The only surprise about the current measles outbreak is that we are surprised. This event, years in the making, is what psychologist Max Bazerman and consultant Michael Watkins called a "predictable surprise" in their 2004 book by the same name. By that label, they refer to problems that worsen over time and eventually spring forth as crises, and that decision makers fail to address early on, even though some see what's coming.
In hindsight, the reasons for a predictable surprise stand in sharper relief. In the U.S., measles was almost eradicated, with "almost" being the key word. The most cited reason for the current outbreak is that vaccination rates in many locales have dropped below the 95-percent level needed for "herd immunity." But the underlying reasons go much deeper. They transcend this one disease -- and diseases themselves.
In the mid-1950s, the government established a mass vaccination campaign against polio. Children, brought by their parents to immunization centers that were often in local schools, stood in long lines waiting for the chance to be protected against a disease that could finally be prevented. People trusted the government to mount this effort, trusted the scientists who had developed the vaccine, and accepted that they had a responsibility to their neighbors to stop the spread of a highly contagious virus. The "predictable surprise" of the current measles outbreak is the result of the weakening of all three of these factors during the decades since -- not among all Americans, of course, but among too many.
In 1958, 73 percent of Americans trusted the government in Washington to do the right thing "most of the time" or "just about always." In 2014, that figure was 19 percent. The challenge to nearly all major institutions and sources of authority in society since the 1960s and the particular challenge to governmental authority by politicians, interest groups, and the media, have led us to the point that government is presumed untrustworthy and incompetent, even when it is not. Some of those who refuse to vaccinate their children claim that they cannot trust the Centers for Disease Control and Prevention (CDC). "After all, they botched Ebola," is the claim, ignoring the fact that the CDC did contain Ebola in the U.S. and has been instrumental in slowing its spread elsewhere. There has not been a case in this nation in months.
In 1958, the U.S. began a major investment in science and engineering, spurred by the launch of the Soviet satellite Sputnik. Americans watched with pride as that effort put men on the Moon. Yet by 2013, one poll found that only 36 percent of Americans have "a lot" of trust that the information they get from scientists is accurate and reliable. Fifty-six percent said they trust such information only "a little." Those who claim that vaccines cause autism discount the mass of scientific evidence that disproves that worry. Many attack science because it conflicts with their personal or political views. Science produces "inconvenient truths." This distrust has, ironically, become easier for both those on the right and those on the left by a product of science itself: the Internet. You can find evidence for almost anything you want to believe somewhere in cyberspace, as long as you are willing to ignore the critical distinction between opinion and fact. Indeed, studies suggest that those who are more techno-savvy and more educated seem more skilled at finding Web-reported "research" to back up their predetermined beliefs.
The 1960s also signaled the start of a revolt against authority in most social institutions and, at the same time, an expansion in individual wealth. As a result, the language of individuality pushed to the background the language of community. "My rights" became emphasized more than "my responsibilities." The baby boomers have been called the "me" generation for a reason, but the claims of the personal over the public sphere have grown beyond just them, and the "rights" of both individuals and businesses have advanced in every venue from the culture to the courts. This helps explain the demand that vaccination be a choice, not a requirement. In 17 states, parents can opt out of vaccinating their children for purely "personal reasons." For too many, it seems, the individual's "right" to avoid vaccination trumps that individual's responsibility to help protect the community's most vulnerable citizens, who cannot be vaccinated due to age or medical condition.
There is nothing wrong with a healthy level of distrust of government, which is by no means unerring. There is nothing wrong with questioning science, since that is what scientists do as well. There is nothing wrong with a concern with individual rights, because their expression forces us all to be careful about denying or restricting them. But there is something wrong when the distrust of government and science and the concern with "my rights" get out of balance in ways that lead to predictable surprises. Measles is not the first such surprise. Unless we correct this imbalance, it will certainly not be the last.