2004 Guestbook
Comments and Responses

Gay rights as a risk communication problem

Name:Martha Filipic
Field:University communications officer
Date:December 1, 2004
Location:Ohio, U.S.


I have been touting your risk communication/outrage concepts to faculty members for years, mostly in the areas of food safety and environmental issues. Lately, a few faculty members have asked how they can apply the concepts to a specific controversial issue they are currently facing: gay rights and gay marriage. While certainly this issue can provoke outrage in people who feel strongly one way or the other, it doesn’t seem to me to be a traditional risk communication issue. Still, these faculty members would like to find ways to discuss the issue without turning off either side. What do you think?

Peter responds:

I’ve never had a chance to work professionally on this issue, though like everyone I have thought about it, and I welcome the chance to reconsider it as a risk communication problem. I should start by noting that I am personally on the “progressive,” pro-gay rights side of the issue – which may not be obvious in some of what follows.

Start with the fact that gay rights and gay marriage are risks. Any major innovation in a society’s social arrangements is a risk. There are going to be some intended and predictable impacts and there are bound to be some that are unintended and unpredictable. The same is true, of course, for a major innovation in environmental arrangements – widespread use of genetically modified foods, say.

It’s worth noting in this context that (at least in the U.S.) the political right tends to be risk-tolerant about the ecosphere and risk-averse about the sociosphere, while the political left takes the opposite tack. “Don’t meddle with things you don’t thoroughly understand” – that’s what the left says about new chemicals and technologies and the right says about new laws and customs. “Solve today’s problems today and leave tomorrow’s problems till they actually arise” – that’s what the right says about new chemicals/technologies and the left says about new laws/customs.

So for many on the right but few on the left, gay rights and gay marriage seem risky. (It would be an interesting exercise to apply the Precautionary Principle – the left’s very appealing prescription for uncertain environmental risks – to a social risk like gay marriage.)

Of the 12 items on my “A” list of outrage factors, many can easily be applied to gay rights and gay marriage. Familiarity, control, dread, voluntariness, memorability, and morality come immediately to mind. For those who were comfortable when gays were in the closet, gays coming out of the closet is unfamiliar, beyond their control, and so forth. Of course it’s entirely different for gay people for whom the closet was far from comfortable! Nonetheless, as far as the first group is concerned, new social arrangements vis-à-vis sexual orientation constitute a high-outrage risk.

And of course fear is an important component of this sort of outrage. What are these people afraid of? That’s not for me to say, really; ask them – as inquiry, not as provocation. But parts of the answer are clear: the collapse of values they hold dear; the threat of having their noses rubbed in aspects of reality they prefer to ignore; the contamination of symbols they cherish with behaviors that give them the willies. Doubtless some of these fears are characteristic mostly of homophobes – which is itself an interesting word; most phobias are spoken of with more compassion and less contempt than this one. Some of these fears, moreover, are shared by some people who are not homophobes (or who try not to be), who favor much of the progress that gays and lesbians have made and much of the further progress they seek, but still find some pieces of the gay rights agenda risky and scary.

Now the hard part: In any risk controversy the burden of empathy (if not always the burden of proof) is on those who want to make a change that others consider risky. This burden is especially appropriate when applied to those who will benefit from the proposed innovation. What does a company wishing to emit dimethylmeatloaf owe its alarmed neighbors? Respect for their concerns and fears, candor about the possible risks, willingness to collaborate and compromise, etc. The alarmed neighbors owe the company rather less. My corporate clients find this hard to accept. They are often as outraged at their neighbors as their neighbors are at them. They feel their rights (as well as their profits) are at stake. They feel science and “the facts” are on their side. They are often not very inclined to listen to their neighbors with any sort of empathy.

Gay activists and their supporters are often similarly disinclined.

I don’t want to carry the analogy too far. Corporate polluters are not emerging slowly from a history of oppression. Gays and lesbians are. That makes a difference. Gay people denied the prerogatives of their straight neighbors are more entitled to be self-righteous and contemptuous of their critics than my corporate clients are. But in both cases, I believe, this posture is ineffective and self-defeating.

Respect for the other side’s fears might lead not just to different rhetoric but also to different policy recommendations. One idea that has appealed to me for a while is to preserve the sanctity of marriage by getting the government entirely out of the marriage business. Let governments administer the bureaucratic red tape of civil union to gays and straights alike. Define marriage – like baptism and bar mitzvah – as a ceremony that many find supremely meaningful and that governments have nothing to do with. People who wanted the rights and responsibilities of the civilly united would have to jump through the government’s hoops; and if they wanted out again, they’d have to jump through the government’s divorce hoops too. Religions would set their own standards for who’s marriageable, who’s divorceable, who’s married, and who’s divorced – standards that would have no secular legal standing whatsoever. If people without any religion wanted to devise their own marriage ceremonies, that would be okay too, freighted with whatever significance they and their friends accorded it – but with no legal significance whatsoever.

What about the “rights” of gays and lesbians? As a citizen, I believe gay people have a moral right to exactly the same prerogatives as straight people; I want them to have the same legal rights too. (I want to take away from gay and straight alike the “right” to get married and give them all the right to get civilly united instead.) That said, the language of rights is pretty off-putting.

I continually urge my corporate clients to ground their policy preferences in something less offensive than the endless assertion of their “private property rights.” Advocates of gay rights might consider something similar. There are many solidly conservative reasons for wanting gay and straight people to be entitled (and encouraged) to settle down in monogamous, mutually responsible social arrangements, especially as we all age and need more caring for. Perhaps the bathhouse lifestyle (for gays) and the swinging single lifestyle (for straights) need to be defended as the right of those who prefer them; there’s not much to be said on their behalf other than the principle of the thing. But the partnered lifestyle, I think, is most easily defended not as a right but as good social engineering.

Company crisis communication plans

Date:November 3, 2004
Location:Colorado, U.S.


This is a great Web site… I’ve enjoyed the articles and insight I’ve gained. I do have a question…do you have a sample of what you consider to be a good crisis communication plan? We are slowly trying to put one together for the communications section of my company, and anything would be helpful. Thanks again for this resource.

