CBM 2000-7

Health Risk Communication

January 1990 through October 2000, plus selected earlier citations

847 Citations

Prepared by

Marcia Zorn, M.A., M.L.S., National Library of Medicine

Scott Ratzan, M.D., M.P.A., M.A., Journal of Health Communication

 

2000 October

U.S. DEPARTMENT OF HEALTH

 AND HUMAN SERVICES

Public Health Service

National Institutes of Health

National Library of Medicine

Reference Section

8600 Rockville Pike

Bethesda, Maryland 20894
ii

SERIES NOTE

Each bibliography in the Current Bibliographies in Medicine (CBM) series covers a distinct subject area of

biomedicine and is intended to fulfill a current awareness function. Citations are usually derived from searching

a variety of online databases. NLM databases utilized include MEDLINE®, BIOETHICSLINE®,

HEALTHSTARTM, LOCATORplus® , POPLINETM, PubMed®, and TOXLINE®. The only criterion for the

inclusion of a particular published work is its relevance to the topic being presented; the format, ownership, or

location of the material is not considered.

Other publications in the Current Bibliographies in Medicine series are available at no cost to anyone with

Internet access through the Library's World Wide Web site at http://www.nlm.nih.gov/pubs/resources.html

Comments and suggestions on this series may be addressed to:

Karen Patrias, Editor

Current Bibliographies in Medicine

Reference Section

National Library of Medicine

Bethesda, MD 20894

Phone: 301-496-6097

Fax: 301-402-1384

Internet: ref@nlm.nih.gov

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iii

TABLE OF CONTENTS

Pages

Introduction v

Sample Citations viii

OVERVIEW, BACKGROUND, AND HISTORY 1

GLOBAL ISSUES AND CULTURAL DIVERSITY 4

PUBLIC UNDERSTANDING OF SCIENCE 8

PUBLIC PERCEPTION OF RISK 16

ETHICS OF RISK COMMUNICATION 21

MODELS, TECHNIQUES, AND STRATEGIES OF RISK COMMUNICATION 22

GOVERNMENT AND OTHER AGENCY ROLE IN RISK COMMUNICATION 26

SUBJECT SPECIFIC ISSUES IN RISK COMMUNICATION

Medical Risk 29

Environmental Risk 38

Industrial Risk 44

Other Risks 48
iv
v

INTRODUCTION

There are many challenges in how we communicate risk, especially risks to health. Few areas continue to stir

debate more than advances in medicine and biotechnology. Stem cell research, vaccine development, and

genomic manipulation are but a few of the areas under recent attack. Even public health successes that have

decreased morbidity and mortality--such as vaccination, air bags, and fluoridation--have been surrounded by

controversy. Scientific and health literacy require understanding, but the incremental and imprecise nature of

science and experimentation that contribute to defining risk thrives on doubts, criticism, and debate, which often

translate into only theoretical causality and "risk." Furthermore, scientifically valid information is not absolute

and may change over time. Translating theoretical (imprecise and incomplete) and changing knowledge of

causality and risk has developed into its own body of knowledge called "risk communication." According to

a 1996 National Research Council report* risk communication "emphasizes the process of exchanging

information and opinion with the public."

Recognizing the challenges to health progress that lie in the communication process, not in the laboratory, we

created this issue for the Current Bibliographies in Medicine (CBM) series. Our overarching goal was to

identify a body of published knowledge relating to risk communication from multiple perspectives. This

bibliography was also developed to complement the presentations at the International Symposium on Health

Risk Communication: Uncertainty, Stakeholders, and Public Health Action held on November 1-3, 2000 in

Bethesda, Maryland. The Symposium was sponsored by the Subcommittees on Risk Communication and

Education and International Health of the US Department of Health and Human Services Environmental Health

Policy Committee. Citations for the bibliography were gathered from sources including, but not limited to,

bibliographic databases, online catalogs, the Internet, and printed publications. Single words ("risk" and

"communication") and the phrase "risk communication" were used to search electronically. The contents of

some journals were also searched and reviewed in print or electronically. From the 4,000 bibliographic

citations located through these sources, English language publications about risk communication were selected

which focus primarily on risk communication of scientific information rather than on risk assessment, risk

management, risk factors, risk behavior, risk taking, decision making, hazard communication, duty to

warn/informed consent, or other dimensions of communicating about health risks. Similarly, this publication

does not focus on health interventions, health education, health promotion, or advertising, although these are

important topics in the overall picture of how scientific risks are communicated to the public. The scholarship

in each of these other subjects alone is far greater than could be represented here. Our concern for this

bibliography is with the presentation of scientific risk information; the strategies, tactics, and models that are

used to communicate scientific risk information to an audience; and the difficulty of translating scientific

knowledge in a meaningful way to enable the public to make informed health decisions.

