It also ignores the economic potential and quality of health conditions available which could be even more important factors in cancer outcomes in this demographic than a spiral of silence. Finally, I believe that the existence of the spiral of silence is best determined indirectly in studies not associated with the spiral of silence, since respondents might be inclined to modify their answers if the spiral of silence, typically subconscious, is discussed openly . Even polls based on individual opinions about community opinions might not fully address the problem, because believing that one person's opinions are in the minority does not necessarily equate to a deterrent effect. The sociological study of cultural mores and taboos can better explain the existence of a spiral of silence in a given culture. Analysis from a practitioner