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Risk Communication for Public Health Professionals

During the “Syringe Tide” of the 1987-88, the beaches along the Eastern Seaboard were littered with raw garbage and medical waste as a result of a landfill spill in the Atlantic Ocean. A family in State X was walking along the beach when their child stepped on a hypodermic needle. The family’s immediate response was hysteria. Similarly, a child in State Y also stepped on a needle that washed up on the shore and panic ensued. Both families had lots of questions about the harm and what might happen next to their respective children.

  • In State X, the Department of Environmental Protection continuously told people, “This medical waste is not harmful.”
  • In State Y, the Commissioner of Health responded: “This is an outrage! The people will not, and should not, tolerate any hypodermic needles washing up on our shores. We are going to do absolutely everything in our power to stop it, even though the hazard from it is essentially nonexistent… We are going to turn budget upside down if we have to. We will put a stop to it no matter how much it costs.”

Who do you believe was more effective in communicating, resolving the crisis, and alleviating the families’ anxiety? The answer may be clearer than you think.

In an earlier post, we learned that when faced with strong negative or positive emotional outcomes, human beings become impervious to the concept of statistics when calculating risk. However, when faced with a health crisis, how do trained health professionals overcome that very human tendency to put emotion before scientific risk probability? There are many risks that make people furious though they cause little harm, while others kill many without making people mad. So how can we properly allay fears or generate a sense of urgency about public health issues? The solution: Risk Communication.

Risk Communication is the exchange of information for the purpose of informing the public. Some Risk Communication professionals have also called it: alerting the apathetic and reassuring the hysterical. This exchange could be between trained medical professionals and the government, corporations, industry groups, unions, the media, professional organizations, interest groups, communities, individual citizens and others. Reciprocal communication between these parties is essential to Risk Communication. The goal is not to merely abate any outsized public concerns, but to generate an informed public that is involved, interested and solution-oriented.

There are seven cardinal rules of Risk Communication:

  1. Accept and involve the public as a partner.
  2. Plan carefully and evaluate efforts.
  3. Listen to the public’s specific concerns – People often care more about trust, credibility, competence, fairness, and empathy than about statistics and details.
  4. Be honest, frank, and open—Trust and credibility are difficult to obtain; once lost, they are almost impossible to regain.
  5. Work with other credible sources—Conflicts and disagreements among organizations make communication with the public much more difficult.
  6. Meet the needs of the media— use them as a partner, not an audience,
  7. Speak clearly and with compassion.

Just as important as the Seven Cardinal Rules of Risk Communication are the Seven Deadly Don’ts. Do not:

  1. Lose your temper
  2. Attack the interviewer or questioner personally
  3. Repeat the negative allegation in your response
  4. Indulge jargon as a way of confusing or defusing the question
  5. Make promises you cannot keep or speak “off the record”
  6. Indulge “what if’s”
  7. Lie

So, who was more effective in adequately conveying risk from the “Syringe Tide?” By using the tools described above, the Commissioner of Health from State Y was much more effective in communicating the risk to the family and the general population. The State Y Commissioner of Health’s response essentially made the public feel as though they were heard. Because the risk was essentially non-existent, the public did not see good reason to use up State Y’s budget unnecessarily. In contrast, the State X Department of Environmental Protection denied that there was a problem from the beginning. The people from State X did not believe the public health officials because they did not feel as though they were being heard or taken seriously. State X’s response also increased the level of resources expended and public outrage about the problem increased exponentially.

What makes Risk Communication effective is knowing how people may respond and making sure you acknowledge that they are heard and their concerns are understood. This critical step must be done before communicating about the risk or the statistics. In risk communication, people do not care about what you know until they know that you care.

Knowing how people perceive risk and how emotion can sway judgment is a large part of the risk communication strategy. By using knowledge, understanding, trust and credibility, medical and trained medical professionals can effectively improve risk understanding, alleviate fear and highlight the need for appropriate public health actions.

For more information about risk assessment, risk perception and risk communication strategies education or for crisis prevention, contact the experts at Cogency at

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