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Public sneezes, private fears

ANN ARBOR, Mich.—Seeing other people sneeze and cough affects how people view the U.S. health care system and how likely they are to support federal spending to develop a flu vaccine, a University of Michigan study shows.

Being exposed to another person's sneezing or coughing also leads people to think it's more likely that the average American will contract a serious disease, have a heart attack before age 50 or die as a result of a crime or accident.

U-M researchers conducted two experiments showing that actually seeing possible flu symptoms nearby heightens perceptions of risks and a general feeling that the world is a dangerous place. The report is forthcoming in Psychological Science, a peer-reviewed journal published by the American Psychological Society.

"We found that exposure to public sneezing and coughing increased risk perception even for risks that are completely unrelated to the flu," said Norbert Schwarz, a research professor at the U-M Institute for Social Research, a professor in the U-M Department of Psychology and a professor at the U-M Ross School of Business. "We also found that people were unaware that exposure to public symptoms of the flu had influenced their judgments of risk, their views about government spending on flu research or their opinion of the U.S. health care system."

Schwarz conducted the experiments with U-M graduate student Spike W.S. Lee, first author of the report, and undergraduate students Danielle Taubman and Mangyuan Hou. They conducted the first experiment in May 2009 shortly after the H1N1 pandemic began receiving intense media coverage.

First, a member of the experimental team walked by students in public areas around campus buildings, both sneezing and coughing (experimental condition) or not (control condition).

Next, an experimenter asked students to complete a one-page questionnaire to help with a class project. Twenty-six students in the experimental condition and 24 in the control condition complied. The questionnaire asked participants to estimate the risk that an "average American" would contract a serious disease, have a heart attack before age 50 or die as a result of a crime or accident, on a scale from 0 (impossible) to 100 (certain to happen).

Participants exposed to sneezing and coughing estimated the risk of contracting a serious disease at 41.2, compared to a risk of 26.7 estimated by those in the control condition. The risk of having a heart attack before age 50 was assessed at 45.4 by people in the sneezing condition, compared to 32.1 for those in the control condition. And the risk of dying from a crime or accident was estimated to be 41.2 by those exposed to sneezing and coughing, compared to 27.9 for those in the control condition.

Participants were also asked to evaluate the U.S. health care system on a seven-point scale, where 1 equals "Our health care system has so much wrong with it that we need to completely rebuild it" and 7 equals "Our health care system works pretty well and only minor changes are necessary to make it work better," (the health care question was taken from a NYT/CBS News poll.) The U.S. health care system was rated 3.07 by those exposed to someone sneezing, compared to 3.67 for those who were not exposed.

For the second experiment, conducted the same month, an experimenter asked pedestrians in shopping malls and downtown business areas to participate in a one-minute survey. Forty-seven people agreed to do so. For the sneezing condition, the experimenter coughed and sneezed once while covering her mouth with her left forearm before handing the questionnaire to 23 participants. In the control condition, the same experimenter did not cough or sneeze before handing the questionnaire to 24 people. This time the first question noted that the New York Times reported on a $1.3 billion federal investment in vaccine development and asked if participants would prefer the government spend this money to facilitate the production of flu vaccines or to fight unemployment by creating green jobs.

Less than 17 percent of those not exposed to the experimenter's sneezing and coughing said they preferred the government to spend $1.3 billion on vaccine development, compared to 48 percent of those who were exposed to the experimenter's coughing and sneezing.

"These studies clearly show that exposure to a mundane event like coughing or sneezing can affect people's attitudes and feelings about risk when there is heightened awareness of a salient threat like a flu pandemic," Lee said.
