Car seat belts and AIDS in Africa

What have those two things got to do with each other?

Still thinking? Well, this month’s Smithsonian magazine has the answer.

It is 50 years since the invention of the three-point car seat belt by Nils Bohlin for the Volvo company -- possibly the most effective safety device ever. Experts estimate that it has saved at least a million lives and spared millions of others life-altering injuries -- or has it? An analysis conducted in the US in 1975 concluded that while federal auto-safety standards had saved the lives of some vehicle occupants, they had also led to the deaths of pedestrians, cyclists and other non-occupants. A study of seat belts in the UK in 1981 found there was no overall decrease in highway fatalities.

The explanation for these counter-intuitive results seems to be that when drivers feel safer in their vehicles they take more risks. Behavioural scientists call it “risk compensation” and trace it to an inbuilt human tolerance for risk. Skydivers leave it too late to use their improved ripcords; people move back in to flood plains reassured by subsidised insurance and disaster relief; children who wear protective sports equipment engage in rougher play; and enhanced HIV treatment can lead to riskier sexual behaviour.

Responsible scientists and health workers know that the big hole in the condoms-against-AIDS campaign is this very human tendency to follow our impulses when we feel it is safe -- rather than good or responsible -- to do so. For every advance in “protection” or treatment of HIV there will be a compensating tendency to take more risks. That is why no major HIV-AIDS epidemic has been curtailed by condoms, but only by behavioural change -- chiefly, a reduction in partners.

Unfortunately, some psychologists push the concept of risk compensation too far, claiming that humans have an automatic risk setting (“risk homeostasis”) that needs external manipulation to be re-set. It’s then up to society or employers and so on to reward safe behaviour and thus turn the risk thermostat down. But this merely infantilises people, or treats them like animals, ignoring the human capacity for self-restraint. Risk-taking is a positive element in human behaviour -- civilisation depends on people who dare a lot -- but only when kept in check by a moral code, in which case it becomes virtue.


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