Consumer perception and understanding of

risk from food

Barbara Knox
Northern Ireland Centre for Diet and Health, The University of Ulster, Coleraine, County
Londonderry, UK

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The study of risk perception has been punctuated with controversy, conflict and
paradigm shifts. Despite more than three decades of research, understanding of
risk assessment remains fragmented and incoherent. Until recently, food and
eating has been viewed as a low-risk activity and perceived risk surrounded
matters of hygiene or lack of food. Consequently, theories of risk have been
constructed with reference to environmental and technological hazards, such as
nuclear power, whilst neglecting food issues. However, following a decade of
'food scares', attention has moved towards the study of food risk. Within this,
food risk research has focused almost exclusively upon attempting to explain the
divergence of opinion that exists between experts and the lay public whilst
neglecting to address it. The following discussion provides a brief historical
overview of theories and approaches that have been applied to the study of risk
perception, continues with a summary of findings derived from food risk
research and concludes with a discussion of methodological issues and some
projections for future research.

Risk is an important determinant of food choice and correspondingly,

estimates of risk are strongly related to estimates of consumption1. Food
risk has become particularly salient in the wake of a decade of 'food
scares' (such as: alar residue in apples, 1988; salmonella in eggs, 1988;
and bovine spongiform encephalopathy (BSE) in beef, 1996), which
have served to seriously undermine public confidence in the food
industry and government regulatory bodies. Consumer concern over
food safety has steadily increased since the 1970s213, yet only recently
Correspondence to:
Dr Barbara Knox,
have risk perceptions been explored in relation to food. This recent
Northern Ireland Centre attention may well reflect the vested interests of government and
for Diet and Health, The funding bodies who are eager to introduce new technology, such as food
University of Ulster, irradiation and genetically modified foods, into food production in the
Coleraine,
County Londonderry
knowledge that the success of these new technologies will largely depend
BT52 ISA UK upon public acceptance.

British Medical Bulletin 2000, 56 (No 1) 97-109 C The Brrthh Council 2000
Health and the food-chain

Risk: a historical perspective

Theories of rational choice/quantitative risk

Historically, theories of risk have assumed that public perception of risk is

constructed rationally and have focused upon associated probabilities,
costs and benefits, the best example of which is Kahneman and Taversky's
expected utility theory4. Also known as prospect theory, expected utility

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theory was derived from Von Neuman and Morgenstern's (1944), mixed-
motive game theory which arose out of the experimental study of strategic
thinking and decision-making within the context of conflict5. Gaming
studies were undertaken within laboratory constraints and results were
expressed and interpreted in terms of mathematical models. This
approach, therefore, failed to embody the social and cultural context of
decision-making with the result that the approach has proved to be of little
utility for the prediction of behaviour. It is now generally acknowledged
that perceived risk is influenced by a wide range of qualitative factors
rather than statistical rationale and probabilities, yet attempts to model
risk assessment mathematically persist6"8.

Individual differences approach

The individual-differences approach, which has focused upon the effect of

cognitive style upon risk perception through psychometric measures, has
also failed to find any evidence that risk is quantitatively or rationally
assessed.
Starr (1969) was first to point out the importance of dispositional and
cognitive factors, such as volition and perceived control in the perception
of technological risk9. Following on from Starr, the idea that risk per-
ceptions are biased by heuristics (rules of thumb or operating principles)
was suggested by Kahneman and Taversky4, who then set out to test this
idea. Although as far back as 1974, Kahneman and Taversky found no
relationship between objectively calculated risk judgements and public
risk perceptions, research has persisted in the search for rules through
which to predict and influence public response.
Expanding further upon Starr's model of technological risk, Slovic and
colleagues treated risk as a psychological construct and set out to define
and quantify the nature of heuristic bias in risk perception through
psychometric means10. Risk was defined in terms of benefit to society,
magnitude of risk and acceptability of risk, and assessed in relation to
dimensions of risk including voluntarrness, dread, perceived control,
severity, personal and social consequences and familiarity. However, risk
assessments appeared to be related to only two of these dimensions,

98 British Medical Bulletin 2000,56 (No 1)

 Consumer perception and understanding of risk from food

'dread' and 'severity', and these factors have yet to be fully defined in
relation to food risk concepts.
The work of Frewer and colleagues over the last decade has con-
centrated almost exclusively upon food risk, much of it devoted to
testing Slovic's psychometric model of risk perception and expanding it
to include the phenomenon of optimistic bias. The underlying premise
in this research is that through better understanding of the rules and
biases of perception, communication between food regulatory author-
ities and the public might be enhanced.

