COLUMN ONE : Headlines and High Anxiety : We’re safer and healthier than ever--and also more afraid of what we eat, drink and breathe. Why the reality gap? Too often, critics say, the media’s coverage fuels our fears.

“How extraordinary!” wrote political scientist Aaron Wildavsky in 1979. “The richest, longest-lived, best protected, most resourceful civilization, with the highest degree of insight into its own technology, is on its way to becoming the most frightened.”

Extraordinary, indeed.

Life expectancy in the United States is 75.5 years, up almost 13 years since 1940 and more than double what it was at the turn of the century. Since 1970, the infant mortality rate has been cut in half, the death rate from heart disease (our No. 1 killer) has dropped 27% and the death rate from stroke (our No. 3 killer) is down 44%. Death rates for emphysema, tuberculosis and other once-dreaded diseases have also declined. Polio and smallpox, long the scourge of childhood, have all but disappeared.

Deaths from cancer (our No. 2 killer) have increased, but that increase is largely attributable to smoking--which has led to a doubling of the lung cancer death rate in the last 30 years--and to two simple facts: (1) People are living longer. (2) The sharp decline in fatalities linked to heart disease and stroke means that other causes of death are rising proportionally.

Despite these enormous improvements--and despite recent improvements in the health of our much brooded-over environment as well--psychologists, sociologists and epidemiologists say we may well be the most anxious, frightened society in history.

No reasonable person can deny that very real dangers lurk in all our lives--in our air, in our food and water supply and in other natural and artificial substances. Guns kill. Cigarettes kill. Toxic chemicals, high-fat diets and abuse of alcohol can kill.

“But the risks that kill people and the risks that scare people are different,” says Peter Sandman, a risk communications consultant based in Massachusetts.

Why are we so scared--and so often scared by the wrong things?

Many people say the news media are largely to blame. The media, after all, pay the most attention to those substances, issues and situations that most frighten their readers and viewers. Thus, almost every day, we read and see and hear about a new purported threat to our health and safety.

We are warned about benzene in our Perrier, Alar on our apples, and asbestos in our school buildings. We are told that popcorn, margarine and red meat--as well as Chinese, Italian, French and Mexican food--all contribute to heart disease. Aluminum and zinc are reported to contribute to Alzheimer’s disease. Alcohol is blamed for virtually every malady but the national debt. And everything, it’s said, causes cancer: Caffeine. Cellular phones. Dioxin. High-power lines. The hole in the ozone layer. Hot dogs. Secondhand smoke. Silicone breast implants.

While we are fretting about the fat in our fettuccine alfredo (“a heart attack on a plate,” according to the Center for Science in the Public Interest), we are also being bombarded by terrifying tales of violent crime, crashing airplanes, an AIDS epidemic among heterosexuals and a global warming trend.

The media are supposed to serve as an early warning system for the public, and they have long fulfilled this function in alerting people to a range of risks, from high-fat diets to cars (the Ford Pinto) to medical devices (the Dalkon Shield IUD).

In fact, says Al Meyerhoff, senior attorney for the Natural Resources Defense Council, an environmental group, the media “almost do too good a job” in sounding alarms.

“One of the political problems the environmental movement has had to deal with, particularly over the last few years, is simply getting through the clutter of all the different messages of gloom and doom that the public receives,” Meyerhoff says.

But for the media to “not say anything at all is the worst crime,” says Marlene Cimons, who covers federal regulatory agencies for the Los Angeles Times. “If there’s a debate going on, people need to know about it. My responsibility is to report it in a balanced way. I can’t help the way people react.”

Many people--a number of them journalists--say that media coverage of risk issues is often un balanced, and that does make reporters responsible for the way people react. Too often, critics say, the media provide not just essential information and legitimate warnings but unwarranted alarms for an increasingly susceptible audience, one willing to see risk in almost everything.

In an effort to educate the public and attract readers and viewers, the media often overplay risks of dubious legitimacy. Scientific studies show that many of the alleged hazards the media trumpet are either misstated, overstated, nonexistent or that there just is not enough scientific evidence yet to yield reliable guidance on the true risk for the average American.

David Ropiek, a longtime environmental reporter for WCB-TV in Boston, says risk coverage “gets to the most fundamental failing of the media today.” In their zeal to have an impact, Ropiek says, journalists are “seduced . . . into playing up what is dramatic.”

