Dr Josep Vidal-Alaball
Public Health Medicine
• Is an interactive process of exchange of information
• People’s fears should be taken seriously and steps should be taken to address them even if they are not necessary from a technical perspective
• Management of Environmental Health issues requires more than technical expertise. Social issues such as house prices, house ownership or stigma of the neighbourhood are also important and should be considered from day one
• Clearly, emotions play a large role in public perception of risk
• When people become aware of a threat, they are naturally inclined to:
– Fear the unknown
– Want to maintain control
– Protect home and family
– Be alienated by dependence on others (government, industry officials)
– Protect their belief in a just world
• Experts and responsible authorities often think that the perception of the public is mistaken and irrational.
• They then try to correct the mistaken perception by the dissemination of information containing the "true" facts about the health risks.
• This nearly always fails. Technical measures alone are not enough to ease people’s worries !
• Risks are generally more worrying if perceived:
– To be involuntary
– As inequitably distributed, some benefit while others suffer
– As inescapable by taking personal precautions
– To arise from an unfamiliar or novel source
– To result from man-made, rather than natural sources
– To cause hidden and irreversible damage with onset many years later
– To pose particular danger to small children or pregnant women or more generally future generations
– To threaten a form of death (or illness/injury) arousing particular dread
– To damage identifiable rather than anonymous victims
– To be poorly understood by science
– As subject to contradictory statements from responsible sources (or even worse, from the same source), or from untrustworthy source.
– Invisible or undetectable, catastrophic, memorable, uncertain, uncontrollable or unethical risk.
• Often, an involuntary risk is compared with a voluntary one (e.g. the risk from nearby incinerator is compared with smoking or dietary habits). If such a comparison is done in the spirit of minimising the importance of the involuntary risk, it will generate anger.
• The value of risk comparisons is also limited by the fact that risks tend to accumulate in people's minds. No matter how small the new risk, people are inclined to see it as simply one more unwelcome vexation to add to their already heavy burden of coping with modern-day problems.
• Health Authorities: Very late engagement with unrealistic expectation to respond
• Lack of consultation can result in:
– inaccurate health messages
– raised expectation
– unnecessary community concern
Some solutions ….
• Openness and transparency
– Trust should be based on mutual respect
– Communication should be open and honest
– An open communication process with the public and the media can be achieved by organising public meetings, issuing press reports, sending letters to residents, fact sheets, setting up internet sites, etc
– The language used should be understandable for the general public
• Do not let the media take control of the situation. Ensure that key people responsible for communication are always available and ensure a smooth hand-over between various people involved in the case.
• Engage early with Health Authorities!