I think we first have to ask whether it's necessary to use proportional odds logistic regression to approximate a cumulative relative risk, e.g. the relative risk of reporting a higher outcome. The probabilistic formulation of the proportional odds model relies on observing arbitrary bins of a latent logistic random variable. See my relevant question here. The elegance of this method is that the survival function (1-CDF) of a logistic RV is the inverse logit, e.g. $P(Z > z) = \exp(-z)/(1+\exp(-z))$.
If we are to assume a similar probabilistic derivation of a relative risk model, the desire is to find a latent random variable whose survival function is $P(Z > z) = \exp(-z)$. But that is just an exponential random variable, which is memoryless. Therefore, if we construct the matrix of thresholded outcome variables, $O_{ij} = \mathcal{I}(Y_{i} \ge j)$, (I believe) the cell frequencies are conditionally independent, and thus are amenable to modeling via a log-linear model which is just Poisson regression. This is reassuring because the interpretation of Poisson coefficients is as a relative rate. Modeling the interaction between the response variable as numeric outcome and the regression coefficients leads to the correct interpretation.
That is, fit the log-linear model:
$$\log (N_{ij} | Y_{i}, \mathbf{X}_{i,}) = \eta_0 I(Y_{i} = 0) + \ldots + \eta_j I(Y_i == j) + \vec{\beta} \mathbf{X}_{i,} + \vec{\gamma} \text{diag(Y)} \mathbf{X}_{i,}$$
Using the example from the MASS package: we see the desired effect that the relative risk is much smaller than the OR in all instances:
newData <- data.frame('oy'=oy, 'ny'=as.numeric(y), housing)
## trick: marginal frequencies are categorical but interactions are linear
## solution: use linear main effect and add indicators for remaining n-2 categories
## equivalent model specifications
fit <- glm(Freq ~ oy.2 + ny*(Infl + Type + Cont), data=newData, family=poisson)
effects <- grep('ny:', names(coef(fit)), value=T)
print(cbind(
coef(summary(fit))[effects, ],
coef(summary(house.plr))[gsub('ny:','', effects), ]
), digits=3)
Gives us:
Estimate Std. Error z value Pr(>|z|) Value Std. Error t value
ny:InflMedium 0.360 0.0664 5.41 6.23e-08 0.566 0.1047 5.41
ny:InflHigh 0.792 0.0811 9.77 1.50e-22 1.289 0.1272 10.14
ny:TypeApartment -0.299 0.0742 -4.03 5.55e-05 -0.572 0.1192 -4.80
ny:TypeAtrium -0.170 0.0977 -1.74 8.21e-02 -0.366 0.1552 -2.36
ny:TypeTerrace -0.673 0.0951 -7.07 1.51e-12 -1.091 0.1515 -7.20
ny:ContHigh 0.106 0.0578 1.84 6.62e-02 0.360 0.0955 3.77
Where the first 4 columns are inference from the log-linear model and the second 3 columns come from the proportional odds model.
This answers perhaps the most important question: how does one fit such a model. I think it can be used to explore the relative approximation(s) of ORs for rare events to the RRs.