But emphasizing “overdramatized” stories, suggesting that “everything you eat will kill you, that every breath will kill you, . . . profoundly colors the public psyche,” Ropiek says. “We start living like Chicken Littles being told the sky is falling.”

Why did many Americans suddenly decide last fall, for the first time, to tell national pollsters that crime is “the most important problem facing the country”? Could it have been because last year, for the first time, ABC, CBS and NBC nightly news programs devoted more time to crime than to any other topic?

Several media critics think so; as a Los Angeles Times Poll showed early this year, people say their “feelings about crime” are based 65% on what they read and see in the media and 21% on experience.

Not everyone agrees that the media skew the degree of risk in our society.

Howell Raines, editor of the editorial pages of the New York Times, says we live in “a dangerous world,” and the media have been a major player in making people more aware of those dangers.

“Risk is not just about the statistical threat to health and life,” Raines says. “Risk is also about what kind of society you want to have. . . . I think we’re probably doing a better job (in the media) if we’re responding to the popular sense of risk rather than the scholarly side of risk.”

Michael Jacobson, executive director of the Center for Science and the Public Interest--which conducted the widely publicized studies of movie theater popcorn and ethnic food--says the media have done “an excellent job of alerting people to problems roughly in proportion to the importance of the problems.”

But studies show just the opposite.

“A direct comparison between hazards as topics of news stories and (hazards) as causes of death shows essentially no relationship between the two,” said social scientists Eleanor Singer and Phyllis Endreny in their study of risk coverage by national and local newspapers, newsmagazines and television stations.

The reason, says Sandman, the risk communications consultant, is that “hazard and outrage are independent of each other,” and the media are “in the outrage business.”

“Most media coverage of risk is about outrage, not about hazard,” he says.

Why? Because people and their emotions generally make for more riveting stories--especially on TV--than do dry, often tentative or conflicting scientific facts.

“It’s a basic rule of journalism to get the human angle,” says Jeff Greenfield, an analyst for ABC News. “But with a complicated, technical story . . . the concerns, the worries, the fears of people . . . will always carry more weight than the disputes and the cautions of the experts.

“Human drama, human emotion is what works well on television,” Greenfield says. “Maybe sometimes too well.”

Pictures also work well on television. Pictures are television. Often dramatic pictures--mothers sobbing at a toxic dump, for instance--may get a story on the air even when the underlying science is shaky at best.

In his studies on coverage of risk situations, Sandman has found that the media devote most of their space and time to “opinions, not facts . . . to how upset people are (about an alleged risk) rather than about how likely this risk is to kill you.”

When he is hired to advise industrial clients involved in risk stories, Sandman says, he tells them not to waste time giving reporters facts on why they do not think their product or service is not dangerous; instead, he tells them to “get the compassionate stuff in. (Say) you’re sorry, you made a mistake, you’re going to do something about it.”

Only that approach, he says, can counter the outrage the media will report.

“The media don’t create the outrage,” Sandman says, “but they cover it and, inevitably, they amplify it.”

No risk creates as much media outrage--or attention--as the threat of cancer, the disease that kills more than half a million Americans every year.

Even though heart disease kills 40% more people--more than 700,000 Americans a year--cancer evokes special feelings of dread. Cancer can be painful, debilitating, disfiguring; it can drain your strength and spirit--and your life’s savings.

Around the turn of the century, cancer carried such a stigma that in some places, cancer cases were given other, less terrifying--albeit incorrect--diagnoses. The disease was not mentioned in polite company. Now, says Sharon Begley, a Newsweek senior writer who specializes in science and the environment, there’s a “cancer fixation in this country;” we can’t stop talking about it.

In the media, this often translates into what Begley and others call “the cancer-of-the-week syndrome.”

Most of these stories involve charges that this chemical or that pesticide causes cancer. But Bruce Ames, a biochemist and molecular biologist at UC Berkeley, says the three main causes of cancer are not the much-publicized pesticides or other chemicals developed since World War II, but “smoking, dietary imbalances and chronic infections.”

Ames, who performs no consulting for private industry, is the director of the National Institute of Environmental Health Sciences Center and the recipient of more prestigious awards than you could shake a test tube at. He also invented the standard laboratory test for cancer-causing agents.

