h1n1 influenza risk communications considerations

1. H1N1 Influenza Risk Communications Considerations Robert Emery, DrPH, CHP, CIH, CSP, RBP, CHMM, CPP, ARM Vice President for Safety, Health Environment & Risk Management University of Texas Health Science Center at Houston Associate Professor of Occupational Health University of Texas School of Public Health 1851 Crosspoint Drive, OCB 1.330 Houston, TX 77054 Robert.J.Emery@uth.tmc.edu

2. The Risk Communications Dilemma Risks that truly harm are often different than those that cause alarm No correlation between objective morbidity and mortality data and how upsetting a risk may be to the public Some risks make people furious but cause little harm, while others are overlooked that harm thousands

3. Risk Communications The science (and art) that confronts the dilemma For relatively non-hazardous risks – employed to calm people down Mold For overlooked hazards – employed to wake people up! Seatbelts, smoking, radon

4. Barriers to Effective Risk Communications Communications become difficult when situations are perceived as: Inconsistent Overly complex Confusing Incomplete Lacking trust Drawing media attention Involve psychological and social factors

5. Barriers: Psychological & Social Factors Understanding probabilistic information Expressing risk a probability of death or probability of survival Demand for scientific certainty Adversity to uncertainty Strongly held beliefs Tend to ignore evidence to the contrary Magnitude of risk “Outrage” factor

6. Outrage Factors Voluntariness Controllability Familiarity Fairness Benefits Catastrophic potential Understanding Uncertainty Delayed effects Effects on children Effects of future generations Victim identity Dread Trust Media Attention Accident history Reversibility Personal stake Ethical/moral nature Human versus natural origin

7. Risk Perception Equation Risk = Hazard + Outrage

8. Applying the Outrage Model to H1N1 Within your organization, Is the risk perceived to be unfairly distributed Are there benefits to parties at risk versus no benefit Are there situations with no alternatives versus those with alternatives Risk where parties can control versus no control Is the risk voluntarily versus imposed

9. EPA’s 7 Cardinal Rules of Risk Communication Rule 1: Accept and involve the members of your organization as a legitimate partner Involve them early, clarify that decisions about risk are based on both magnitude and concern Rule 2: Listen to your organization Let people know that what they said was understood

10. EPA’s 7 Cardinal Rules of Risk Communication Rule 3: Be honest, frank, and open For communication to be accepted, the messenger must be perceived as trustworthy and credible Rule 4: Coordinate and collaborate with other credible sources Establish linkages, alliances, references to validate message. Make sure decisions are in lock step with authorities

11. EPA’s 7 Cardinal Rules of Risk Communication Rule 5: Meet the needs of the media The media is a prime transmitter of information – be accessible and prompt in response to requests Rule 6: Speak clearly and with compassion Use clear simple, non-technical language. Use real world comparisons

12. EPA’s 7 Cardinal Rules of Risk Communication Rule 7: Plan carefully and evaluate performance Establish clear, explicit objectives, assess how message was received

13. Avoiding Pitfalls Avoid technical jargon Refute negatives without repeating them Use positive terms Use visuals to emphasize key points Remain calm Ask if you made yourself clear Use simple analogies to make point clear Promise only what you can deliver Attack the issue, not the person Use personal pronouns: “I”, “we” Take responsibility for your share of the issue Focus remarks on empathy, competence, honesty, and dedication

14. Summary Effective risk communication skills are an essential tool for addressing the H1N1 threat By understanding and appreciating your organization’s concerns and apprehensions, mutual goals can be achieved Establish linkages, relationships early Plans and decisions need to follow those of public health agencies Actively communicate Actively listen “Chance favors the prepared mind”

15. Key References Covello, V. and Sandman, P. Risk communication: evolution and revolution. In Wolbarst A. (ed) Solutions to an Environment in Peril. Baltimore, MD: Johns Hopkins University Press (2001): 164-178 atsdr.cdc.gov