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One such optimistic bias is the tendency to overestimate certain risks
and underestimate others. Within certain contexts, such as that of health
risk behaviour, there is a tendency to view others as more at risk of
danger than oneself. This may partly explain why health messages have
so little impact. Moreover, there is some evidence to suggest that optim-
istic bias or 'unrealistic optimism' cannot be countered through inform-
ation and that it can actually be exacerbated through health promotion
messages11.
Frewer and colleagues have, therefore, attempted to explain optimistic
bias in relation to perceived control over risk. Whereas environmental
and technical risks, such as potential risk from food biotechnology, are
characterised by low perceptions of control, life-style and dietary health
risks are associated with greater perceptions of control12-13. Man-made
hazards, such as BSE and potential hazards from biotechnology are
perceived as unlikely to be properly regulated and, therefore, difficult to
control. Consequently, it was hypothesised that optimistic bias or
'unrealistic optimism' would be greater in situations perceived as under
personal control, such as health or food risk. To test this idea, Frewer
and colleagues analysed risk assessments for a range of potential hazards
of a technical, bacteriological, chemical and life-style nature that varied
in terms of perceived control14. However, contrary to what the model
would have predicted, the high fat diet, over which perceived control
would be high, was rated overall the riskiest hazard. The relationship
between perceived risk and perceived control is clearly complex. Later
work has suggested that the perception of risk in relation to perceived
control may be offset by perception of need and benefit15. Another
possible explanation is that optimistic bias is related to perceived
control, but it is mediated by 'reactance'16. In the face of a threatening
communication, reactance may occur such that an individual may
change his or her attitude in a direction contrary to that advocated in
order to restore the perception of control.
Although research into optimistic bias appears equivocal, the evalu-
ation of food risk perceptions has provided some support for Slovic's
model. However, questionnaire structure has tended to be biased toward
the theory13-15, allowing only limited scope for unanticipated factors to

British Medical Bulletin 2000,56 (No 1) 99

Health and the food-chain

arise during the process of inquiry. Furthermore, studies of this type have
been criticized for the almost exclusive use of factor analysis and other
perceptual mapping techniques, allowing researcher bias to intrude into
the analysis through the category labels that are attributed to factors17.
For example, it has been argued that the 'dread' dimension, defined by
Slovic in relation to the psychological construction of risk, is analogous to
the discrepancy between 'lay' and 'expert' risk perception, a discrepancy
that causes the public to experience anxiety expressed as dread18. Further-
more, optimistic bias may represent a proxy for perceived control14 rather

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than a separate entity, and may provide an adaptive way of reducing
anxiety and coping with a situation that is not perceived as controllable.
The model has since been expanded to include 'trust' within the context
of risk communication. There is still no theory behind the psychometric
approach19.
The individual differences approach has been favoured politically,
because of its potential to explain the apparent irrationality of lay risk
perceptions, and the implication that the public can be educated to
overcome perceptual bias and to accept more rational assessments of
risk. However, psychometric approaches which measure cognitive and
dispositional variables have demonstrated only limited explanatory
power m the case of food risk20*21, so that qualitative approaches are
gaining increasing favour.

Sociological theory of risk

The sociological view holds that the rich array of social meanings
surrounding risk perceptions render the quantitative assessment of risk
impossible. Risk, particularly technological risk, which includes food
biotechnological risk, is often imposed upon the public by an elite
authority such as government, science and industry, hence, power can
become the over-riding issue leading to conflict22-23. This conflict finds
expression not only in the polarization of lay and expert risk
assessments, but also in the different schools of academic thought that
guide research.
Risk research has concentrated almost exclusively upon the so-called
'irrational' views of the general public, whilst the private beliefs and
perceptions of scientists and civil-servants have largely been ignored. This
focus upon the lay perception of risk reflects the interests of risk managers
and research funding bodies seeking to influence public opinion24. In
addition, the topic of risk perception has been neglected in favour of risk
quantification, and risk assessment based exclusively upon probability
and rationality has provided little opportunity for active lay input into
research data that have been collected23. Sociologists have attempted to

100 British Medical Bulletin 2000:56 (No 1)

 Consumer perception and understanding of risk from food

overcome these biases by studying risk within the wider social and
ideological context. Recent work looking at the effect of experience
upon risk perception suggests that social factors may be more important
than physical and psychological factors in determining risk percep-
tions26. The sociological approach takes into account the role and
perceptions of regulating and policy bodies, the scientific community
and the media.

