It can’t happen to me, right?
We were recently presented with qualitative research investigating understanding of sudden cardiac arrest among people with no medical training.
Among the research subjects were people who had some previous exposure to cardiac arrest – either through first aid training, or family history.
Every single one of these subjects under the age of 50 said sudden cardiac arrest isn’t relevant to them. Even if they’d witnessed it happen to someone else.
When pressed on why they thought this, the common response was that they thought cardiac arrest is something that happens to old people.
In other words, even when they’d seen evidence to the contrary, they remained convinced that sudden cardiac arrest is something that can’t happen to them.
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There is a name for this underrating of our chances of bad things happening to us: optimism bias.
Optimism bias is the difference between a person’s expectation and the outcome that follows.
An optimism-biased person believes they won’t get cancer. And yet, an estimated 19.3 million new cancer cases occurred in 2020, resulting in almost 10 million deaths.
Depending on how that person lives their life, or their family history and gene pool, they could be at high risk of contracting some form of cancer in their lifetime. If that happens, it’s highly likely it will come as a shock; studies consistently report that around 80 per cent of us display an optimism bias.
There is certainly a sunny side to this (which may be the optimism bias talking). Our society values positive thinking. Scientific analysis has shown that positivity is linked to longevity – even among those who may have been surprised by a cancer diagnosis.
The same known behavioural factors increasing cancer risk – unhealthy diet, physical inactivity, tobacco use and high levels of alcohol consumption – are also contributors to the risk of cardiovascular disease.
Diseases of the heart kill nearly twice as many people as cancer every year. A third of those deaths occur prematurely in people under the age of 70.
That last point is immediately relevant to those under-50s. In fact, the incidence of cardiovascular diseases among over-50s has decreased in the past two decades, while increasing among people aged between 18 and 50 over the same period.
Overcoming low risk perception
In the late 1980s, Australian television viewers were presented with the Grim Reaper advertisements, aimed at raising public awareness on the dangers of AIDS.
These ads used fear to drive home the message that AIDS can affect anyone. They were the brainchild of then-young ad man Siimon Reynolds, who is on-record saying that the possible stigmatization of gay men that could result from these shocking ads was a risk worth taking, if the ads could “wake people up.”
The Grim Reaper ads are a textbook example of how fear can be used to draw attention to public health issues – and the unintended consequences this tactic can produce.
Appealing to fear is a common marketing method. The concept of “believe me, or something bad will happen” has been proven to have some success in relation to impacting behaviours that increase the risk of sudden cardiac arrest, such as smoking.
But, is it effective when trying to enlist active support of individuals to be prepared to respond to sudden cardiac arrest?
In that context, a more – yes, optimistic – approach has been shown to have longer-lasting positive impacts on sudden cardiac arrest survival rates.
Take Denmark’s Little Life Savers program. By introducing mandatory CPR training in schools and for anyone applying for a driver’s licence, it tripled country-wide out-of-hospital cardiac arrest survival rates within five years.
These and other similar programs have provided a roadmap for the rest of us who are trying to overcome the fundamental problem: too many of us are unaware of, or dismissive of the danger of sudden cardiac arrest.
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