Peter responds:

First a quick vocabulary check: I try to distinguish actual crisis situations (where both hazard and outrage are high) from situations where people are angry or frightened about hazards that are actually pretty low. Companies often call the latter situation a “crisis” too, because it’s a crisis for the company; a reputational crisis and perhaps a profitability crisis. For me, it’s not a crisis unless people face real risk of harm. When hazard is low but outrage is high, the task isn’t crisis communication; it’s outrage management.

In these terms, I think most big companies do have communication plans for outrage management situations. The plans may or may not be good, but they usually exist. And most big companies also have crisis management plans – plans for how to cope with an actual emergency. But the corporate crisis plans I have seen pay scant attention to communication. The focus is on emergency response (and on recovery and business continuity), and the communication section tends to be mostly logistical: Who should you call when the siren goes off. What I consider the core messaging and metamessaging issues of crisis communication don’t usually get planned for. (For the best sense of what I think these issues are, see the handouts for my “Crisis Communication: Guidelines for Action” CD-ROM/DVD.)

I am not confident of the generalizations in the preceding paragraph. I haven’t seen enough corporate crisis plans to be sure.

And I’m afraid I can’t suggest a model plan either. The ones I’ve seen are neither publicly available nor models. There are occasional case studies of corporate crisis communication planning (and outrage management planning) that might help some. See especially the work of Caron Chess and her colleagues at the Rutgers University Center for Environmental Communication. They did several such case studies a decade ago that were enlightening; to the best of my knowledge, they are not available online, however.

If you find a model, or even a sample or a current case study, please let me know and I’ll append the link to this Guestbook entry.

One postscript: Although corporate crisis plans are rarely available to the public, government agencies often post their plans. If you think these are relevant to your needs, look online for Nuclear Regulatory Commission plans for a nuclear power crisis; Centers for Disease Control and Prevention plans for various public health crises, from a flu pandemic to a smallpox attack; Department of Homeland Security plans; Federal Emergency Management Agency plans; etc.

How would risk communication have averted the Iraq war?

Name:(no name provided)
Date:November 3, 2004


How would risk communication have averted the Iraq war?

Peter responds:

I can't say I think risk communication would have averted the Iraq war. But I do think attention to risk communication and crisis communication principles could have helped the Bush administration provoke a more constructive debate before going to war and, if we went to war anyway, could have avoided some of the radical disenchantment that afflicts us today. A few examples:

Acknowledging uncertainty; avoiding over-confidence. I am not among those who think the administration flat-out lied about whether Saddam had Weapons of Mass Destruction. I think the administration believed Saddam had WMDs; it reached a conclusion that turned out wrong, based on incomplete and contradictory evidence. But surely the administration did mislead the public about whether the evidence was incomplete and contradictory. When you hide your uncertainty and present your (genuinely held) conclusions over-confidently, you’d better turn out right. If you turn out wrong, people will rightly sense that you didn’t level with them, then extrapolate to the conclusion that you lied. This is a common mistake; I suspect when the dust settles it will turn out to be what Merck has done about Vioxx, for example.

Publicizing yellow flags; acknowledging internal dissent. This is another version of the same error. There were intelligence analysts who expressed their doubts about the WMD conclusion; they questioned the validity of some of the evidence that seemed to support that conclusion, and adduced other pieces of evidence to the contrary. Their reservations were downplayed and in some cases suppressed. On other war-related issues, too (such as how many troops were needed in Iraq), the administration was determined to “speak with one voice.” Here again we are on familiar turf. When you pretend a tough call is a no-brainer, hiding the staffers who take a contrary view and the bits of evidence that support their side, you pay a number of very high prices:

  • In real time, even before we know who’s going to turn out right, your selective version of the truth smells fishy.
  • If you turn out wrong, it looks like you knew it all along and intentionally lied.
  • You alienate those who might otherwise have been your respectful and appropriately tentative opponents. That is, you stifle moderate debate and end up with heated dispute instead.
  • All this tends to end in self-deception. You forget the doubts you hid, and resist noticing any new evidence that you might be wrong – or part wrong; that a course correction might be needed.

Acknowledging errors; predicting errors. It’s hard to know whether or not President Bush has noticed the administration’s errors in Iraq and made appropriate course corrections. I’ve read commentators who say that he has, that Iraq policies keep changing all the while as the President endlessly asserts that he is unwavering. When you’re unwilling to acknowledge your errors, of course, you can’t respond effectively to critics who think you haven’t noticed and corrected them. Even acknowledging errors earns only half-credit. Predicting errors does even better. In a war, as in any crisis, things go wrong. Smart risk communicators predict that things will go wrong, that mistakes will be made, that course corrections will be needed.

Avoiding over-reassurance and over-optimism. The same administration that was excessively alarmist about Saddam’s WMDs has also been excessively sanguine about the emotional, financial, diplomatic, and human costs of the war in Iraq – and about the chances of success. Despite occasional statements to the contrary, the President encouraged a fantasy that establishing a functional democracy in Iraq would be easy, virtually cost-free and risk-free; he continues to encourage a fantasy that the path forward and the way home are clear, that there are grounds for confidence in the outcome. A good risk communicator would instead have contrasted the huge moral, political, and security benefits of succeeding with the commensurately huge costs and risks of trying. He would have worked to build a national consensus that his high-risk high-gain Iraq policy was worth a try. If he had succeeded, we would be ready for sacrifice, ready even for the possibility of defeat. If he had failed, he might have revised his policy.

Dialoguing with opponents; respecting their feelings and arguments; giving them credit for affecting your actions. During the war in Vietnam, several U.S. presidents worked hard to discredit the antiwar movement. Though we now know they were paying obsessive attention to antiwar activists, and even adjusting policies in response, they did everything they could to imply otherwise. The same thing may be happening today. We don’t know yet whether the Bush administration is paying attention to its domestic and foreign critics. We know it is going out of its way to give the impression that it isn’t. The most stunning example was the President’s United Nations address in the early days of the war. The occasion called for a conciliatory acknowledgment of his audience’s strongly felt doubts; instead, the President delivered a stirring, one-sided defense of the policies provoking those doubts. (Tellingly, he chose not to stay for the speeches of other world leaders, a vivid display of his conviction that he had nothing to learn.)

