**How to Create a Disaster By Saying Things the Wrong Way (Risk
Communication Techniques)**

**Presenter: Theodore J. Hogan**, PhD, CIH, Instructor

> Coordinator of Master of Public Health Disaster Management Program
>
> Benedictine University, Lisle, IL
>
> 630-341-3939
>
> <thogan@ben.edu>
>
> [www.ben.edu](http://www.ben.edu/)

**10^th^ Annual All-Hazards Emergency Management Higher Education
Conference**

**June 7, 2007**

**Overview**

This will be a workshop on applying risk management techniques to
disasters. It will build on the theoretical constructs presented in the
previous paper "Understanding Risk Perception\'s Role in the Four Phases
of Emergency Management" by Jeanine Neipert.

Workshop participants will learn how to listen to an audience to
determine their communication needs, and then develop message maps,
public information sheets, and other tools for effective risk
communication.

**"It's Just Like Eating a Banana"**

Saying the right thing in the wrong way can make a disaster go from bad
to worse. There was a recent tritium water contamination incident in
Illinois. Hundreds of drinking water wells were potentially
contaminated. The expert for the nuclear power plant was comparing the
dose of radiation a resident might receive from daily drinking the
contaminated water was the equivalent of eating a banana every day.
While this was technically correct (bananas contain some radioactive
potassium), it caused outrage among the public. Why?

Imagine how you would feel if you found out your drinking water was
contaminated with the radioactive material tritium leaking from a nearby
nuclear power plant. In fact, the contamination levels were as high as
1524 picocuries per liter of drinking water. These questions might go
through your mind:

-   What is tritium?

-   What is it doing in my water?

-   How long has it been there?

-   Why wasn't I told before?

-   Is it safe to drink the water?

-   Can I wash my baby in the water?

-   Can my dog drink the water?

-   Will my tropical fish be affected?

-   Who's responsible for this?

-   What's going to be done to protect my health?

-   1524 of anything sounds like too much

-   What are picocuries?

You can see how the banana comparison fails to answer the questions you
might have. Instead, such an approach is an attempt to minimize, instead
of directly addressing, concerns. Also, people choose to eat bananas for
their nutritional value and health benefits (knowing the fact that all
food can pose some risks). They did not choose to have their drinking
water contaminated. Comparing voluntary and involuntary risks is a sure
way to raise the anger level in the room.

I worked with the Will County (Illinois) Health Department to address
the community concerns related to the tritium contamination issue. In
sections that follow I will use examples from this to illustrate risk
communication techniques.

**Be Prepared**

Once you have an idea of the public concerns (and concerns of specific
groups within the community), its time to start building your messages.
You should not wait until disaster hits. You will make mistakes in
communication during a crisis. You can minimize these by preparing in
advance press releases, information packets, message maps (to guide
verbal presentations), web sites, and other tools to get out your
messages. Remember the primary purpose is to address the audience's
concerns, not yours.

**Be Direct and Transparent**

Your job is to answer the public's concerns in an open, honest, and
respectful way. Do not try and soften bad information to make it more
palatable. People see this as

disrespectful and it will anger them.

Do not try and filter the information for the audience. They will
eventually have access to all the information anyway and look at you
with distrust if you tried to massage the message.

In the tritium case, we developed a water sampling plan that was
distributed at public meetings. We wanted the communities to know
exactly how and why we were going to determine if their water was
contaminated. This allowed them to comment on the plan before the
sampling took place, increasing their confidence in the reliability
results.

**It's Not About You**

Risk communication in disasters is not about trying to diminish or
decrease the level of anger or concern in the public. Instead, it's
about understanding questions people might have about the situation and
providing them with accurate information that they can use to reduce the
impact of the disaster. It's important to focus on their issues, not
yours. Some of the most important words you can say are: "I recognize
your concerns." This puts the emphasis on the listener's issues, not
yours. Of course, you have to really mean it when you say it.

