Agency for Toxic Substances and Disease Registry
A Primer on Health Risk Communication
Principles and Practices
Overview of Issues and Guiding Principles
Merely disseminating information without regard for communicating the complexities and uncertainties of risk does not necessarily ensure effective risk communication. Well-managed efforts will help ensure that your messages are constructively formulated, transmitted, and received and that they result in meaningful actions. Consider how the process works and some general principles for improving effectiveness.
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Belief in some common myths often interferes with development of an effective risk communication program. Consider the myths and actions you can take.
Myth: We don't have enough time and resources to have a risk communication program.
Action: Train all your staff to communicate more effectively. Plan projects to include time to involve the public.
Myth: Telling the public about a risk is more likely to unduly alarm people than keeping quiet.
Action: Decrease potential for alarm by giving people a chance to express their concerns.
Myth: Communication is less important than education. If people knew the true risks, they would accept them.
Action: Pay as much attention to your process for dealing with people as you do to explaining the data.
Myth: We shouldn't go to the public until we have solutions to environmental health problems.
Action: Release and discuss information about risk management options and involve communities in strategies in which they have a stake.
Myth: These issues are too difficult for the public to understand.
Action: Separate public disagreement with your policies from misunderstanding of the highly technical issues.
Myth: Technical decisions should be left in the hands of technical people.
Action: Provide the public with information. Listen to community concerns. Involve staff with diverse backgrounds in developing policy.
Myth: Risk communication is not my job.
Action: As a public servant, you have a responsibility to the public. Learn to integrate communication into your job and help others do the same.
Myth: If we give them an inch, they'll take a mile.
Action: If you listen to people when they are asking for inches, they are less likely to demand miles. Avoid the battleground. Involve people early and often.
Myth: If we listen to the public, we will devote scarce resources to issues that are not a great threat to public health.
Action: Listen early to avoid controversy and the potential for disproportionate attention to lesser issues.
Myth: Activist groups are responsible for stirring up unwarranted concerns.
Action: Activists help to focus public anger. Many environmental groups are reasonable and responsible. Work with groups rather than against them.
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- Accept and involve the public as a partner.
Your goal is to produce an informed public, not to defuse public concerns or replace actions.
- Plan carefully and evaluate your efforts.
Different goals, audiences, and media require different actions.
- Listen to the public's specific concerns.
People often care more about trust, credibility, competence, fairness, and empathy than about statistics and details.
- Be honest, frank, and open.
Trust and credibility are difficult to obtain; once lost, they are almost impossible to regain.
- Work with other credible sources.
Conflicts and disagreements among organizations make communication with the public much more difficult.
- Meet the needs of the media.
The media are usually more interested in politics than risk, simplicity than complexity, danger than safety.
- Speak clearly and with compassion.
Never let your efforts prevent your acknowledging the tragedy of an illness, injury, or death. People can understand risk information, but they may still not agree with you; some people will not be satisfied.
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The likelihood of achieving a successful risk communication program increases with your knowledge of those with whom you are communicating. Early in the process, know who your publics are, what their concerns are, how they perceive risk, and whom they trust.
Identification
- Co-workers
- Area residents
- Elected officials
- Civic organizations
- Health care providers
- Media
- Regulatory agencies
- Environmental activists
- Contractors
- Other
Characteristics
- Concerns
- Attitudes
- Levels of interest
- Levels of involvement
- Histories
- Levels of knowledge
- Opinions
- Reasons for interest
- Types of involvement
Are they potential supporters or potential adversaries?
Categories of Public Concern
- Health
- Safety
- Environment
- Economics
- Aesthetics
- Fairness
- Process
- Legalities
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People's perceptions of the magnitude of risk are influenced by factors other than numerical data.
- Risks perceived to be voluntary are more accepted than risks perceived to be imposed.
- Risks perceived to be under an individual's control are more accepted than risks perceived to be controlled by others.
- Risks perceived to be have clear benefits are more accepted than risks perceived to have little or no benefit.
- Risks perceived to be fairly distributed are more accepted than risks perceived to be unfairly distributed.
- Risks perceived to be natural are more accepted than risks perceived to be manmade.
- Risks perceived to be statistical are more accepted than risks perceived to be catastrophic.
- Risks perceived to be generated by a trusted source are more accepted than risks perceived to be generated by an untrusted source.
- Risks perceived to be familiar are more accepted than risks perceived to be exotic.
- Risks perceived to affect adults are more accepted than risks perceived to affect children.
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Recognize the importance of community input. Citizen involvement is important because (a) people are entitled to make decisions about issues that directly affect their lives; (b) input from the community can help the agency make better decisions; (c) involvement in the process leads to greater understanding of - and more appropriate reaction to - a particular risk; (d) those who are affected by a problem bring different variables to the problem-solving equation; and (e) cooperation increases credibility. Finally, battles that erode public confidence and agency resources are more likely when community input isn't sought or considered.
To the extent possible, involve the community in the decision-making process.
- Involve the community at the earliest stage possible.
- Clarify the public's role from the outset.
- Acknowledge situations where the agency can give the community only limited power in decision making.
- Find out from the communities what type of involvement they prefer.
Identify and respond to the needs of different audiences.
- Try to identify the various interests in a situation at the beginning and meet with representatives of each informally.
- Recognize the strengths and weaknesses of citizen advisory groups.
- Deal with everybody equally and fairly.
When appropriate, develop alternatives to public hearings. In particular, hold smaller, more informal meetings.
- If you cannot avoid a large public meeting, the logistics should enable both the agency and the community to be treated fairly.
- Consider breaking larger groups into smaller ones.
- Be clear about the goals for the meeting. If you cannot adequately fulfill a citizen's request for a meeting, propose alternatives.
- In certain situations, one-to-one communication may work best.
Recognize that people's values and feelings are a legitimate aspect of environmental health issues and that such concerns may convey valuable information.
- Provide a forum for people to air their feelings.
- Listen to people when they express their values and feelings.
- Acknowledge people's feelings about an issue.
- When people are speaking emotionally, respond to their emotions. Do not merely follow with data.
- Show respect by developing a system to respond promptly to calls from community residents.
- Recognize and be honest about the values incorporated in agency decisions.
- Be aware of your own values and feelings about an issue and how they affect you.
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