不知道你说的哪篇，弄了两篇。话说lz还真爱学习啊，回家还看大英。
Risks and You
1 At some time or other, all of us have played the part of a hypochondriac, imagining that we have some terrible disease on the strength of very minor symptoms. Some people just have to hear about a new disease and they begin checking themselves to see if they may be suffering from it. But fear of disease is not our only fear, and neither is risk of disease the only risk we run. Modern life is full of all manner of threats-to our lives, our peace of mind, our families, and our future. And from these threats come questions that we must pose to ourselves: Is the food I buy safe? Are toys for my children likely to hurt them? Should my family avoid smoked meats? Am I likely to be robbed on vacations? Our uncertainties multiply indefinitely.
2 Anxiety about the risks of life is a bit like hypochondria; in both, the fear or anxiety feeds on partial information. But one sharp difference exists between the two. The hypochondriac can usually turn to a physician to get a definitive clarification of the situation-either you have the suspected disease or you don't. It is much more difficult when anxiety about other forms of risk is concerned, because with many risks, the situation is not as simple.
3 Risks are almost always a matter of probability rather than certainty. You may ask, "Should I wear a seat belt?" If you' re going to have a head-on collision, of course. But what if you get hit from the side and end up trapped inside the vehicle, unable to escape because of a damaged seat belt mechanism? So does this mean that you should spend the extra money for an air bag? Again, in head-on collisions, it may well save your life. But what if the bag accidentally inflates while you are driving down the highway, thus causing an accident that would never have occurred otherwise?
4 All of this is another way of saying that nothing we do is completely safe. There are risks, often potentially serious ones, associated with every hobby we have, every job we take, every food we eat-in other words, with every action. But the fact that there are risks associated with everything we are going to do does not, or should not, reduce us to trembling neurotics. Some actions are riskier than others. The point is to inform ourselves about the relevant risks and then act accordingly.
5 For example, larger cars are generally safer than small ones in collisions. But how much safer? The answer is that you are roughly twice as likely to die in a serious crash in a
small car than in a large one. Yet larger cars generally cost more than small ones (and also use more gas, thus increasing the environmental risks!), so how do we decide when the reduced risks are worth the added costs? The ultimate risk avoider might, for instance, buy a tank or an armored car, thus minimizing the risk of death or injury in a collision. But is the added cost and inconvenience worth the difference in price, even supposing you could afford it?
6 We cannot begin to answer such questions until we have a feel for the level of risks in question. So how do we measure the level of a risk? Some people seem to think that the answer is a simple number. We know, for instance, that about 25,000 people per year die in automobile accidents. By contrast, only about 300 die per year in mine accidents and disasters. Does that mean that riding in a car is much riskier than mining? Not necessarily . The fact is that some 200 million Americans regularly ride in automobiles in the United States every year; perhaps 700,000 are involved in mining. The relevant figure that we need to assess a risk is a ratio or fraction. The numerator of the fraction tells us how many people were killed or harmed as the result of a particular activity over a certain period of time; the denominator tells us how many people were involved in that activity during that time. All risk levels are thus ratios or fractions, with values between 0 (no risk) and 1 (totally risky).
7 By reducing all risks to ratios or fractions of this sort, we can begin to compare different sorts of risks-like mining versus riding in a car. The larger this ratio, that is, the closer it is to 1, the riskier the activity in question. In the case just discussed, we would find the relative safety of car travel and coal mining by dividing the numbers of lives lost in each by the number of people participating in each. Here, it is clear that the riskiness of traveling by car is about 1 death per 10,000 passengers; with mining, the risk level is about 4 deaths per 10,000 miners. So although far more people are killed in car accidents than in mining, the latter turns out to be four times riskier than the former. Those ratios enable us to compare the risks of activities or situations as different as apples and oranges. If you are opposed to risks, you will want to choose your activities by focusing on the small-ratio exposures. If you are reckless, then you are not likely to be afraid of higher ratios unless they get uncomfortably large.