In the efforts to meet the challenges imposed by scientific progress, perhaps this CBM can help to advance a

common lexicon for health literacy, risk comprehension, and public health priorities. Use of such terms such

as "infinitesimal" and "probable" in defining risk place a great responsibility on those who determine what

information is valuable and salient for their audience. A high ethical standard has thus become necessary for

the purveyors of health--whether they are in academia, marketing, publishing, (new) media, or other fields of

* Stern, Paul C.; Fienberg, Harvey V., editors. Understanding risk: informing decisions in a democratic

society. Washington (DC): National Research Council, Committee on Risk Characterization; 1996. p. 27.
vi

public address. To facilitate optimal decision making, finding ways to increase the quality of information

becomes more important than increasing the quantity of information. Ideally, this CBM and the symposium it

supports will contribute to the body of communication knowledge that advances salient, valuable, factual, and

ethical risk information.

The compilers wish to thank Dorothy Moore of the Specialized Information Services Division, NLM, for her

valuable assistance in the production of this bibliography.

This publication is not copyrighted and may be freely reproduced. However any reproductions of this

bibliography, in whole or in part, must include all credits. If you wish to cite this bibliography, the correct

format is:

Zorn, Marcia; Ratzan, Scott, compilers. Health risk communication [bibliography]. Bethesda (MD): National

Library of Medicine (US); 2000 Oct. (Current bibliographies in medicine; no. 2000-7). 847 citations from

January 1990 through October 2000, plus selected earlier citations.
vii

SAMPLE CITATIONS

Citations in this bibliographic series are formatted according to the rules established for Index Medicus7 *. 

Sample journal and monograph citations appear below. For journal articles written in a foreign language, the

English translation of the title is placed in brackets; for monographs, the title is given in the original language.

In both cases the language of publication is shown by a three letter abbreviation appearing at the end of the

citation.

Note also for journal articles that an availability statement follows many citations. This statement contains the

Internet address for the citation in the NLM PubMed® retrieval system. The PubMed record includes an

abstract for most articles and may also provide a link to the publisher's Internet site.

Journal Article:

 Authors Article Title

Gotsch WD, Griffith BC. Strategies to improve risk communication: foreword.

 Health Educ Q 1991 Fall;18(3):269-71.

 Abbreviated Journal Date Volume Issue Pages

 Title

Monograph:

 Authors/Editors Title

Bennett P, Calman K, editors. Risk communication and public health.

New York (NY): Oxford University Press; 1999. 272 p.

 Place of Publisher Date Total No.

 Publication of Pages

_________________________________

*For details of the formats used for references, see the following publication:

Patrias, Karen. National Library of Medicine recommended formats for bibliographic citation.

Bethesda (MD): The Library; 1991 Apr. Available from: NTIS, Springfield, VA; PB91-182030.
viii
1

Overview, Background, and History

Barr C. Fear not: the art of risk communication. J

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Bennett P, Calman K, editors. Risk communication

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Boroush M. Understanding risk analysis: a short guide

for health, safety and environmental policy making

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Brehmer B, Sahlin N, editors. Future risks and risk

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Effective risk communication: the role and

responsibility of government and nongovernment

organizations. New York (NY): Plenum; 1989. 370 p.

Workshop on the Role of Government in Health Risk

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Task Force on Environmental Cancer and Heart and

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Gotsch AR, Goldstein B. Strategies to improve risk

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Holland WW. Advances in epidemiology and disease

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Johnson BB. Coping with paradoxes of risk

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Johnson BB, Slovic P. "Improving" risk

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Johnson FR, Fisher A. Conventional wisdom on risk

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Jungermann H, Wiedemann PM. Risk communication

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Laird FN. The decline of deference: the political

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