Draft for WHO Workshop, Rome, 13-14 December 2007. The cost of inaction: economic valuation in environment and health.

Contemplation of the costs of inaction usually provokes questions about the benefits of inaction, which leads to cost-benefit analysis. Cost-benefit analysis, as a method for settling arguments about action or inaction is enormously seductive. You simply add up the benefits of doing something and subtract the costs and if the result is positive you have a case for doing it. What could be wrong with that? In practice quite a lot. ….

The cost of inaction, the title of this workshop, implies the existence of a set of problems within WHO’s sphere of responsibility in which conventional methods of economic evaluation will be able to convince those responsible for taking action that the benefits of action will outweigh the costs. I have my doubts. Read full paper .

In 1971 Mayer Hillman conducted a survey of how English children got about: at what age were they allowed to play in the street, ride a bike, get to school on their own, visit friends and get about the neighbourhood? In 1990 Mayer persuaded me to join him in re-surveying the same schools he had visited in 1971. We discovered a change even more dramatic than we had anticipated. In 1971 80% of 7 and 8 year old children got to school unaccompanied by an adult. By 1990 this had dropped to 9%. The report of the 1990 survey, documenting the demise of the free-range child between 1971 and 1990, is now available online - One False Move … a study of children’s independent mobility
Since 1990 for children things have got much worse. Two new reports document the continuing loss of children’s traditional independence and, one hopes, will inspire a counter-revolution: No Fear- growing up in a risk averse society by Tim Gill , and Risk and Childhood , by Nicola Madge and John Barker.

In October 2007 the Insurance Institute for Highway Safety published a Status Report (PDF: 1MB) complaining about my article “Britain’s Seat Belt Law should be Repealed” (PDF: 0.2MB) (published as “Seat Belt Laws – Repeal them?” in the June 2007 issue of the statistical journal Significance). It went on to denounce all those who invoke the risk compensation effect to question the efficacy of seat belt laws. It concludes: “Don’t believe them, not until they produce credible evidence that people compensate for safety”.

I first produced evidence on the subject sufficiently credible to pass peer review for publication in the Society of Automotive Engineers Transactions in 1982 - “The Efficacy of Seat Belt Legislation” (PDF: 0.2MB). I have revisited the evidence that people monitor their environments for signs of safety or danger, and adjust their behaviour in response to perceived changes, in numerous publications since, including two books: Risk and Freedom: the record of road safety regulation (1985) and Risk (1995).

The idea that people compensate for safety was considered outrageous in 1982,  and still is by the Insurance Institute for Highway Safety: “To believe Adams you’d have to believe that people have a certain tolerance for risk and that their levels of risk are regulated by a homeostatic mechanism so that, if forced to “consume” more safety than they voluntarily would choose, people will balance the safety increase by taking more risk. It’s a stretch, isn’t it?” 

The “stretch” appears to be now becoming conventional wisdom. It underpins the increasingly popular concept of shared space (PDF: 15KB); Hans Monderman, the Dutch originator of the concept spoke to an enthusiastic sold-out meeting in London’s City Hall this week. And it is even finding its way into government planning guidance in Britain. This quotation can be found in the Department for Transport’s Manual for Streets: evidence and research (PDF: 10MB): “One of the most important variables that needs to be taken into consideration is ‘risk homeostasis’ – the way in which drivers adjust their behaviour to maintain a consistent level of risk. As drivers feel safer they begin to take more risks, whereas conversely, if road conditions make them feel unsafe, drivers are likely to adjust their behaviour to take fewer risks.”

Many thanks to Jim Tubman who noticed that the previously posted version of the book was missing page 89. Further thanks to Jim for inserting it, and adding further bookmarking features. The new, improved product is now online at http://john-adams.co.uk/wp-content/uploads/2007/10/risk%20and%20freedom.pdf.