The onetime darling of the ecology movement, he now makes such provocative statements as:

“I don’t think pesticide residues have anything to do with cancer.”

But the media almost invariably focus on pesticides and other artificial chemicals--”story after story,” Ames complains.

A 1992 study by researchers Robert Lichter, Stanley Rothman and Mark Mills supports Ames’ judgment. Their study of 1,147 stories on cancer over 20 years found that the major print and broadcast media gave the most attention to artificial carcinogens that scientists generally thought were low risk, while largely neglecting the often natural carcinogens that the scientists thought were higher risks.

Ames says “99.99% of the pesticides we consume are naturally present in plants to ward off insects and other predators.” One cup of coffee, he says, contains 10 grams of natural carcinogens--the amount the average American consumes in pesticide residues in one year. The average American, Ames says, ingests 10,000 times more natural pesticides than artificial pesticide residues every day.

But Ames thinks that fruits and vegetables, which contain carotenoids and antioxidant nutrients such as Vitamins C and E, suppress the cancer process--despite two recent studies calling these conclusions (and earlier studies) into question.

Thus, he argues--and he wants the media to point out--pesticides actually help prevent cancer; they lower the cost and increase the yield of produce, enabling more people to eat them.

“Pesticides,” he says, “are one of the public health advances of the century.”

But what of widely reported laboratory studies that have shown pesticides and some other chemicals to be toxic? What of the Delaney Clause, the 1958 law that prohibits any food additive, including pesticide residues, that have been shown to cause cancer in laboratory animals?

Ames says that the standard cancer tests--feeding chemicals at high doses to rats, then extrapolating to lower doses for humans--is not a good way to find out if a substance will cause cancer in humans. He argues that large doses cause cells to proliferate and the new, mutated cells to form tumors. Under normal circumstances, a body repairs cell mutations before cancer develops. But a rat--or any other animal--cannot do this if its metabolism is overwhelmed by a massive dose of chemicals.

Environmental activists say such chemicals should be banned anyway, on the theory that it is better to be safe now than sorry later. Ames thinks that that is bad science and bad public policy, and he says it is bad journalism for the media not to point it out.

When pesticides are banned, he says, all that’s left is organic or other pesticide-free produce, which is more expensive. That deprives many people, especially the poor, of a natural “medicine” and creates what Daniel Puzo, who covers food safety issues for the Los Angeles Times, calls “an obvious inequity . . . in our system.”

Many scientists and risk assessment experts agree.

“The economics is at the most basic level,” says John Graham, director of the Center for Risk Analysis at the Harvard School of Public Health. “If the prices of fruits and vegetables go up, people are likely to eat fewer fruits and vegetables,” and there is solid evidence that eating more produce makes you healthier.

“This is not rocket science,” Graham says. Journalists do not need “advanced degrees from Harvard” to make this connection.

Despite the media coverage of and public anxiety about a “cancer epidemic” triggered by environmental pollutants, “less than 5% of human cancer can be traced to causes that are within the jurisdiction of the U.S. Environmental Protection Agency,” Graham says.

Indeed, according to the National Cancer Institute, the age-adjusted mortality rate for all cancers combined except lung cancer has been declining since 1950, except for those 85 and over.

But one wouldn’t get that impression from the news media.

The same is true of a whole range of other “risks.”

Violent crime? Certainly, urban life is much more violent than it was 40 years ago. Random violence is far more prevalent. But despite what television says, FBI and Justice Department statistics show that the national crime rate, including violent crime, has been fairly level for 20 years--and it dropped slightly last year.

Silicone breast implants? The news media have been filled with tales of cancer and other diseases attributed to these devices. But in June, researchers at the Mayo Clinic reported that they could find no connection between silicone implants and the diseases that had been attributed to them. In August, researchers at Massachusetts General Hospital said preliminary tests in a small study suggested that silicone seeping from implants may actually help fight breast cancer.

Although some doctors have challenged the methodology and provenance of studies that seem to exculpate breast implants, Elinor Brecher, who has written widely on the issue for the Miami Herald, says: “There has yet to be a credible study supporting the women--and their lawyers--who claim they have this disease or any of those diseases.”

Brecher--who had breast cancer, a double mastectomy and two silicon breast implants--acknowledges that “some women have had some problems” with the implants, but she says she has been “deeply disturbed . . . outraged” by the way the media have overplayed the risk and underplayed studies repudiating the risks.