Now here comes a big “but.” There is a fundamental counter-argument to all of the above. It’s an argument I often make myself. The communication approach embodied in this list of recommendations isn’t the only kind of communication. It is the right approach for situations where you need the acceptance or cooperation of an audience that is paying close attention and is upset (angry, hostile, worried, frightened, at least skeptical) or likely to become so. What if the audience is mostly on your side already; or if it’s not paying that close attention; or if you don’t need to mollify your critics as much as you need to rally your supporters? Under those circumstances, other communication approaches make more sense. (See “Four Kinds of Risk Communication.”) Politicians are accustomed to speaking mostly to two groups: people who are already on their side and people who aren’t paying much attention. My expertise is mostly about speaking to two quite different groups: people who are paying angry or hostile attention and people who are paying worried or frightened attention. Before deciding what role risk communication should have played in the Bush administration’s communications about Iraq, you must first decide who you think the President should have been talking to. We just reelected a President who blew off his critics. Would we have reelected one who sought to meet them halfway? I hope so, but conventional political wisdom says I’m wrong.

Flu vaccine risk communication

name:Andrea Littlefield
This guestbook entry
is categorized as:

      link to Pandemic and Other Infectious Diseases index

Field:Public health information officer
Date:October 13, 2004


I know you’re probably thinking about it already, but what messages would you have developed surrounding the current flu vaccine shortage? Are government officials handling it correctly? Anything you would do differently? Just curious from your professional standpoint what your thoughts are on the subject.

Peter responds:

My wife Dr. Jody Lanard and I have been reading and talking endlessly about the flu vaccine “crisis” (as some have called it), and we may well post a column on the subject soon. In the meantime, here are some preliminary reactions.

The shortage isn’t really a crisis. The CDC’s Julie Gerberding has rightly said the vaccine shortage is not an emergency. One way to tell: We’re trying to reallocate doses to the elderly and other high-risk groups. In a real crisis – a flu pandemic, for example – plans call for the opposite prioritization: Cops, waterworks engineers, power plant operators, morticians, and others essential to keeping the society functioning get the antivirals and the early doses of vaccine. Indispensability, not vulnerability, is the main triage standard for crises. (Health care workers qualify under both standards.)

Jody adds: There is a profound flu vaccine shortage every year, when it comes to protecting high-risk people. Last year 87 million doses were available in the U.S., but there were over 180 million people in the CDC’s identified target groups. (The list included healthcare workers and household contacts of high-risk people because they might infect high-risk people; it also included “healthy” people 50–65, because they’re likely to be high-risk without knowing it. The latter group is off the list this year because of the shortage, as are most of the household contacts of high-risk people.) But unlike this year, no one last year suggested seizing the millions of doses ordered by doctors for their healthy patients (and by employers for their healthy employees), and redistributing them to people in the high-risk groups (who didn’t want them). There is a shortfall this year, fewer doses than the demand. We always have a serious shortage, fewer doses than the public health authorities say we need and ought to want.

If the 2004–2005 flu season is of average severity, it will probably kill more than the 36,000 Americans who have succumbed to flu in the average recent year. There won’t be enough doses for all the high-risk people who usually get vaccinated, not even if everybody who isn’t in a high-risk group goes without. (On the other hand, this year’s vaccine looks like a better match than last year’s to the actual strains of the flu virus that are likely to be out there, so the people who do get vaccinated will be better protected than last year’s vaccinees.) Given a successful reallocation, the economic cost of lots of unvaccinated workers out with the flu for a week or two will increase more than the flu-related mortality and hospitalization rates will.

If there is a crisis, it is only a crisis of supply versus demand. A decade ago, about 25 million Americans wanted flu vaccine each year. Now, about 80 million want it – a big public health achievement. Worldwide, only Canada vaccinates a higher percentage of its citizens than the U.S. In the U.K., very few healthy adults want flu vaccine. Until a few years ago, the CDC estimated that 20,000 Americans died every year of the flu. Most of these deaths were preventable with wider vaccination, but not many Americans were especially upset. When the CDC increased the mortality estimate to 36,000, based partly on changes in statistical modeling and partly on increased circulation of the more virulent H3N2 strain of influenza, Americans were again not especially upset at the extra 16,000 annual deaths. This year’s increase, if there is one, will be more upsetting – for reasons that have more to do with outrage than with hazard. But they don’t add up to a crisis.

The shortage isn’t really a surprise. The flu vaccine manufacturing process is notoriously fragile. It is far from unprecedented for manufacturers to have problems ensuring that the vaccine is sterile. And it is far from unprecedented for regulators (in the U.S., not just the U.K.) to watch closely for months as manufacturers struggle over quality control problems, then reluctantly conclude that the struggle has been unsuccessful and they must withhold the vaccine from distribution. On September 27, 2000, the Food and Drug Administration barred distribution of former manufacturer Parkedale’s flu vaccine, about 12 percent of the U.S. supply for that year. What’s new is that the number of flu vaccine manufacturers licensed by the U.S. is down to two, Chiron (the source of the problem) and Aventis Pasteur (the only remaining U.S. supplier). So this year we lost roughly half our supply, instead of the much smaller percentage lost when similar problems arose in years past, and the much smaller percentage lost this year by the U.K., which has approved more manufacturers.
Those who are being asked to forgo their flu shot this year deserve respect, thanks, and an apology. Their diligence helped build the supply we do have (each year’s order is based mostly on the previous year’s use), and now they are being urged to risk weeks of weariness and lost income in order to reduce the likelihood that a less hardy neighbor will die or need hospitalization. It is certainly sound public health to make this request, even though it may not be sound economics. But it isn’t strange that some are reluctant to assent, or that they (we) assent with some reluctance. Far too many health authorities have voiced contempt for those who hesitate to make the sacrifice, rather than gratitude to those who make it. Even when health authorities have expressed their thanks (at least once, the CDC’s Gerberding referred to those who forgo the vaccine as “health heroes”), the media have generally not thought it newsworthy. And as far as I know no authority has yet apologized for the policy errors that have made the sacrifice necessary. (People sacrifice more willingly and with less resentment if they’re asked nicely.)
This is the teachable moment for the 2005–2006 flu season. Millions of people who do not routinely get their flu shot want one this year. This is the natural psychology of shortages. It means that right now is the best opportunity in years to persuade people (high-risk and otherwise) to establish an annual flu shot habit next year. Of course the best persuasion includes a behavioral commitment. So someone should be mailing out (or emailing) coupons, to be filled out and sent to our doctors (or pharmacies, or employers): “I will want a flu shot in October 2005. Please order one for me, and send me a reminder when it comes in.” At least so far, I have seen very little effort to capitalize on this year’s shortage to inculcate a long-term behavior. If this is done effectively, the shortage could end up saving lives instead of costing lives.

