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Agency for Toxic Substances and Disease Registry
A Primer on Health Risk Communication

Principles and Practices

Note: While the original publication dates on some of ATSDR's documents may not appear to be current, the information in the documents is valid and may still provide relevant information.

"Get the receiver involved up front."

Barry Johnson, Ph.D.
Assistant Surgeon General
Assistant Administrator
Agency for Toxic Substances and Disease Registry
Public Health Service, US Department of Health and Human Services (1987)

"If we have not gotten our message across, then we ought to assume that the fault is not with our receivers."

Baruch Fischhoff
Department of Engineering and Public Policy
Carnegie-Mellon University


The public contributes significant information in determining the public health impact of exposure to toxic substances at hazardous waste sites. The public health professional must understand the needs of the community and be able to facilitate dialogue concerning the technical issues of public health risk and the psychological, political, social, and economic needs of the community.

The purpose of this Primer is to provide a framework of principles and approaches for the communications of health risk information to diverse audiences. It is intended for ATSDR staff and personnel from other government agencies and private organizations who must respond to public concerns about exposure to hazardous substances in the environment.

The Primer begins with brief descriptive material about the mission of ATSDR and the importance of local community involvement in the health risk communication process. The remainder of the Primer is devoted to a discussion of issues and guiding principles for communicating health risk accompanied by specific suggestions for presenting information to the public and for interacting effectively with the media.

Although the Primer attempts to identify principles relevant to and consistent with effective health risk communication practice, it is not intended to suggest that a standard of health risk communication effectiveness is measured solely on the number of principles that are employed. Rather, the manner in which the guidance should be applied will vary from case to case, based on needs, priorities, and other considerations.

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The ATSDR Mission

The Agency for Toxic Substances and Disease Registry (ATSDR), created by the US Congress in 1980, is a federal Public Health Service agency and part of the US Department of Health and Human Services. The mission of the Agency for Toxic Substances and disease Registry is to prevent exposure and adverse human health effects and diminished quality of life associated with exposure to hazardous substances from waste sites, unplanned releases, and other sources of pollution present in the environment.

The Role and Importance of Community Involvement in ATSDR Health Risk Communication

Health risk communication is an emerging area of emphasis and importance at ATSDR and in parts of the broader public health community. Over the past decade, health risk communication has played an integral part in ATSDR's comprehensive efforts to prevent or mitigate adverse human health outcomes related to hazardous substance exposure.

It is ATSDR's responsibility to ensure that decisions are made using the best available information. Community residents, site personnel, citizen groups, health professionals, and state and local government representatives are all unique sources of information needed by ATSDR to effectively communicate about the public health risks of exposure to hazardous substances. They can provide information concerning site background, community health concerns, demographics, land and natural resource use, environmental contamination, environmental pathways, and health outcomes. Information is needed from the community at several points in the health risk communication process. Involving the community in the information-gathering process makes ATSDR communications more credible and sets the stage for community participation in helping to resolve problems. Communities need and want to be actively involved in identifying, characterizing, and solving problems that affect their lives.

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