Dr Josep Vidal-Alaball
Public Health Medicine
• Is an interactive process of exchange of
• People’s fears should be taken seriously and
steps should be taken to address them even if
they are not necessary from a technical
• 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,
– Protect their belief in a just world
Risk perception cont.
• Experts and responsible authorities often think
that the perception of the public is mistaken and
• 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
– 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
– 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
– 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. 5
• 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
• 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
Some solutions …. cont.
• 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!