“It was pure horror, creating needless panic,” she wrote.

Heterosexual AIDS? The disease has wreaked horrible devastation. It is a shattering, global tragedy that warrants government action, scientific research and human compassion. But statistics from the Centers for Disease Control make it clear that the media--which long ignored or underplayed the threat in the gay community--have overstated the threat in the general heterosexual community. AIDS remains confined, by an overwhelming margin, to gays, bisexuals and intravenous drug users.

Although the number and percentage of heterosexual AIDS deaths have increased considerably in recent years--especially among women--only 6% of all adult and adolescent AIDS cases have involved heterosexual contact, the CDC says--and two-thirds of those involved people who had sex with someone who already had (or was in a known risk group for) HIV infection. Only 2.2% of AIDS cases have involved heterosexuals with no other known risk factor.

In other words, AIDS is not presently a serious threat to the non-promiscuous, non-intravenous drug-using, North American heterosexual--notwithstanding the Time magazine cover stories (“How heterosexuals are coping with a disease that can make sex deadly”) and Oprah Winfrey warnings (“AIDS has both sexes running scared. Research studies now project that 1 in 5 . . . heterosexuals could be dead of AIDS in the next three years”).

Secondhand smoke is probably the risk issue getting the most media, public and political attention right now, so its coverage--and the controversy surrounding it--is worth examining.

Although virtually no one outside the tobacco industry doubts that smokers run a much higher risk of lung cancer and other diseases, the science on secondhand smoke is more problematic. Some critics have accused the EPA of distorting the findings in its landmark 1993 report alleging a link between secondhand smoke and lung cancer and other diseases. Critics in science, medicine and the nonpartisan Congressional Research Service say the EPA ignored contrary studies, used unreliable methodology, failed to consider such “confounding factors” as diet, health care, poverty, heredity and consumption of alcohol and caffeine and changed its statistical standards midstream to produce the politically desired result.

“I am adamantly opposed to smoking; I completely agree about the magnitude of this health threat for people who smoke,” says Michael Gough, senior associate in the congressional Office of Technology Assessment. “But I think that the EPA played very fast and loose with its own rules in order to come to the conclusion that (secondhand) smoke is a carcinogen.”

Most mainstream media--daily newspapers, weekly newsmagazines, the TV networks--have ignored or given such short shrift to suggestions that the EPA data was flawed and had been manipulated that the tobacco industry bought full-page advertisements four days in a row in major newspapers across the country in June; the ads reprinted criticisms of the methodology and integrity of the EPA report that were published in the quarterly journal Forbes MediaCritic.

When a few newspapers--including the Los Angeles Times--reported on the ads, they generally emphasized the tobacco industry ties of critics quoted in the story and of major donors to the Reason Foundation, publisher of Reason magazine, whose former managing editor was the author.

But the stories did not address the substance of the criticisms of the EPA report.

Investor’s Business Daily, National Review and Consumers’ Research Magazine are the only national publications apart from Forbes MediaCritic that published detailed critiques of the EPA report. Science magazine also noted the EPA’s “fancy statistical footwork,” and the Wall Street Journal, Washington Post and New York Times, among (very few) others published stories on the controversy.

The Los Angeles Times devoted several paragraphs to the controversy in a three-part series on secondhand smoke in May, a series that may be the most comprehensive discussion of secondhand smoke in the mainstream media.

Although generally evenhanded, the ultimate impact of The Times series seemed to support those who say secondhand smoke is hazardous; one story was largely devoted to the plight of a 39-year-old cocktail waitress who “never touched a cigarette but got lung cancer after 11 years of serving drinks in the blue haze of a smoky airport bar.”

But more than most mainstream media stories, this series did acknowledge that critics of the EPA report--and of the campaign against secondhand smoke--might have some legitimate basis for their opposition. The series touched only briefly on specific criticisms of the EPA report because Sheryl Stolberg, the author, says she did not believe she could resolve that dispute herself, being neither a statistician nor an epidemiologist.

Stolberg, a Times medical writer, did allow critics of the EPA to state their general case, and her series did say, at one point, that the evidence on deaths caused by secondhand smoke, “while compelling, is not as complete” as some anti-smoking crusaders insist.