Better risk communication begins by reorientating our perspective on the
public. They should not be viewed as victims of a disaster, but as
participants in the response and resolution of the situation. By
providing them with the information they need (rather than what we want
them to hear), the public will be effective partners in disasters.

You need to find out what people are thinking and feeling before,
during, and after disasters. You can find out about their concerns by
going and talking to existing community groups. Instead of "selling"
your emergency response efforts, ask questions about their preparation
needs. Ask how your agency can help them be better prepared. Ask them
what information they would like from your agency.

Do not talk to yourself (that includes people who think like you).
Asking your volunteers about their perspectives will give you a very
narrow view. Go out and seek communities that are different than you.
Ask them about their concerns and what approaches should be taken to
work with them in a disaster.

For example, you might find out that group shelters where men and women
are together are totally unacceptable to some members of your community.
While those may not be your values, it really doesn't matter. Segments
of the population could end up being excluded from disaster response and
recovery if you do not respect their values. Since our job is to assist
the whole community in a disaster, we must learn to reach out and listen
to those whom we do not know.

One thing learned in the tritium case is that the community did not
trust laboratories in Illinois to analyze the drinking water samples for
radiation. There was a concern that these labs could be influenced by
the nuclear utility and might manipulate the results. While these fears
were totally irrational and unjustified, I had to remember that it was
not about me and what might be convenient for the county in getting the
samples analyzed. A laboratory outside the state was found, increasing
the trust of the public in the results.

**Be Specific**

The goal of disaster risk communication should not be about making the
public feel better about how you are managing the situation or to feel
less concerned about the risks. This can come across as condescending
and dismissive of their concerns. "Don't worry, we have everything under
control" is an unbelievable statement. Instead, it's better to provide
specific information on actions being taken. "We have three shelters
opened right now within one mile of the affected area." You should tell
them specifically what you do and don't want them to do. "We appreciate
that you want to come into the affected area and help your neighbors.
However, there are downed power lines and other safety issues that could
put you at risk. It would be best if you worked with your local church,
synagogue, mosque, or community service agency to provide coordinated
and effective support for your neighbors."

Another example where specificity is needed is disaster guidelines for
people with disabilities or chronic disease conditions. You cannot lump
together someone on crutches with someone on dialysis. Their needs
during a disaster are completely different. Treating them similarly by
grouping them under a "special needs" (a term which is considered
offensive by some people) ensures that no one will have their needs met.
You need to reach out to these communities and get their input on plans
you are developing for them. You can also ask their advice on how to
word documents in a respectful manner.

**"I Don't Know the Answer to That, But I Can Tell You..."**

Despite the need for directness and no surprises, there are times you
should wait before sharing facts with the public. This is when you are
unsure of the answers. Sometimes the best approach is to refer them to a
reliable source. For example, it may be best to refer people to an
authoritative source rather than try and answer the question yourself.
If there is a chemical incident in the community, you can provide
residents with a copy of the ToxFAQS for the chemical. These are
prepared by the Agency for Toxic Substances and Disease Registry and can
be found at <http://www.atsdr.cdc.gov/toxfaq.html>. Here you will find
substance-specific information sheets specially designed to address
health concerns of the general public. There is no need to prepare your
own information when you can find reliable resources like these.

In the tritium case, we reproduced the ATSDR ToxFAQs for tritium onto
one page and passed this out at community meetings.

The phrase that heads this section is a standard communication technique
for addressing questions you cannot answer right now. You need to
acknowledge your uncertainty in public and tell them what you are doing
to try and get an answer to the question. This is not seen as a sign of
weakness, but as a realistic approach to the uncertainties of the
situation. In a public meeting on tritium, I had to answer the question,
"Can I wash my baby in my well water?" What would you say?

**No Surprises**

Do not surprise people by holding back information. You should tell your
audience as soon as practical what you know. While you want to structure
your messages, you cannot give them too much information. You might
consider setting up information repositories at libraries or on web
pages. At the resolution of the disaster you want to be so forthcoming
with information that people eventually tire of hearing from you. Then
you will know you have done a good job of informing the public.

