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Communicating Health Risk Information
Condensed from the Epidemiology
Monitor, Volume Ten, Number Six, June, 1989
Following are excerpts from a talk
given at a conference on ethics and epidemiology held in
Birmingham in 1989 and sponsored by The Industrial Epidemiology
Forum.
... the third session on the afternoon
of the first day included the largest number of speakers. A
colorful talk was given by Peter Sandman, a Rutgers communications
expert, on the topic of communicating risk information. He
described his work as alerting people to risks they are likely to
ignore - and as reassuring people about risks that are
overestimated. In simpler terms, scaring people and calming people
down - but not at the same time!
Dr. Sandman presented several
principles to keep in mind in the communicating risk information
from epidemiologic studies. They are:
1)
Tell the affected group in a timely
fashion what you have found.
This responsibility is not met by putting a report in
a professional journal, according to Dr. Sandman. People do not
wish to be told about their risks in the mass media. He joked,
"You don't want to hear you're dying on the six o'clock news!"
2)
Make sure people understand your
findings and their implications.
To accomplish this, he suggested simplifying the
content of findings and cutting out jargon. All scientists hate
this, he said. But either you will simplify or it will be done by
the media or the public. The choice is clear.
Also, to make people understand, epidemiologists must interpret
their findings for others. This is difficult because it takes
epidemiologists outside of epidemiology, and many consider it none
of their business. But Dr. Sandman urged epidemiologists to go
beyond their field and to address the most obvious and appropriate
questions which arise from the point of view of the public.
3)
Find ways to bolster credibility.
Dr. Sandman urged epidemiologists to do things in
advance of releasing results such as insulating themselves from
their sponsor by the use of review boards, and obtaining the
participation of the community in the study. The results will be
easier to believe if the community participates in the design and
implementation of the study, he said.
4)
Acknowledge uncertainty.
If investigators do not acknowledge uncertainty, it
makes them appear incredible. In any case, your peers will point
out uncertainty if you do not, and you are more believable if you
are the first to point this out.
5)
Apply epidemiology where it is called
for and do not misapply it where it will not help.
For example, avoid studies with low power. Avoid
studies which cannot answer questions.
6)
Show respect for the public.
In this regard, Dr. Sandman reminded the audience that
people trust anecdotal data even if epidemiologists do not.
"People do
not like to hear that Aunt Matilda's cancer was an
outlier", he said.
He
also encouraged epidemiologists to draw the distinction between
the statistical and social significance, and finally to respect
and acknowledge the public's genuine outrage when there has been a
lack of fairness or truthfulness.
Note
added at press time:
A later version of this presentation
has been published in full in a recent supplement to the Journal
of Clinical Epidemiology Volume 44, Supplement I, 1991. This
recent article adds two other recommendations about communicating
health risk information:
7)
Involve people in the
design, implementation, and intervention of the study, and
8)
Decide that
communication is part of your job and learn the rudiments – it’s
easier than epidemiology.
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