The series also noted that the nature of the campaign against secondhand smoke is “a little bit of science--still emerging, not all of it conclusive--shaping a lot of public policy.”

“Secondhand smoke is bad for your health,” Stolberg said in an interview, “but I think if you really examine the overall body of evidence, you’ll see that politics really comes into play and that the medical evidence has been used to, in essence, sell the notion to the public that secondhand smoke is bad for you, and it may have led some people to think it’s a lot worse for the general public than it really is.”

Clearly, Stolberg says, “the real health risk from tobacco smoke is smoking.” The issue of secondhand smoke is “more complicated than most people believe.”

One reason the media have generally minimized criticism of the EPA report--and of the anti-secondhand smoke campaign--is the widespread sense among journalists that spokesmen and apologists for the tobacco industry have long lied about the dangers of smoking. As a result, anyone who says anything that seems supportive of a tobacco industry position is viewed with skepticism.

The EPA says it “absolutely stands by” its report, and in June, the agency released an eight-page, point by point rebuttal of its critics’ charges. The EPA and others in the anti-smoking movement also point out that most independent scientists agree that heavy exposure to secondhand smoke can exacerbate respiratory illnesses in nonsmokers, can cause death and disease in some healthy nonsmokers and can contribute to respiratory ailments in children.

But how much exposure is “heavy” and how great a contributor secondhand smoke is to death and disease--and to which diseases--is not incontrovertibly settled, many independent scientists say.

“There is a real problem estimating the quantitative effect of environmental tobacco smoke,” says Sir Richard Doll of Oxford University, one of the world’s leading epidemiologists.

Research on secondhand smoke and heart disease is relatively new and incomplete. Yet activists say 70% of the deaths linked to secondhand smoke--37,000 of the 53,000 total--come from heart disease.

A much smaller number of deaths--3,000--are attributed to lung cancer, but because of the dreadful power of the word cancer , it was cancer that the EPA emphasized in its report. The first major conclusion, listed at the top of Page 1 of its 137-page report, said secondhand smoke is “a human lung carcinogen, responsible for approximately 3,000 lung cancer deaths annually in U.S. smokers.”

Not surprisingly, that statistic was the lead paragraph in virtually every major media story on the EPA report.

Ironically, except for coverage of the U.S. surgeon general’s landmark 1964 report and, to a lesser degree, follow-up reports in 1982 and 1986, the dangers of smoking did not receive widespread media attention until recent years, when activists seized on the issue of secondhand smoke.

Indeed, many medical experts long complained that if the media would cover the hazards of smoking even a fraction as aggressively as they covered many other, lesser hazards, thousands of smokers might quit and thousands of lives might be saved.

Many journalists agree.

“For years, I think it was true that the risks posed by tobacco smoke were severely underplayed by the media,” says Timothy Noah, an environmental reporter for the Wall Street Journal.

As Susan Okie of the Washington Post documented in 1985, most magazines ignored the smoking story--and some censored stories that might have offended the tobacco companies, who accounted for about 9% of magazine advertising at the time.

Newspapers, which drew only 1% of their advertising from tobacco companies, were not substantially better.

It may be significant that, until relatively recently, many journalists smoked; like most other smokers, they scoffed at the risks inherent in their habit.

But today’s better-educated journalists--like their better-educated readers--are much less likely to smoke. In contrast with previous generations of journalists--many of them hard-living, hard-drinking news hounds whose only exercise was using a dull knife to cut a tough steak--many journalists are now card-carrying members of the jogging, tofu-eating, Perrier-drinking, health club set, and they aggressively object to smoking anywhere around them.

Responsible reporters try hard to prevent their personal feelings from unfairly influencing what they cover, but they are only human, and that’s not always possible. As Noah says: “The changing culture of the newsroom has probably affected the way the media cover” the smoking issue.

Besides, the growing sensitivity of many in the media to smoking has coincided with the development of secondhand smoke as a “hot” story.

Time magazine was correct when it said this year that “nothing has galvanized today’s anti-smoking activities as much as the Environmental Protection Agency report released a year ago that classified environmental tobacco smoke as a Class-A carcinogen.”

That enabled anti-smoking activists--like AIDS activists before them--to say: “Everyone is at risk.” No longer could nonsmokers smugly say to themselves, “OK, go ahead, smokers; you want to poison yourself, be my guest.”