This is also the teachable moment for changes in vaccine policy. Public health agencies have been warning for years that flu vaccine manufacturing was too fragile an industry. Neither the public nor the Congress has been terribly interested. But we’re interested now. Do we need to create incentives for more manufacturers to enter the vaccine market? Do we need to change licensing procedures so more of those in the market can sell to the U.S.? More fundamentally, do we need to encourage research on a more modern, more resilient manufacturing technology? Public health agencies do seem to be capitalizing on this opportunity; they need to keep it up.

Jody adds: This is also a teachable moment for various aspects of pandemic influenza planning. Right now we have all become aware that there are only two vaccine producers licensed in the U.S., and that one of them is across the Atlantic. In its pandemic planning, Canada has worked hard to assure that influenza vaccine production is domestic; once a pandemic is well underway, transportation may well be disrupted, and countries may seize or nationalize vaccine supplies for their own citizens (just as certain counties in the U.S., such as San Mateo, California, are now contemplating). It requires raising some public alarm to use this teachable moment well, and officials seem too preoccupied with allaying fears right now to consider doing this.

One possible policy change I haven’t seen much about: Encouraging universal flu vaccination. Except for people who are allergic to eggs (the medium in which the vaccine is grown), virtually everybody is better off getting vaccinated than not. And the economy is enormously better off without a few million extra people flat on their backs for a week or two. But public health authorities have traditionally been interested mainly in mortality (will people die?) and morbidity (will they get sick enough to require hospitalization?). Since healthy adults are unlikely to suffer these effects, the public health establishment hasn’t been particularly keen on urging healthy adults to get vaccinated.

That makes sense every October, when it’s too late to manufacture more doses and it’s important to get the doses you have to the people who need them most. But it doesn’t make much sense every February, when the manufacturers are deciding how much to make based on how many doses they sold last October. Encouraging healthy people to get their annual flu shot also builds the market, builds the habit, builds the social norm, builds some herd immunity, and protects people who are high-risk and don’t know it. It’s time to take notice that even people who are nearly certain to recover from the flu without medical care are still much better off not getting the flu at all.

Doctors shouldn’t be asked to choose voluntarily to give their own patients suboptimal care. It makes sense to request that healthy adults voluntarily go without the flu shot this year. And it makes sense to ask that non-medical providers suc as employers and pharmacies voluntarily abandon or redesign their vaccination programs in recognition of the shortage. (This is a huge sacrifice for employers, who suffer the resulting absenteeism.) Alternatively, it makes sense for governments to order doctors and others with vaccine doses in hand to use them in specific ways, assuming the legal niceties have been seen to (which may mean declaring some kind of state of emergency).

What doesn’t make sense, I think, is to ask medical professionals to voluntarily put public health ahead of the medical best interests of their own patient. If I am in my doctor’s office, and I want a flu shot, and the doctor has a dose available, and I am better off with it than without it, then it stretches both medical ethics and the doctor-patient relationship for my doctor to choose to deny me the best care in order to enable some other provider (a nursing home, say) to help some needier recipient. Vaccine redistribution decisions should be made either by patients or by governments, not by doctors.

The dilemma of triage standards needs open discussion. As I mentioned earlier, public health authorities tend to prioritize by vulnerability – until a real crisis, when they have to think in terms of indispensability instead. But even in the present non-crisis situation, a case can be made for giving some people a flu shot not because they’re likely to suffer serious health consequences (or because they’re likely to spread it to people who are likely to suffer serious health consequences), but simply because they shouldn’t be out of commission for two weeks.

President Bush announced that he would not get a flu shot this year. Unless reducing mortality and morbidity is the only standard in play, it’s hard to justify the President of the United States risking being down with the flu so one more nursing home patient won’t risk being hospitalized or killed. But if letting the Commander in Chief go unvaccinated makes sense to you, then how do you justify the CDC announcement that the Pentagon would get enough doses to vaccinate all soldiers being deployed overseas? I see lots of reasons to vaccinate Iraq-bound soldiers – but a thoughtful discussion of those reasons is bound to reveal some other healthy Americans who ought to be vaccinated too starting with the President.

The run-up to the Chiron decision needs open discussion – and needed it much, much earlier. As I write this, ten days have passed since the “surprise” announcement that Chiron’s vaccine might be unsafe and probably could not be distributed. Even the bare rudiments of the story are still to emerge. We know that Chiron had contamination problems, and that both the U.K. regulators and the U.S. regulators were aware of those problems. Then, apparently, the U.K. regulators did what was to have been the final inspection before the doses were shipped; they gave Chiron a written preliminary report (not yet released) that apparently identified some continuing problems; Chiron submitted a response (also not yet released) that apparently explained why the company thought everything was okay; then the U.K. regulator announced that no doses would be authorized for shipment.

The details of what Chiron knew when, what the U.K. regulators knew when, and what the U.S. regulators knew when are all very fuzzy. The impression of cover-up is strong, as is the sense that the company and its regulators are all engaged in blame-avoiding spin control rather than candidly revealing what they know. Various state attorneys-general and Congressional committees are already on the prowl, so most of the truth will eventually emerge. It seems likely that what’s being kept “secret” isn’t any scurrilous misdeeds on anyone’s part, but rather the mundane reality of a fragile manufacturing system that’s always on the brink of disaster. Early candor could have made this clearer – and less suspicious-looking – sooner.

There is a comparative risk story yet to be told. The problem with the Chiron vaccine is contamination with serratia, a common bacterium that can cause potentially deadly infections of the bloodstream, respiratory tract, urinary tract, etc. Apparently the experts agree that a shot from a Chiron batch that tests positive for serratia is more dangerous than facing the flu season without a shot. But a shot from a batch that tests negative for serratia is a tougher call. The experts should tell us explicitly how risky they think it is to get a flu shot from that second batch, compared to no flu shot at all. And they should tell us why. Are they worried about undetected serratia – perhaps very low concentrations that could grow like any other bacteria once in a vaccinee’s body? Are they worried about other possible contaminants and overall poor quality control?

