CONTENTS MESSAGE FROM THE DIRECTOR-GENERAL OVERVIEW Introduction Enemies of health, allies of poverty Recommended actions Summary of chapters CHAPTER 1 PROTECTING THE PEOPLE Reducing the risks 3 The risk transition CHAPTER 2 DEFINING AND ASSESSING RISKS TO HEALTH What are risks to health? why focus on risks to health? 799 Development of risk assessment Key goals of global risk assessment Standardized comparisons and common outcome measures Assessing protective as well as hazardous factors Including proximal and distal causes 13 Assessing population-wide risks as well as high-risk individuals Including risks that act together to cause disease Using best available evidence to assess certain and probable risks to health 16 Assessing avoidable as well as attributable burden 17 Overview of risk assessment methods Choosing and defining risks to health Estimating current risk factor levels and choosing counterfactuals Estimating current and future disease and injury burden Estimates of avoidable burden Estimating the joint effects of multiple risks Estimates of uncertainty CHAPTER 3 PERCEIVING RISKS Changing perceptions of risk Emerging importance of risk perceptions Questioning the science in risk assessmen Risk perceptions Defining and describing risks to health 323 raming the information on risks ocial and cultural interpretations of risk Perceptions of health risks in developing countries 37 mportance of risk communicationsOverview iii CONTENTS MESSAGE FROM THE DIRECTOR-GENERAL ix OVERVIEW xiii Introduction xiii Enemies of health, allies of poverty xiv Recommended actions xvii Summary of chapters xviii CHAPTER 1 PROTECTING THE PEOPLE 1 Reducing the risks 3 The risk transition 4 CHAPTER 2 DEFINING AND ASSESSING RISKS TO HEALTH 7 What are risks to health? 9 Why focus on risks to health? 9 Development of risk assessment 10 Key goals of global risk assessment 11 Standardized comparisons and common outcome measures 12 Assessing protective as well as hazardous factors 13 Including proximal and distal causes 13 Assessing population-wide risks as well as high-risk individuals 15 Including risks that act together to cause disease 15 Using best available evidence to assess certain and probable risks to health 16 Assessing avoidable as well as attributable burden 17 Overview of risk assessment methods 18 Choosing and defining risks to health 20 Estimating current risk factor levels and choosing counterfactuals 22 Estimating current and future disease and injury burden 22 Estimating risk factor–burden relationships 22 Estimates of avoidable burden 23 Estimating the joint effects of multiple risks 23 Estimates of uncertainty 24 CHAPTER 3 PERCEIVING RISKS 27 Changing perceptions of risk 29 Questioning the science in risk assessment 30 Emerging importance of risk perceptions 31 Risk perceptions 32 Defining and describing risks to health 34 Influences on risk perceptions 35 Framing the information on risks 36 Social and cultural interpretations of risk 36 Perceptions of health risks in developing countries 37 Importance of risk communications 38