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Cultural theory of risk

Risk assessment is a social phenomenon based upon culturally deter-

mined ideas. Social and cultural factors determine what risks are salient.
Communication regarding risk probabilities is seldom successful in
reducing lay risk concerns because the quantitative construction of risk
represents only one aspect of public risk assessment. It has been argued
that the quantitative approach has led to a focus upon the failings rather
than the richness of human perception27. Within this is the implication
that the lay view is somehow inferior.
According to cultural theory, risk perception is ideologically driven
whether it be the lay public, the media, the government or the scientific
elite28. Risk perceptions are an expression of four different socially
determined 'thought worlds' or ideologies: (i) the 'atomised' perspective,
which is expressed through a fatalistic attitude; (ii) the hierarchical view,
characterised by trust in authority; (in) the individualistic or rational
view; and (iv) the egalitarian or critical view29. These views are dynamic,
such that people shift from one perspective to another depending upon
the issue.
Food is embedded in our social and cultural practices within which it
holds symbolic significance. In particular, meat holds a varying degree of
significance across cultures30. Food choices and food risk perceptions
are, therefore, motivated by culturally relevant ethical concerns. Food-
related risk is, therefore, likely to be construed in a way that is unique
and may vary by food type. Exploration of food risk perceptions across
societies would establish the degree to which risk perceptions are
culturally determined. Both social and cultural theories have yet to be
fully explored in relation to food risk.

The marketing viewpoint

Having only recently entered the research arena, market researchers

have attempted to put risk in context and observe it in relation to
different decisions of product choice, including food.

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Health and the food-chain

Product involvement, the degree to which a product purchase reflects

personal goals, values and needs, is reflected in risk perceptions and this
may be particularly true of food. In one study, different product classes
including consumable and electrical goods were correlated for both
perceived risk and product involvement31. The only food item that was
included in the study, tinned soup, received highest ratings in terms of
both risk and product involvement. Although only one food was
evaluated in this study, this high level of product involvement is a
reflection of the importance ascribed to food. Food is deeply embedded

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in our social and cultural fabric and frequently acts as a vehicle through
which to express personal, social and cultural identity. Given the high
degree of involvement associated with food, it is perhaps not surprising
that ethical concerns direct public food risk perceptions.
Schutz and Weidmann (1998)32 compared perceptions of personal
versus environmental risk for a range of 30 different products including
electrical goods, clothing items, medicines and food items such as organic
vegetables, butter, and genetically modified strawberries32. Food tended to
be perceived largely in terms of personal risk, except for genetically
modified foods, which were considered risky both on a personal and
environmental level. However, there was a correlation between personal
and environmental risk assessments, suggesting that both personal and
environmental issues are considered when making risk judgements.
In one of very few studies to consider emotion in relation to risk,
Chaudhuri (1998)33 attempted to bring together the information
processing approach, which is objective and rational, and the experiential
approach, which is subjective33. It was found that the degree of emotion
associated with products varied by product class. Luxuries tended to
receive higher risk ratings than essential items, however, essential items,
such as food, became viewed as risky if associated with negative emotion.
This suggests that objective and subjective factors are considered together
and interact in the perception of food risk. Further research is required in
order to gain deeper insight mto the nature of such interactions.

The perception of risk from food

The bovine spongiform encephalitis (BSE) scare

Recently, consumer confidence in government food regulation has been

seriously undermined. Food regulatory bodies had been aware of the
potential risk of BSE for some time, an awareness based upon strong
epidemiological evidence, however, until 1996, any suggestion of risk to
the public was discounted by government, the scientific community and

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 Consumer perception and understanding of risk from food

policy makers through media sources. Denial, indecision and lack of

preparation characterised the management of the BSE crisis. In effect, the
British government misled the public from 1988 until 1996, while
exposing them to serious health risk from beef. Was this a case of
ignorance or of putting industrial interests over public health concerns? In
hindsight, given the uncertainties associated with the risk from BSE
infected meat, the lay public appeared as well placed as the scientific elite
to assess and manage the risk25. Given the cultural emphasis upon the
quantitative rational approach to the assessment of risk, it is of note that

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no quantitative analysis of the effectiveness of the culling exercise and
subsequent risk of BSE transmission, has yet been published25. The
incident has changed the face of public food risk perception for the future.
The only study that appears to have made direct qualitative inquiry into
public perceptions of BSE at the time of the crisis, Keane and Willets (1996)
has indicated polarised views34. While many viewed BSE as the result of
society going against nature, others saw BSE as purely a media creation.
Whereas the former attitude may constitute a moral stance against tech-
nological interference in natural processes, the latter may reflect an
'atomised' perceptual set, characterised by a fatalistic view of risk.
Attitudes toward meat appear intrinsically linked to ideological beliefs
with regard to the natural world 30 . In this sense, the feeding of meat to
ruminants represented a flagrant breach of cultural taboo, hence, the
strong public reaction. 'Mad cow' disease arose out of unnatural animal
husbandry practices, hence, the 'unnaturalness' of genetic modification
has proved a major barrier to public acceptance. Consumer rejection of
genetically modified (GM) foods may reflect this generally accepted
taboo against unnatural food production practices.