What will be interesting is if the risk of getting no shot turns out bigger than the risk of getting a Chiron shot from a batch not demonstrably contaminated – and if the U.K. and U.S. regulators nonetheless continue to ban the Chiron vaccine. This gets into very traditional risk perception distinctions – natural versus industrial risk, for example. (We’d all rather die of flu than of contaminated flu vaccine.) And it gets into deep legal and political waters. Victims of a contaminated vaccine might have a viable lawsuit against the manufacturer; the regulators who let it happen would be in serious trouble; public acceptance of other vaccines and other years’ flu vaccine could suffer. Victims of the flu die with much less fanfare. So how many flu deaths equal one vaccine contamination death? Of course vaccine contamination may turn out to be the bigger of the two risks, which would enable us to avoid this can of worms. Don’t expect the public health authorities to be clear about which risk is bigger – especially if it’s the flu and not the vaccine.

Jody adds: An interesting technical story is the question of whether, and if so at what cost, the existing batches of Chiron vaccine could be assessed for safety. With little detail, the FDA announced that none of the vaccine can be characterized as “safe.” A more credible, suspicion-reducing, and anxiety-allaying answer would be: “It is completely impossible to test these batches for safety, and here is why,” or “It costs X dollars and Y amount of time to test these batches for safety.” At the moment, we are left wondering if there are absolute medical contraindications to using any of the vaccine, or if some of the reasons are bureaucratic, economic, or legalistic.

Now is a good time to do badly needed influenza education. This is the teachable moment for anything we want people to learn about flu, whether it directly concerns the current situation or not. My top two candidates:

  • There is no such thing as a “stomach flu,” and “a touch of the flu” usually isn’t the flu at all. Influenza is a devastating disease. Even the healthy victim, who usually recovers without medical intervention, goes through a week or more of hell, often followed by several weeks of serious fatigue.
  • We are protected each year from the worst of the flu by some combination of natural immunity and vaccine. Both are dependent on the predominant flu strains of the year being familiar ones. Every once in a while a brand new strain of flu emerges, resulting either from mutation (a flu virus changes its genetic code) or reassortment (two flu viruses exchange genetic material). If the new strain is deadly and easily transmitted, the result is a flu pandemic – a worldwide scourge against which we have no natural resistance and, until we manage to develop one, no vaccine. The last huge flu pandemic was 1918; 20–40 million people died. Many infectious disease experts think the current outbreak of bird flu (mostly in southeast Asia) represents a serious risk of another such pandemic. The new strain of bird flu, H5N1, has proved extraordinarily deadly to the few humans who have contracted it. If it mutates or reassorts into something equally deadly but much more contagious, we’re in serious trouble.

There are few if any signs of panic. For the record, there has been the usual rash of authorities and journalists predicting that people will panic over the vaccine shortage, and the usual tendency to see as “panic” such unpanicky behaviors as standing in long lines or making lots of telephone calls or flying to Canada in search of a shot. There have been a few cases of theft of vaccine – which might qualify as something like panic if it was for personal use; it’s just criminality if it was for sale. With that exception, there hasn’t been any panic yet, and there probably won’t be any. There usually isn’t.

Jody and I had some similar (and some different) comments last December when it looked like there was a flu vaccine shortage for the 2003–2004 season. See “Flu: A Touch of the Panic.”

The “outrage” concept and black-and-white thinkers

name:Bradd Witt
This guestbook entry
is categorized as:

      link to Outrage Management index

Date:August 30, 2004


I have been teaching a course called environmental problem solving at undergraduate level for a few years. I often refer to ideas related to risk, perception of risk and its influence in problem solving.

Over the past few years of teaching it has appeared to me that there are very distinct personality types in the classroom that seem mirror to general society. I often have the ones that immediately understand the issues of risk perception, emotion and outrage, and see how legitimate it is to understand and deal with. On the other hand there are the “rational” types who just don’t see why everything is not simply black and white (an artifact of our schooling I suspect). The latter have trouble seeing why “facts” are not universally accepted.

One of my goals is to try to get through to as many students as possible that people’s perceptions of risks and hazards must be understood and appreciated and not just dismissed as emotional, subjective or some other ill-informed reason. I would be very surprised if you’ve not found something similar in the “real world” when dealing with organisations.

My general question relates to advice on how to get through to the black-and-whiters. This group doesn’t seen to realise that their hard factual view is actually quite irrational to some other stakeholders. Advice on tools, techniques etc. would be useful.

Peter responds:

Like you, I have noticed that some people take naturally to the outrage concept, while others resist it. There are at least two quite different sorts of resistance, I’ve found. Some people are deeply committed to the notion that the world works “rationally” – a word they define so as to exclude what I call outrage as a reason for action. Others readily concede that outrage does affect people’s behavior, but they regret that this is so and have reservations about “giving in” to it or “catering” to it.

It’s also worth noting that some of the people who visibly dislike the outrage concept and give me a hard time in seminars and consultations later become their organizations’ staunchest advocates of an outrage management approach to controversy. I have learned to be grateful for those who resist actively instead of shutting down or giving me a facile assent that isn’t deeply felt and doesn’t much affect their actual plans.

I used to think that technical people had the toughest time with the outrage concept – less because of their technical training, I assumed, than because of the personality traits that led them to choose a technical field in the first place. Obviously there is some truth to this. Many scientists and engineers have a deep emotional commitment to keeping emotion out of their work, even out of their lives. See Lanard and Sandman, Scientists and the Public: Barriers to Cross-Species Communication.

But many techies respond readily, even gratefully, to the outrage model. It’s as if they gave up years ago on understanding people and decided they’d better stick with abstractions and equipment. Then along comes a nicely reductionist explanation of how people work. (It’s basically a hydraulic explanation, after all; you poke outrage here, it sticks out there: the law of conservation of outrage.)

It is often not my clients’ scientists and engineers, but their lawyers and P.R. people who object most viscerally to the strategies of outrage management. Scientists and engineers, after all, don’t expect themselves to know how to deal with people; that’s not their field. But lawyers and P.R. people have communication strategies of their own. Mine are different. Techies may see me as an alien being, but it’s worse for lawyers and P.R. people: I’m poaching on their turf and criticizing their modus operandi.

