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.