Genetic modification and food

Uncertainty typifies lay perceptions of risk from both BSE and GM

foods. In the absence of quantitative information, the public must rely
almost exclusively on qualitative concerns when deciding whether or not
to eat beef or GM foods. Fears of the consequences of science 'meddling
with nature' have been brought about through the BSE food scare. The
BSE crisis demonstrated the power of 'nature' to 'strike back' and
genetic modification seems to have tapped into the same type of fear35.
Investigation by the Consumers' Association, combining the approaches
of survey by interview and focus group discussion, revealed that during
1994 only 2 1 % of people had heard of gene technology and only 17%
understood the term36, but that by 1996, 4 1 % understood the meaning of
the term. Since then, a classic risk conflict scenario has evolved, evidenced
by the polarized views of experts and the lay public.

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Health and the food-chain

As in the case of BSE, public risk perceptions of food biotechnology

appear directed towards ecological and ethical issues. Concerns have
been raised regarding antibiotic-resistant genes37 and other environ-
mental issues such as herbicide-resistant plants38. On ethical grounds,
the public appears more willing to accept genetically modified products
in which the genetic material has been derived from a plant source as
opposed to taken from an animal source15*39. Qualitative studies have
clearly demonstrated the nature of consumer ethical concerns.
Consumers view genetic modification as 'unnatural', that it is 'meddling

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with nature' and that science is 'playing God' by altering the genetics of
nature35"37. This may reflect the apparent cultural taboo against
unnatural production processes.
The public believes that the only people to benefit from genetic
engineering will be food producers and manufacturers. In contrast, the
scientific community and the food industry present genetic modification
as a 'saviour' technology capable of solving world food shortage and
production problems40'41. Genetic modification could also be used to
enhance the nutrient content of foods37 and help to eliminate known
food-borne allergens42. In attempting to present a philosophical rationale
for GM foods, Robert Shapiro, chief executive of the Monsanto
Company, drew an analogy between information technology and gene
technology arguing that both are merely concerned with the transfer of
information40. The innovative idea of linking genetic modification
conceptually with 'consumer-friendly' information technology assumes a
rational approach and appears unfounded given that food attitudes are
culturally embedded and construed differently to other types of risk.
Consumers are suspicious of the motives of the food industry and
biotechnologists because the two groups appear to be working from
'unsound value systems'. Whereas science and industry view the
consumer as lacking understanding, a problem which could be overcome
through public education, the consumer views science and industry as
commercially driven and the technology as being imposed upon them
without consultation.
During 1996, two genetically modified products, tomato puree and
soya produced by the Monsanto Company for use as an ingredient in
other food products, went on sale for the first time in Europe36. Although
there was no legal requirement to label such products, the companies
concerned took the decision to do so voluntarily. Nevertheless, conflict
between consumers and industry surrounds the issue of the labelling of
GM foods and ingredients. A recent survey found that 62% of scientists
oppose mandatory labelling of foods containing GM ingredients43. The
Food Advisory Committee and the Advisory Committee on Novel Foods
and Processes saw no requirement for labelling herbicide-resistant soya
produced by the Monsanto Company. They argued that labelling was

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 Consumer perception and understanding of risk from food

unnecessary as the ingredient was safe and that is was impossible to

determine the approximate amount of GM soya contained, as it was
unsegregated from normal soya.
The Novel Food and Novel Ingredients Regulation came into force
during 1997 allowing food manufacturers, if they wished, to label
products as 'may contain GM ingredients'. However, consumers do not
want ambiguous statements but clear and precise labelling to indicate
which foods have been genetically modified36'44'45. Food labelling
increases consumer perceived control. Information enables the public to

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choose or to reject GM foods if desired, otherwise the risk becomes
involuntary, beyond personal control and thus may be perceived as more
threatening46. The current debate surrounding GM foods provides a
unique opportunity through which to study food risk perceptual pro-
cesses prospectively both in context and in relation to existing theory.

