Sneezing at health care reform

I ride a public bus to and from work, and today some of my fellow commuters were sneezing. My guess is that people sneeze on the bus ride every day, but I am especially mindful of any contagion at the moment. And well I should be. We’ve got the regular seasonal bug out there, plus the ominous swine flu on the horizon. And the airwaves and newspapers are filled with warnings about this year’s heightened risk for a flu pandemic. Hundreds of thousands have already been struck by swine flu, with deaths in the thousands and climbing daily.

A stranger’s sneeze can be a good thing in a way. Think of it as a public service announcement, a very-simple-to-understand message about health risk. A sneeze can remind us to wash our hands and schedule our inoculations—probably more effectively than a lecture. But what if, in our hyper-vigilance, we overreact to everyday sneezes and coughs and sniffles? Can such signals change healthy prudence into an unreasonable fearfulness about germs and more?

A team of University of Michigan researchers thought that might be the case, and ran a couple field studies to test the idea. Psychologist Norbert Schwarz and grad student Spike Lee suspected that a heightened perception of risk for a flu pandemic might unconsciously trigger fears of other, totally unrelated hazards. So last May, when the first wave of swine flu was just beginning to claim lives, the researchers stationed a sneezing actor in a busy campus building. As large numbers of students passed on their way to and from class, the actor would occasionally sneeze loudly. The psychologists then cornered and interviewed the students—and compared those who has witnessed the sneeze and those who had not.

They asked both groups to assess the risk of an “average American” getting a serious disease. They didn’t mention the flu, although it is a serious disease and could well have been on some of the students’ minds. Perhaps not surprisingly, those who had just witnessed someone sneezing perceived a greater chance of falling ill. But here’s the interesting part: Those with sneezing on their mind also perceived an increased risk of dying of a heart attack before age 50, dying in an accident, or dying as result of a crime. That is, the public sneeze triggered a broad fear of all health threats, even ones that couldn’t possibly be linked to germs—and sparked thoughts of mortality.

What’s going on here? Well, it gets better—or worse. The researchers asked the same people their views on the country’s existing health care system: Is it a wreck, or working pretty much okay? Those within hearing distance of the sneezing actor had far more negative views of health care in America. Think about that: The country’s health care system encompasses everything from obstetrics to diabetes prevention to insect-borne illnesses, yet a single sneeze in the corridor colored people’s views of the entire system.

This last finding was so striking that the psychologists ran another version of the sneezing scenario at a local mall, just to double-check the perplexing results. This time the interviewer himself sneezed and coughed (or did not) while conducting the interview, and in this version the interviewer didn’t even bother to ask about the personal risk of illness—at least not directly. Instead, the interviewer was ostensibly doing a public opinion survey on federal budget priorities. He asked, for example: Given limited tax dollars, should the government spend the money on vaccine production or on green jobs?

Clearly this issue is only tangentially connected to the flu or personal health, but it does play into people’s fears and doubts about health and disease: Is the government watching out for Americans’ welfare, broadly construed? And the results (to be published in a forthcoming issue of the journal Psychological Science) were unambiguous. Those who had just witnessed someone sneezing were much more likely to favor a public investment in vaccine production rather than green jobs. In other words, the sneeze sparked concerns not about personal health, but more broadly about public health.

This is quite remarkable when you tie it all together: Completely outside of awareness, a simple sneeze triggered fear of the flu, which in turn sparked fears of mortality, which even shaped people’s views on a somewhat abstract public policy question. So achoo! Let’s write our Congressmen about health care reform.


For more insights into the quirks of human nature, visit the "Full Frontal Psychology" blog at True/Slant. Selections from "We're Only Human" also appear regularly at Newsweek.com and in the magazine Scientific American Mind.

Another Roadside Distraction

When Pulitzer Prize-winning music critic Tim Page was in second grade, he and his classmates went on a field trip to Boston. They later wrote about the experience as a class assignment, and this is part of what the nine-year-old Page wrote:

"Well, we went to Boston, Massachusetts through the town of Warrenville, Connecticut on Route 44A. It was very pretty and there was a church that reminded me of pictures of Russia from our book that is published by Time-Life. We arrived in Boston at 9:17. At 11 we went on a big tour of Boston on Gray Line 43, made by the Superior Bus Company like School Bus Six, which goes down Hunting Lodge Road where Maria lives and then on to Separatist Road and then to South Eagleville before it comes to our school. We saw lots of good things like the Boston Massacre site. The tour ended at 1:05. Before I knew it we were going home. We went through Warrenville again but it was too dark to see much. A few days later it was Easter. We got a cuckoo clock."

Page received an unsatisfactory grade on his essay. What's more, his irate teacher scrawled in red across the top of the essay: “See me!” As he recalls in his new memoir Parallel Play, such incidents were not uncommon in his childhood, and he knew why he was being scolded: “I had noticed the wrong things.”

The subtitle of Page’s memoir is Growing Up With Undiagnosed Asperger’s, and indeed Page didn’t learn until age 46 that he suffers from what’s called an autism spectrum disorder, or ASD. ASD is usually defined by impairments in social interaction and communication, but many people with autism and the milder Asberger’s syndrome also tend to fixate on irrelevant information in their world. Their attention seems to be awry or, to use Page’s words, they notice the wrong things.

But why? What’s going on in the autistic mind that makes the details of bus routes infinitely fascinating? Why are people like Page so easily distracted from the main act? Psychologists at University College London think that it might be a mistake to think of such distractibility as simply a deficit. To the contrary, Anna Remington and John Swettenham and colleagues speculate that people with ASD might have a greater than normal capacity for perception, so that what appears as irrelevant distraction is really a cognitive bonus. They decided to test the idea in the lab.

They studied a group of people with ASD, mostly Asperger’s, along with normal controls. They had all the subjects look at a computer screen, which displayed various combinations of letters and dots forming circles. They had to very rapidly spot the letters N or X among the other letters, and hit the corresponding key on the keyboard. Some of the circles—those with more letters—were more difficult to process than others. There were also other letters floating outside the circle, but the subjects were specifically instructed to ignore those letters. Those floating letters were the laboratory equivalent of an irrelevant distraction in the real world.

The psychologists were measuring perceptual capacity. That’s why they varied the complexity of the task. They were also measuring distractibility. They reasoned that, as long as the subjects’ total perceptual capacity was not exhausted, they would also process the irrelevant, distracting letters within their visual field. Once they had surpassed their capacity, irrelevant processing would stop. So if ASD subjects in fact have greater processing capacity, then they should process more distracting information even as the main task becomes increasingly complex.

And that’s exactly what they found. As reported on-line in the journal Psychological Science, while there was no difference among subjects in either reaction time or accuracy on the main task, those with ASD processed the irrelevant letters while solving much more complex problems. Put another way, they weren’t ignoring the main task, nor were they distracted away from it. Instead, they were completing their important work and moving on, using their untapped capacity.

But here’s the rub. While this increased distractibility may be a talent rather than a deficit, the psychologists say, it nevertheless can have detrimental consequences in real-life situations. Just ask Tim Page about his uncanny facility for bus routes.


For more insights into the quirks of human nature, visit the “Full Frontal Psychology” blog at True/Slant. Selections from the “We’re Only Human” blog also appear regularly at Newsweek.com and in the magazine Scientific American Mind.