Talking About Risk Communication

[Originally published in Synapse on November 10, 1988.] The relationship between scientists and the public is often fraught with misunderstanding and miscommunication.

This can lead to fear and distrust on the side of the public, and frustration and anger for scientists.

Cristine Russell, president of the National Association of Science Writers and a journalist currently on leave from the Washington Post, addressed this problem in the School of Pharmacy Regent’s Lecture.

Her talk, entitled “Risk versus Reality: Challenges in Reaching the Public,” drew an audience of about 300 to Cole Hall on Nov. 2.

“Understanding why experts and the lay public fail so frequently to see eye to eye on the nature of health risks in the world around them is a subject of increasing concern,” said Russell.

She then noted that efforts to ameliorate this failure have resulted in the development of a major new field of research known as “risk communication.”

It studies how the public perceives risk and the clearest ways to explain risk to the public. Risk communication, Russell continued, is currently being addressed by a number of different organizations and institutions.

Federal agencies are funding studies in the new field, the EPA has over three-dozen current projects, the National Academy of Sciences has a panel which is preparing a report on it, there are new centers for risk communication at Columbia University, Carnegie-Mellon, Rutgers, and Tufts and the list goes on.

Russell pointed out that much of the communication problem arises because the public and scientists perceive risk very differently and use different sets of values when they evaluate it.

This was illustrated by a study headed by Baruch Fischoff of the Risk Center at Carnegie Mellon.

Fischoff and his colleagues compared the perceived dangers of various activities and technologies among four groups of people.

Nuclear power was chosen as “riskiest” by the League of Women Voters and college-student participants, eighth riskiest by businessmen and 20th by technical experts.

Russell noted that the judgements technical experts made about risk were based on technical estimates of annual fatalities; in contrast, the lay people included concerns about other types of danger in their evaluations.

Concerns of the public

The “factors used by the public in defining and evaluating risk,” have been delineated by several research groups.

Russell presented them as follows: “Magnitude: People are more concerned about major accidents involving fatalities and injuries at one time, such as airplane crashes, than the same number scattered over a longer time period... They are more concerned about irreversible hazards than reversible ones. Risk to future generations...increases concern.”

“Evidence: Concern increases if a risk is poorly understood.”

“Personal Choice: Voluntary risks are far more acceptable than imposed ones.”

“Not in my backyard syndrome: A risk that is closer to home, threatening one’s family, is more upsetting than more widespread risks shared by the world at large.”

“Publicity: Media attention heightens concern, regardless of the numbers involved.”

“Who’s in charge? People are more concerned about situations where the risk managers are seen to lack credibility... Man-made hazards are less acceptable than those caused by acts of nature.”

Russell encouraged all people responsible for communicating science to the public not to limit themselves to educating the public about science.

It is just as important for scientists to be educated about the public, she observed, and to understand how the public will evaluate and understand what is presented to it.

In response to a last-minute request by her hosts, and “at the risk of straying into what is obviously a war zone,” Russell evaluated the role of risk communication in the ongoing UCSF-Laurel Heights conflict.

She prefaced her remarks by acknowledging that she is new to the situation, and that UCSF “has been working very hard on this issue.”

Russell said that UCSFs plan to move the School of Pharmacy to Laurel Heights created a particularly difficult situation because “issues collide here, the combining of interest groups: environmental toxins, radiation, animal rights and the community right-to-know groups.”

Russell felt that given these circumstances, opposition should have been anticipated. She suggested that a policy which emphasized more openness from the earliest planning stages might have made things go more smoothly.

Russell suggested that one thing the university could do now would be to enlist “neutral allies” to build the credibility of its case. Such a strategy would broaden the issue so that it would not be regarded as simply the institution against the community.

In addition, Russell felt that there is a need to explain the benefits of UCSFs plans more clearly and to provide more explicit information about the safety “a paternalistic point of view that ‘only the university knows best’ must be avoided.

She pointed out that what the university “has done in the past might be an indicator of what [it] would do in the future.”

She pointed out that UCSFs conflict with the Laurel Heights community groups is not unique.

“What’s been happening here has been playing out in towns all across America... it has happened in towns like Love Canal and in states like New Jersey, which is still fighting a reputation as a chemical cancer alley. Now, what can be done?”

Many people are searching for an answer to this question. Russell elaborated that “the EPA has attempted a variety of risk communication experiments in communities across the country. In New Jersey... they’ve set up a risk communication unit... which uses a manual, produced by a Rutgers University group, called ‘Improving dialogue with the community.’”

Summarizing what has been found by the various task forces on improved communication to be most helpful, Russell outlined what she termed “a few practical pointers.”

She again stressed that scientists must take the extra step of considering how the public will understand the information they give out.

Russell concluded by saying that if there is a single message in what the task forces on risk communication preach, it is that “risk communication must be a two way street, like it or not.”

Cristine Russell’s Guidelines for Improving ‘Risk Communication’

1. Release risk information on public health consequences as quickly, responsibly and openly as possible.

2. Start talking about potentially risky situations of concern to the community before there is a crisis.

3. Avoid overdramatizing risk and dichotomizing stories into “catastrophe or cure” categories.

4. Sort out the numbers. Be selective in stressing which numbers are significant and which are not.

5. What does it mean? Make more effort to put the risk in perspective.

6. Leave in the uncertainty. Don’t try to make certain that which is not.

7. Try to distinguish scientific findings from personal judgements.

8. Risk stories should disclose any outside financial interests that might be relevant

9. Anecdotal stories need to be put in perspective and often get more attention than they deserve.

10. Always keep the public in mind. Risk stories are taken personally so public reaction should be expected.