The communication of food risk perception

Consumer concern over food risk has increased while at the same time
trust in government and industry to control and monitor technological
development has been seriously eroded, further amplifying risk
perceptions. This has driven research into the communication of risk
perception.
Communication appears to enhance trust only under certain con-
ditions6. Frewer and colleagues have applied the elaboration likelihood
model47 to the study of risk communication and the effect of trust in the
information source upon attitudes to GM foods. According to the theory,
persuasion can occur on one or both of two interacting levels or channels
- deep and peripheral. Information itself is processed at a deep level, while
contextual factors surrounding the information, such as perceived
credibility of the source, are processed at a peripheral level, influencing
how the information is interpreted. An initial study that considered
perceived risk from food poisoning and from excessive alcohol
consumption found that the perceived credibility of the source had no
effect upon persuasiveness of the risk message48. More recently, com-
parison was made between information sourced either from a consumer
organization (trusted) or government (less trusted). The persuasiveness of
the information was also varied. However, contrary to what the model
would predict, it was information which was 'high in persuasiveness' from
the consumer organisation, and 'low in persuasiveness' from government
sources, which was most trusted49. Perhaps government authorities come
across to the public as 'trying too hard' when attempting to communicate
risk messages, and in doing so, appear dishonest.
Consistent with the idea of 'trying too hard', qualitative exploration

British Medical Bulletin 2000,56 Wo 1) 105

Health and the food-chain

has suggested that the least trusted sources are those perceived to
exaggerate or distort information, those with an apparent vested interest,
and those motivated to self-protection. The most trusted sources were
those which are moderately accountable to others, those which have little
vested interest in promoting the viewpoint and those which are only
somewhat self-protective12.
Understanding of public perception of risk is crucial to the success of
food safety communication and the uptake of new technology. Toward
this end, we need to know more about how people define and interpret

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risk and the ideological framework within which risk decisions are
expressed.

Conclusions
Whereas quantitative and psychometric models of risk perception provide
some insight into how risk perceptions are constructed at the cognitive
and dispositional level, social and cultural theories provide a framework
through which to understand such perceptions. However, people do not
think and behave in mechanistic ways, consequently, appreciation of
public response to food safety issues requires some understanding of the
subjective perceptions and meanings ascribed to such issues, as well as the
wider cultural and social forces operating to determine public response to
food safety issues. Taken together, the evidence implies that risk cannot be
studied in isolation as a discrete entity, but that risk concepts run like a
common thread, linking a diverse range of decision-making factors.
Despite the importance of risk perception in determining food choice,
very few studies of risk have been applied to food specifically. Theories
and models have been adapted from research into financial, nuclear or
environmental risk. Given that health risk, and particularly food risk, is
likely to be uniquely construed, even food product specific, it would seem
appropriate to first go back and explore food risk qualitatively within the
context of food purchase and choice, and to develop specific theoretical
models accordingly. Theories of food choice provide a framework through
which to understand and predict human dietary behaviour. Models of
food choice clearly must incorporate the perception of risk as a decisional
factor.
The private views of scientists, civil servants and industrialists have
been largely ignored2; however, what little research there is, suggests that
scientists hold ethical arguments against genetic engineering and share
many consumer reservations43. Given the suggestion that the public
perception of risk is subject to optimistic bias, is it not conceivable that
government and scientific personnel representing official groups are

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 Consumer perception and understanding of risk from food

expressing the same optimistic bias through their emphasis upon the
probabilities of risk, whilst apparently disregarding the intuitive ethical
views of consumers, when communicating risk messages? This apparent
neglect of consumer concerns has served to undermine consumer
confidence in the safety of the food supply. Risk perceptions require
exploration within the social and cultural context in which they are
embedded. This means that the views and interactions of all parties
involved in the risk assessment and management forum need to be fully
considered. Only then can it be determined if the discrepancy between

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lay and expert assessments of risks is perceived or actual.
Risk is a 'fuzzy' concept19, which has yet to be described or explored
in all its facets. Co-ordinated interdisciplinary collaboration is required
in the endeavour to encompass the scope and complexity of risk
perception and the nature of any interactions therein. Furthermore, risk
assessment is dynamic, the processes of which require definition by
means of prospective, longitudinal research51, surrounding food-related
'live issues'. Meanwhile, there is a growing market for food products
with enhanced safety attributes.

Acknowledgement
The author wishes to acknowledge the assistance of Corrina Donnelly in
gathering some of the cited literature. A full bibliography can be obtained
from the author.

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