There are doubtless also demographic and psychographic correlates of resistance. I tend to think that men have a tougher time with the legitimacy of outrage than women do – though I have met plenty of exceptions of both genders. As for age, my cohort (which came of age in the sixties) is famously more comfortable with emotion than our parents … and now than our children too. At least that’s how we see ourselves.

I don’t have much sense of the racial correlations, but I suspect power may be a key psychographic correlate. People who have usually been powerful (or young people who anticipate becoming powerful) have an incentive to see the world as governed by logic. That way they get to impose their will on the less powerful, then persuade themselves that they prevailed only because they’re right. (It’s amazing how many bosses make their subordinates pretend to agree, so the bosses can continue pretending they won the debate rather than pulling rank.) People whose experience tells them they lose more power struggles than they win find it comparatively easy to understand outrage.

The strategies I have tried for winning over the “black-and-whiters” mostly amount to using risk communication on behalf of risk communication. Acknowledgment and the use of the seesaw are crucial. For example, I routinely point out that the key role of outrage in determining people’s response to risk is tough to accept, a painful reminder that life isn’t as rational as many of us wish it were. (A bit later I add that it isn’t really so irrational to take fairness, trust, morality, and the like into account, and later still I note that my rationalist skeptics have their own emotional blind spots.) Sometimes I muse aloud that “if only we could just explain the data to them….” (And a bit later I point out their own resistance to the data about outrage.)

What’s on my website that you can ask your recalcitrant students to read? I’m not sure. Scientists and the Public might work. Or try Elenor Snow’s Risk Communication: Notes from a Class with Dr. Peter Sandman. Elenor is a techie herself – a tech writer at the Hanford Nuclear Reservation when she wrote these notes and posted them on her website more than a decade ago, now a freelance website designer and my webmaster.

Another possibility is my 2001 column on Sound Science, which tries to tease apart scientific and trans-scientific arguments about the seriousness of risks.

A lot of the likeliest prospects are old (I used to spend more time explaining the basics; now I’m preoccupied with spinning off corollaries). Some possibilities:

Getting out preparedness information before a crisis

name:Benjamin Delp
This guestbook entry
is categorized as:

      link to Crisis Communication index

Field:Political science undergrad
Date:August 16, 2004
Location:Virginia, U.S.


My name is Benjamin Delp. I will be a senior this fall at James Madison University. I work for the Institute for Infrastructure and Information Assurance out of JMU. We work in collaboration with George Mason University, University of Virginia, Shenandoah University, and a few others to better secure the infrastructure in Virginia and the NCR. One of our colleagues is Dr. Greg Saathoff at UVA who I believe you have worked with before.

The particular project we are working on now, deals with transportation and communication issues within the NCR in the event of a biological, chemical, or nuclear attack in Washington D.C. My focus has been on risk communication. I have read numerous articles that you have written that have given me a foundation in the field.

However, I have hit a wall in my work and I am now writing to receive your advice. We have met with numerous organizations in Virginia that have compiled excellent guides to secure the safety of those in the affected region after a terrorist event. I am having trouble finding ways to distribute this information to the people of Northern Virginia and Washington D.C.

I was wondering if you have any suggestions on ways to distribute vital information to the public, before an event takes place.

Thank you for your time and I will look forward to reading your next article.

Peter responds:

As I’m sure you know already, the problem of reaching people with information before they need it is a perennial one. Public meetings on potentially important future risks typically are poorly attended; brochures and other printed materials normally go unread. Ours is a just-in-time culture, and unless they’re angry or frightened (outraged) it is hard to get people to take preparedness seriously until the risk is imminent.

Of course this doesn’t keep people from complaining after that future risk materializes that they weren’t informed or consulted. Often the best you can do (and even that isn’t easy) is to remind people often enough that you have things you want to tell them about emergency preparedness that at least they remember you tried. That can protect you partially from later recriminations, though obviously it doesn't save many lives.

More importantly, it makes sense to replace the goal of informing people in advance with the more achievable goal of getting the information into their possession … so when the risk is indeed imminent they will know where to look (and they won’t have to try to get through to you!). An old standby of hurricane and earthquake experts is to put the relevant information in specially identified pages of the phone book. Some people actually read it in advance (probably while waiting on hold), and most people know it's there, ready when they need it.

A website can also serve this kind of double duty. Try to get the website URL into people’s minds or at least into their hands (on refrigerator magnets and the like). Only the most interested, concerned, or involved people will visit the website now, but millions will find their way to it when their need is urgent.

I wouldn’t give up entirely on educating people now. The trick there, I think, is to create a “need to know” now. For example, consider involving civic groups of various sorts in your outreach effort. A parishioner who accepts the task of briefing his or her church group on emergency preparedness may or may not get through the clutter; plenty of people daydream through church group presentations. But you can bet your mortgage that he or she will learn the material!

Similarly, we need scout merit badges on emergency preparedness. (Or if they exist already, we should work on updating them.) Scouts who are pursuing the badge will thus have a genuine need to know – and will very likely end up teaching their parents, teachers, and friends a thing or two as well.

Asking questions is another way to create a need to know. Instead of just telling people stuff, try outlining some emergency preparedness dilemmas and asking their advice. How much vaccine or antiviral medication should we stockpile? If the supply is limited, who should get it first? Is it okay to evacuate children straight from school without their parents? These are real questions that emergency planners need to answer. More to the point, asking the public to help figure out the answers is likely to generate more interest than simply telling them what they should do to get themselves ready.

Finally, make good use of near-misses and false alarms. Get ready now, so the next time your area is threatened (and feels threatened) by a hurricane, a sniper, or a West Nile Virus outbreak, you can seize the moment, the teachable moment, to do some emergency preparedness outreach.

There are plenty of people more experienced, knowledgeable, and creative about getting the word out than I am. (My specialty is more figuring out how to say it than figuring out where.) But maybe some of this will help prime the pump.

The role of marketing in risk communication

Field:County health department information officer
Date:August 8, 2004
Location:Michigan, U.S.


I have become acquainted with your work in recent years, especially as the need for risk communications has intensified. I am public information officer for a local health department in West Michigan, and your articles have been a great resource for me as I put together the department’s risk communication plan (for the CDC grant).