Now available as a free online download

Amazon Review (*****):

Risk and Freedom is a book of historic significance. Published in 1985 and out of print for many years it continues to have a profound influence on road safety policy. It provides the first coherent application of the concept of “risk compensation” to the management of risk on the road. Risk compensation is a term coined by Canadian psychologist Gerald Wilde in the 1970s to describe the behavioural adjustments of people to perceived changes in safety or danger. In Risk and Freedom Adams applies the idea to a wide variety of road safety measures - seat belts, helmets, speed limits, alcohol limits, highway improvements, crumple zones and other crash protection measures, improved brakes and tires, and accident blackspot treatments, to name the main ones.

The idea that risk compensation could explain the failure of such measures to achieve their promised benefits was, at the time, unanimously dismissed out of hand by highway engineers, vehicle designers, and regulators. Today it is widely accepted as mere common sense, and serves as the basis for the new, and increasingly popular, shared space schemes. The most obvious explanation for the success of these schemes is Adams’ argument that road users are not obedient automatons, but alert and responsive participants in what Adams calls in his last book, Risk, “the dance of the risk thermostats”. Also, unlike most books on this subject it is well-written and entertaining.

(Commissioned, but not used - and worse not paid for - by The Los Angeles Times. So published here free of charge on the slightly-smaller-circulation Adams’ Blog)

There is a growing enthusiasm amongst European transport planners for “shared space”. It is an intriguing idea pioneered by Hans Monderman, a highway engineer in Friesland. He removed almost all the traffic lights, pedestrian barriers, stop signs and other road markings that had been assumed to be essential for the safe movement of traffic.

For traditional highway engineers his idea was anathema. Since the advent of the car they have planned on the assumption that car drivers are selfish, stupid, obedient automatons who had to be protected from their own stupidity, and that pedestrians and cyclists were vulnerable, stupid, obedient automatons who had to be protected from cars - and their own stupidity…
Full article here [PDF]

(Published in abbreviated form in The Times Higher on 24 August 2007, as “Tide of paranoia swells safety fears needlessly”)
“We are in danger of having a wholly disproportionate attitude to the risks we should expect to run as a normal part of life.” So said the Prime Minister in May 2005. At the highest level those concerned with our Health and Safety are worried that we are getting things out of proportion. Bill Callaghan, chair of the Health and Safety Commission is “sick and tired of hearing that ‘health and safety’ is stopping people doing worthwhile and enjoyable things.” He urges people to “stop concentrating effort on trivial risks and petty health and safety.” This is a sentiment shared by Rick Haythornthwaite, head of the Better Regulation Commission who declares “Enough is enough – It is time to turn the tide”.
“Field work perils mount”, the main front-page story in The Times Higher on 3 August shows that the tide of risk aversion is still running strongly in the world of higher education…
Full article here [PDF]

Britain’s Liberal Democrat History Group provoked a mid-summer controversy with its search for the greatest British Liberal of all time. Its short list, to be voted on at the party’s annual conference in September, consisted of William Ewart Gladstone, David Lloyd George, John Stuart Mill and John Maynard Keynes. The front runner for most of the summer has been Mill. Roy Hattersley disputed Mill’s pre-eminence in an article in the Guardian . His article persuaded me that Mill did indeed deserve to win the competition. Below my reply to the Guardian in which I conclude that Mill’s policies on seat belts and drugs are ones with which I would have agreed.

John Stuart Mill and the cream-bun theory of liberty
Saturday August 11, 2007

Roy Hattersley (Liberty is not what it was, 6 August ) argues that Gladstone, not John Stuart Mill, was the most important Liberal in British history. He quotes Mill’s famous dictum - “all errors which [a citizen] is likely to commit against advice and warning, are far outweighed by the evil of allowing others to constrain him to what they deem his good” - and proclaims it out of date. He could not have chosen two better examples, compulsory seat belts and the prohibition of recreational drugs, to make the case for Mill…
Full letter here [PDF]
More on drugs here>

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Keynote address to OpRisk Europe Conference, 21 March, London:

• All risk is subjective. “Risk” is a word that refers to the future, and that exists only in the imagination.
• Risk management involves speculating about this future, about things that could go wrong, and about ways of preventing them.
• In recent years, in the public sector and throughout the worlds of commerce and industry there has been an explosion in the numbers of risk assessments undertaken and a remarkable increase in the thoroughness and comprehensiveness that they attempt.

View full PowerPoint notes presentation