Now, according to the EPA, everyone was being poisoned. The groundswell of opposition to smoking mushroomed, and the media moved in: TV specials. Page 1 series. Newsmagazine cover stories (Time: “Is It All Over for Smokers”; U.S. News & World Report: “Should Cigarettes Be Outlawed?”)

The EPA report made smoking “a political issue, not just a medical issue,” says Cristine Russell, a special health correspondent for the Washington Post, and the media have always been more interested in politics than in medicine; the former provides clear conflict while the latter is usually burdened by uncertain data.

“The No. 1 health story in the American media today is tobacco,” Noah says. “I think it’s also the No. 1 health risk in America today. That’s a happy convergence of circumstances.”

In fact, news media coverage of the hazards of smoking has become so aggressive that studies show Americans believe that more than 40% of the people who smoke heavily will die of lung cancer.

The real figure is less than 10%--and perhaps as low as 5%.

Next: The impact of risk coverage on society, government and the economy.

Jacci Cenacveira of The Times editorial library assisted with the research for this series.

Risk and Reality

Life expectancy is increasing. Infant mortality is decreasing. So are most forms of cancer. But Americans see their lives as riskier than ever.

CANCER DEATHS

Death rates per 100,000 people for most forms of cancer have been declining for decades. The big exception: lung cancer.

Stomach 1930: 31.3 1940: 26.7 1950: 17.3 1960: 11.6 1970: 7.9 1980: 5.7 1988: 4.7 Uterus 1930: 30.7 1940: 28.5 1950: 21.8 1960: 15.7 1970: 10.8 1980: 7.9 1988: 6.3 Liver 1930: 13.5 1940: 9.7 1950: 7.4 1960: 5.8 1970: 6.6 1980: 4 1988: 4 Lung 1930: 3.2 1940: 6.7 1950: 13 1960: 21 1970: 32 1980: 42.6 1988: 48.2 Colon 1930: 19.7 1940: 25.3 1950: 25.7 1960: 23.7 1970: 22.6 1980: 21.6 1988: 19.3 Leukemia 1930: 2.6 1940: 4.1 1950: 6.2 1960: 7.3 1970: 7.1 1980: 6.7 1988: 6.1 ***

LIFE EXPECTANCY INCREASES . . .

Life expectancy for Americans in years. 1890: 31.1 1900: 35.2 1910: 50.0 1920: 54.1 1930: 59.7 1940: 62.9 1950: 68.2 1960: 69.7 1970: 70.9 1980: 73.7 1988: 75.4 ***

. . . INFANT MORTALITY DECREASES . . .

Infant deaths for every 100,000 births in the United States. 1970: 20 1975: 16.1 1980: 12.6 1981: 11.9 1982: 11.6 1983: 11.2 1984: 10.8 1985: 10.6 1986: 10.4 1987: 10.1 1988: 10 1989: 9.8 1990: 9.2 ***

BUT PUBLIC’S FEARS RISE

Americans think they are subjected to more risk today than their parents were 20 years ago. More risk: 78% Less risk: 6% About the same: 14% Not sure: 2% Sources: National Center for Health Statistics, Centers for Disease Control, Marsh and McLennan

Fearing AIDS

Although the media have played up the threat of AIDS in the heterosexual community, only 6% of all AIDS cases have involved heterosexual contact.

Who has AIDS

Through 1993, there were 356,275 cases of AIDS reported among adults and adolescents nationwide. The cases break down like this: Gay men: 54% Heterosexual intravenous drug users: 24% Gay intravenous drug users: 7% Hemophiliac coagulation disorder patients: 1% Other cause or unknown: 6% Recipients of blood transfusion, blood components or tissue: 2% Infected through heterosexual contact: 6% ***

Of the 6% infected through heterosexual contact: 23,039 people 12,620 had sex with an IV drug user. 8,323 could not specify origin of infection. 2123 had sex with a hemophiliac or with a blood transfusion recipient. 508 had sex with HIV-infected person. 1,375 had sex with bisexual male. Source: Centers for Disease Control

Smoking Storm Clouds

An EPA report on secondhand smoke gave anti-smoking activists a big boost and subsequently triggered widespread media coverage. Many critics said the report and the coverage were flawed.