For the tritium issue, Will County added a special tritium page on their
health department web site. The site included the sampling plans,
aggregate sample results, and links to credible external resources,
including Federal and State documents on tritium. There was no attempt
to downplay the information or risks. Instead, the site referred them
out to reliable sources which they could use to answer the questions for
themselves. Incidentally, one of the biggest reasons for community
outrage over the tritium issue is that the leaks had been going on for
about 12 years before the public was informed. Talk about surprises.

**Do Not Talk Science and Math to Emotions**

Disasters are always charged with emotions. Some people try and calm
down the audience by presenting "experts" that spew data. Experts often
get frustrated because they can't understand why others do not see it
their way since the facts are so clear to anyone who can read them. An
attitude may creep out that the expert considers the audience ignorant,
and if they just understood things they would calm down. As a result,
experts can be seen as someone who is talking down to the audience.

Unfortunately, scientific terms can be like "picocuries per liter" can
be difficult to explain. In an effort to address this problem, experts
sometimes take a shortcut by performing risk comparisons. It was
absolutely true that the dose of radiation received by drinking water
contaminated with tritium in the incident was the equivalent to a dose
received by eating a banana daily. So what? As stated earlier, this did
not address the audiences' questions.

**Summary**

Remember that you are "experts" in disaster management. Do not expect
the public to respond well to complicated data, scientific reasoning, or
what you think are your rational, thoughtful pre-plans. They just may
not speak your language. For example, you would not expect an accountant
and a biologist to understand the details and terminology of each
other's disciplines. Yet we often expect the public to understand our
special way of talking. Even I'm still having trouble fitting everything
into the "standard" four phases of a disaster, and I teach the stuff.

If we want the public to understand us, we need to listen to their
concerns, provide information in a way that is respectful to them, use
terms that they can relate to. This will allow them to draw their own
conclusions about the issues and help ensure that they are participants
in disaster response.

**WORKSHOP EXERCISES**

**Message Mapping**

-   Source: US EPA, in
    <http://www.epa.gov/ord/NRMRL/news/news012006.htm>

-   Message maps are documents used to organize verbal communication

-   Steps involved in developing a message map include:

    -   Identify stakeholders

    -   Identify stakeholder concerns and questions

    -   Organize key concerns

    -   Develop key messages

    -   Develop supporting information

    -   Pre-Test

    -   Plan for delivery

![](media/image1.jpeg){width="6.834722222222222in"
height="4.215277777777778in"}

Source: MS Department of Health, in
<http://www.astho.org/pubs/MDHMMs-Katrina.pdf>

-   **Exercise**: Prepare a message map for a disaster. See form at end
    of document. Possible topics:

    -   Measles outbreak on college campus

    -   Directing people to a shelter

    -   Identifying how to obtain smallpox vaccinations

**WORKSHOP EXERCISES, continued**

> **Community Meeting**

-   **Exercise**: Prepare an outline for a community meeting.

    -   Define objectives

    -   Identify messages

    -   Explain ways to identify community concerns

**Disaster Response Guide for People With Specific Disease Conditions**

-   **Exercise**: Prepare guide that provides information on how a
    person with a specific disease condition can:

    -   Get prepared (before a disaster)

    -   Take action (during a disaster)

    -   Stay informed (how to obtain additional information from
        credible sources)

**WORKSHOP EXERCISES, continued**

**Haddon Matrix**

A Public Health tool for disease control that has been adapted to
Disaster Response.

Example:

![](media/image2.jpeg){width="6.98125in" height="2.8069444444444445in"}

Source: "The Application of the Haddon Matrix to Public Health Readiness
and Response Planning", Barnett et al. *Environmental Health
Perspectives* Volume 113:561-566 (2005)

-   **Exercise**: Use the Haddon Matrix to organize a communication plan
    for a specific type of disaster