I have a question that is not entirely related to risk communication, and would appreciate your perspective if you have the time or inclination. Actually, it is a series of questions.

While my role here has always been public communications and public information (“public relations,” media relations, report writing, etc.), new administrators at our department want my position to have more of a marketing emphasis. While this may on some level be a semantic debate, what are your thoughts on marketing, and is it something government agencies should do? When I issue a news release or develop a brochure about our services, I see this as public information, though perhaps it could be called marketing as well. I do understand that image-building (what I might call public relations) does help market the organization on some level.

My personal feeling is that marketing is necessary when people have a choice, but using the health department in many cases is not a choice – it is either a requirement, or a provider of last resort. In which cases, I argue, public information is necessary – so that people are aware of what services we provide – but not marketing per se. Is this just semantics?

In any case, I am not going to share your response with my administrators, but would appreciate your perspective for my own sake. I will be leaving the organization shortly and it appears that a marketing person will be hired to replace me.

Let me thank you in advance for your time; any insight you could provide me would be greatly appreciated.

Peter responds:

Thanks for your email, and your kind words about my work.

There are really three questions here, I think. The most fundamental of the three is the issue of selling versus informing. On that one, I’m on the side of selling.

My government clients often take the position I think you’re taking – that their job is just to get the information out there and let people respond however they respond, that their goal is “awareness” rather than any specific audience attitude and behavior. If they mean what they say, they’re defining their job very narrowly. There are certainly times when a health agency should provide objective information and not take a position on what the receiver of that information ought to do with it. But there are plenty of times when you want more than that – you want people to use DEET when taking a walk on a summer evening; you want parents to keep their kids’ vaccinations up to date; you want smokers to quit and partners to practice safe sex. It’s a rare (and weird) health department that has no preferred position on these issues.

And if you do have a position on these issues, then your goal isn’t mere awareness. If the outcome of your “vaccination awareness campaign” is that lots of people say that now they’re aware of vaccination, find it boring or off-putting, and have no plans to do anything about it, you’re probably not going to see the program as a success. In that case, it’s self-deceptive to imagine that you’re just informing people, not trying to sell them on getting the right vaccinations. Every once in a while some state legislature gets a bee in its bonnet that government agencies shouldn’t do propaganda (an even more negatively loaded term than “marketing”), and passes a law to that effect. They never mean it literally. From “pay your taxes” to “stop at red lights” to “get your vaccinations,” governments have lots of behavioral goals for their publics. They would be fools not to use what marketing experts know about how to talk people into doing what you want them to do.

Of course deciding that much of public health communication is a species of marketing doesn’t get you very far in answering the tough questions about what’s an acceptable marketing strategy and what isn’t. Presumably you’re not willing to lie to people, but is it okay to tell a carefully manicured version of the truth? What about appeals to emotion? (Are all emotions out? Are they all in? Is it okay to appeal to positive emotions like love but not nasty ones like anger? Is anger at cigarette companies an exception?) What about pivoting on your audience’s pre-existing values? (Does your opinion change if we change “values” to “prejudices”?) A public agency may approach its marketing tasks with different ethical sensitivities than a for-profit corporation. Or not.

A second question you raise is whether a health agency should do marketing on behalf of the agency itself – as opposed to what is usually called “social marketing” on behalf of good public health. This is a closer question, and I think a less important one. I don’t object to conscious, targeted efforts to persuade your publics that your agency knows what it’s doing. Those efforts presumably have an indirect payoff in the credibility of your public health messages; they also contribute to your employees’ morale and may inspire higher levels of performance. But I see the point that this is special pleading, and I agree that agencies ought to be more focused on accomplishing their objectives through communication than on communicating how well they accomplish their objectives.

The third question is the least obvious of the three, but in some ways the most important: the relative priority a health agency should put on marketing communication as opposed to other kinds of communication. (See my column on “Four Kinds of Risk Communication.”) When people are apathetic about serious health risks, marketing is a crucial guide to figuring out how to arouse them to concern and to action. But when people are excessively frightened about tiny risks, then the risk communication task is outrage management – and traditional marketing approaches are likelier to backfire than to help. And when people are rightly upset about serious risks, then we’re in the realm of crisis communication – and once again traditional marketing isn’t the right toolkit.

Bottom line: I think a health agency should have somebody on board who is good at marketing and willing to use marketing to sell public health. I also think a health agency should have somebody who knows how to do outrage management, and somebody who knows how to do crisis communication, and (as you stress) somebody who knows how to provide neutral, objective information via the media. Whether an agency does the job with one multi-skilled person or an office full of specialists depends on its size and budget. Marketing isn’t all you need. But I wouldn’t want to do without it.

Telling people something they do all the time is more dangerous than something they’re newly worried about

Name:Jed Waldman
Field:State health agency scientist
Date:July 10, 2004
Location:California, U.S.


Below is a recent editorial from the July 8 Santa Rosa Press Democrat. This seems to describe a balanced approach, but I guess it depends on how much credibility the officials have built up.

I have often reflected on your column from last year, “Fear Is Spreading Faster than SARS” – And So It Should!

Reality Bites:
Driving to the store is more dangerous than West Nile virus

When it comes to infectious diseases, panic can sometimes be as dangerous as the actual illness.

In October of 2001, public health officials were less concerned about anthrax contamination than they were that the overuse of the antibiotic Cipro by frightened citizens would make the drug less effective in real emergencies.

For this reason, local public health officials should be applauded for proactive efforts to quell fears regarding West Nile virus.

At a recent news conference, local officials let residents know what is being done to protect the community against the virus, which is now in Southern California. Representatives from the Mosquito Abatement District were upfront about spraying, which began this week in channels of the Laguna de Santa Rosa. The Blood Bank of the Redwoods assured people that blood is being tested. County health workers told people to take preventative measures by covering up in the evenings and using bug sprays that contain DEET.

Most important, the panel reminded citizens not to panic if the disease does gain a foothold locally.

“You have a better chance of getting killed on your way to the store to get DEET than of dying from West Nile virus,” said Chris Canterbury, a spokesman for the Mosquito Abatement District. It’s a reminder that while the unknown can terrorize, it’s the everyday acts that are deadly.

Santa Rosa Press Democrat, July 8

Peter responds:

Thanks for letting me see this editorial.

