Communicating about Risks: A Checklist for Health Agencies

Article excerpt

Abstract Much of the information an environmental health agency provides about health and safety risks is routinely delivered against a background of community disinterest that often approaches apathy. In such instances, the main challenge is to raise awareness and motivate risk-avoidance behavior. At other times, however, public panic, fear, and anger can reach such a pitch that these reactions themselves can be far more dangerous than the object of the fury. The latter setting is the focus of this paper.

An understanding of risk perception is applied to the process of risk communication, with the emphasis on the expectations and needs of local official health agencies. The format for the discussion is a checklist of considerations for the effective communication of risk-related information.

Introduction: Risk Communication and the Role of the Local Health Agency

A group of parents has just discovered that the ceiling in their children's school contains sprayed asbestos insulation. They are angry and frightened. They have removed their children from the school. They loudly demand to know exactly what health effects their children can expect to encounter over their lifetimes.

Would the local health agency be ready to respond effectively?

Communities are demanding more control over the management of certain hazards, and, at the same time, a considerable loss of public trust in the traditional institutions and authorities has developed (1). Local health agencies can still demonstrate public trust and credibility to a relatively higher degree than most government departments (2). That trust, however, is fragile and easily destroyed by careless statements (or by no statements at all).

Most crises requiring the communication of risk-related information usually arise without warning, and agencies often must respond without the time to prepare practiced responses: a neighborhood is contaminated with smoke containing PCBs from a bunting plastics plant, portable classrooms are found to contain Stachybotrys mycotoxins, or several cases of meningococcal meningitis occur at the local school.

Although the "technical" threats are different in each case, the public's reaction and anxiety will have similar characteristics allowing much of an agency's response process to be planned and reviewed ahead of time. Unfortunately many organizations in both the public and private sectors still rely on an outdated model of communication in which a source (usually the agency) transmits its message through a medium (such as a pamphlet, a verbal presentation, or TV announcement) to the receiver (the resident). If initial attempts fail, the message is repeated or the "volume" is increased. This approach, which may be sufficient in primary school and military settings, does not permit members of the community to ask their own questions or express their information needs, and that circumstance alone often increases outrage in the community and decreases the agency's credibility.

The checklist below offers some basic steps for applying an understanding of risk perception, as discussed by the author in a previous article, to achieve effective risk communication (3).

A Risk Communication Checklist

1. Whom Should We Tell?

Tell all segments of the community the same information, but, if possible, tell the people most at risk first. The risk will burden them unfairly in any case, and they should not have to be the last to find out that they have been exposed. They may hear it on the six o'clock news and then find that the agency and others have known for two weeks--an example of what might be termed the "double indignity" of poor risk communication.

2. What Should We Tell Them?

In a crisis setting, people will want answers to questions like the following:

* "What has happened?"

* "What will the health effects be for me and my family? …