8 Once we understand that risk can never be totally eliminated from any situation and that, therefore, nothing is completely safe, we will then see that the issue is not one of avoiding risks altogether but rather one of managing risks in a sensible way. Risk management requires two things: common sense and information about the character and degree of the risks we may be running.
Health Risks
Opinion polls repeatedly tell us that the only thing Americans worry about more than the environment is their health. This is entirely understandable, for health is obviously preferable to illness. What makes today's preoccupation with health slightly surprising is that Americans are far healthier now than they have ever been. Many diseases that once struck terror into hearts have either been completely eliminated or brought under control. Although AIDS is a notable exception, few new mass killers[1] have come along to replace the ones that have been eliminated.
Nonetheless, health—and the various threats to it—remains everyone's permanent concern. After all, more than half of us (57 percent) will die from either heart disease or cancer, if current trends continue.
One major problem with any comparison of health risks—especially life-threatening ones—is that they differ enormously in their immediacy. For instance, AIDS—if you get it—will probably be fatal after a number of years. Cancer induced by smoking or exposure to radiation, on the other hand, may take 20 to 30 years before its catastrophic effects show up. In making choices about health risks, therefore, it is important to bear in mind the likely time lag between taking a risk and suffering its consequences.[2]
Those with a mind to "live for today"[3] are apt to be indifferent to health risks that have a very long incubation period. Although this is short-sighted, it does make sense to discount long-term risks more than short-term ones. After all, when virtually any of us is confronted with the choice of doing something likely to kill us today versus doing something likely to kill us in two decades, the choice is going to be the lesser of the two evils[4].
One commonly used measure to deal with such problems is a concept called years of potential life lost YPLLS. The idea is that for a 25-year-old, doing something that will kill him in 5 years is much more "costly" than doing something that will kill him in 40 years. Both may involve the same element of risk—the same probability of eventually dying from that activity—but a risk that may cause immediate damage is much more costly than one for which the piper needn't be paid for a long time[5]. In the first case, he will have his normal life span cut short by about 45 years; in the latter case, the deficit is about 5 years[6]. Thinking about matters in this light inevitably causes a reassessment of many of the threats to health. For instance, heart disease is the single largest killer of Americans, way[7] in front of cancer or strokes. However, heart disease tends to strike[8] the elderly in much greater proportions than younger people. Cancer, by contrast, kills fewer people but tends to strike somewhat earlier than heart disease. Hence, more(YPLL)are lost to cancer than to heart disease—despite the greater incidence of fatal heart cases. Specifically, cancers claim[9] about 25 percent more (YPLL)than heart disease (if we define the YPLL as a year of life lost before age 65).
The concept of YPLLs has an important, if controversial, influence on issues in health care economics. It is frequently argued that money devoted to medical research on curing diseases should be divided up on the basis of the number of lives lost to each disease. Thus, some critics of the massive levels of funding devoted to AIDS research claim that—compared to killers such as heart disease and cancer—AIDS receives a disproportionately high support. That criticism fails to consider the fact that AIDS, by virtue of striking people principally in their 20s and 30s, generates far more YPLLs than the bare figure of 20,000 deaths per year, bad as that is, might suggest.[10] Put differently, finding a cure for AIDS would be likely to add about 25 to 30 years to the life of each potential victim. Finding a cure for heart disease, although it might save far more lives, would probably add only another 5 to 10 years to the life of its average victim.
The assessment of the seriousness of a risk changes, depending upon whether we ask how many lives it claims or how many YPLLs it involves. Some of the differences are quite striking. For instance, accidental deaths appear relatively insignificant compared to cancer and heart disease when we just count the deaths caused. But once we look at the number of lost years, accidents loom into first place among the killers of Americans. These data show that we need to ask not only how large a risk is but also when it becomes payable. Other things being equal, the sooner a risk causes damage or death, the more that risk is to be avoided.
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