, the main problem is sheer lack of information about COVID-19 risk in public forums.
The risk has become invisible because it is no longer discussed as often in the mainstream media and rarely in government briefings and announcements.
The most recent approach espoused by Australian federal and state governments is to encourage ‘personal responsibility’ for COVID harm minimisation.
This is becoming more and difficult for Australians to enact, given that fewer data about COVID-19 cases, hospitalisations and deaths are now collected or publicised. Vaccination and mask mandates have largely been dropped, even in aged care, hospitals and medical clinics, where the most vulnerable patients are located.
Meanwhile, the recent inquiry into long COVID and repeated infections conducted by the Federal Government revealed the suffering and lack of treatment available to people who are still experiencing debilitating symptoms from COVID-19 infection. The report noted that the best way to prevent long COVID is to prevent COVID infection in the first place.
In this environment of powerful interests seeking to minimise, challenge or silence the policy recommendations and research generated by reputable scientists, what chance does the general public have of understanding the continuing risks posed by COVID-19 and protecting themselves?
Calls to action
Risk communication and public health researchers have learnt a huge amount over the past decade about the ‘playbook’ of individuals and organisations deliberately spreading disinformation about human and planetary health crises.
Governments, health agencies, health researchers and community advocacy groups must address the current lack of trustworthy information about COVID in the news media, as this source is still the primary way that members of the public access COVID information.
As one example, I have been using the hashtag #MakeCOVIDVisible as a way of drawing attention to the latest medical and public health findings concerning COVID cases, deaths, hospitalisations and the long-term effects of infection.
We must continue to identify the networks of bad actors that are operating in Australia and elsewhere and challenge their efforts to support commercial interests over public health.
We are seeing progress in bringing together community organisations with parliamentarians, industry groups and academic researchers to fight for better public information and action. Examples are the Clean Air Forum group and the Healthy Futures not-for-profit organisation, both of which are fighting for better policy and infrastructure for cleaner air for all Australians.
• Professor Deborah Lupton is a social researcher at the Centre for Social Research in Health and Social Policy Research Centre, UNSW Sydney. She has a background in sociology, media and cultural studies, as well as training in public health. She has written about the social, cultural and political dimensions of risk, including in medical and health contexts, for around three decades now. She is a member of OzSAGE and is involved in the Clean Air Forum group.
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