Editorials like this are all too common – telling readers they’re foolish to panic about X when Y (which they do all the time) is actually more dangerous. Those of us on the East Coast are already well along the much-traveled path from “Don’t panic about West Nile Virus!” to “Don’t forget to use your DEET!” But the next time we’re newly worried about something, the editorialists will forget all over again that people (a) rarely panic and (b) usually don’t even manage to stay worried for long.

What should we say to Chris Canterbury, the mosquito control official who is quoted as telling people: “You have a better chance of getting killed on your way to the store to get DEET than of dying from West Nile virus” (WNV)?

I doubt it’s true. I haven’t tried to work the numbers, but I’d guess that the marginal additional time on the road when DEET is added to the shopping list is awfully low. Does Canterbury really think people who make sure they always have a ready supply of DEET have higher mortality than people who don’t – that their increased mortality from auto accidents is higher than their reduced mortality from WNV? I assume both numbers are tiny, but I wonder at his confidence that shopping for DEET is more dangerous than going without. If he means it, then shouldn’t governments stop telling people to use DEET – or at least caution them not to make a special trip to the store and be sure to wear their seat belt when they go DEET-shopping?

I suspect he doesn’t mean it. It’s hyperbole, meant to suggest that the WNV risk for any one individual is small – which of course it is. But the public health risk is presumably substantial enough to justify the public health response of which Canterbury is a part … and of which using DEET-containing products is also a part. So he’s undercutting his own professional efforts – which brings me to number two.

I think it can backfire. Canterbury is in the mosquito control business. He needs public support for the continuing use of pesticide sprays, a risk controversy in its own right. He also needs the public to take seriously the hassle of such mosquito-control measures as getting rid of sources of standing water.

So if the risk of WNV is so low that it’s not sensible to drive to the store for DEET – which is what he’s saying, after all – then how can it possibly be wise to spray malathion and the like? Even if pesticide spraying is itself fairly benign, anxiety about spraying is demonstrably widespread, and demonstrably harmful to health. The logical extension of Canterbury’s argument would be that when risks are small, as the spraying risk and the WNV risk and the DEET-trip-to-the-store risk all are, anxiety is the biggest health factor – and therefore whichever policy frightens people less is the right policy, independent of technical data. DEET is much likelier to survive that test than malathion!

Or how about this: “Don’t remove that old mosquito-breeding tire from your front lawn. You might sprain your ankle, then get in an auto accident on the way to the doctor. You might encounter a deer tick and end up with Lyme Disease. Better the tiny risk of West Nile Virus than the greater hazards of tire removal.”

It ignores what we know about the psychology of risk. The normal way of coping with a new risk (or an old risk of which one is newly aware) is to go through a period psychiatrists call “adjustment reaction” – a period of hypervigilance and exaggerated caution, of “personalizing” the risk. (See “Crisis Communication: Adjustment Reactions by Sandman and Lanard for a rundown on adjustment reactions.) Adjustment reactions help people rehearse, emotionally and logistically; they are conducive to coping well with the new risk. Soon enough – too soon, usually – the adjustment reaction subsides and people revert to the New Normal.

So what happens when you tell people not to have an adjustment reaction? They have one anyway, but you lose your chance to guide it. Or worse, they feel they shouldn’t have the reaction they’re having, so they go into some form of denial instead. If people’s response to a risk is actually quite dangerous, it’s important to discourage the response, of course. But if the response is harmlessly excessive – wearing face masks against SARS, buying but not taking a CIPRO prescription in case of anthrax – officials should legitimize and guide the reaction instead of criticizing it. And when the reaction is actually the one officials recommend, such as using DEET, it doesn’t make much sense to undermine it with sarcasm or hyperbole.

Above all, it’s unnecessary. Canterbury is urging people not to panic about West Nile Virus. I have seen no evidence that anybody has panicked about West Nile Virus.

Panic is ungovernable emotion leading to behavior that substantially adds to the danger to oneself and/or others. It isn’t just feeling more alarmed than officials think necessary – it’s being unable to cope with the feeling and acting out in dangerous ways. It’s breaking into a drug store to get your DEET; it’s running over your grandmother in a frenzy of DEET-seeking. You know my shtick on “panic panic” already, I think – for a more thorough discussion than the “Fear Is Spreading Faster than SARS” column, see “Fear of Fear: The Role of Fear in Preparedness … and Why It Terrifies Officials” by Sandman and Lanard. Bottom line: Officials imagine panic when there are no signs of it, then patronizingly tell the public there’s no reason to panic.

Sorry to respond with a diatribe. But I’m guessing it’s about what you thought I’d write.

Jed responds:

Your response is a wonderful case study. My “training” (taking US EPA’s risk comm course in SF and reading your columns) made me concerned about the issue of (a) meaningless comparisons, (b) false assurances. Thanks for taking the time to parse the issues on this one.

(1) Web-based risk communication; (2) mental models

Field:Risk management
Date:June 8, 2004


There appears to be a dearth of literature investigating risk communicaitons using the web as the means of communication. Is your Risk = Hazard + Outrage equally applicable to web-based risk communications? Does mental models have a place in your theory?

Peter responds:

Thanks for raising two important questions.

I agree that there hasn’t been much research on Web-based risk communication. Let me offer some preliminary guesses about how the Web works in each of the three main sorts of risk communication: crisis communication, precaution advocacy, and outrage management.

The Web is most important for crisis communication. In a crisis, people mobilize their own information resources – and for those with Web access, that’s going to be first and foremost the Web. (The same is true for other new and user-controlled media; while newspapers and broadcasting were censored, news of SARS in China was spread chiefly via cell phone.) Just this morning I read a Canadian government survey on public attitudes toward a possible flu pandemic. More than half of those responding named the Internet as the place they’d go for information during a pandemic. Organizations vary widely in their preparedness to get a dedicated crisis website up and running, to keep the site current, to link it to other information sources, and to make it two-way and user-friendly. But there aren’t many organizations left that don’t know that a website will be crucial to their crisis communication efforts. Some organizations may actually be over-emphasizing their websites at the expense of other important crisis communication vehicles, from sound trucks to voicemail systems.

The Web plays a much more specialized role in precaution advocacy. The key task here is arousing apathetic people to take more seriously a hazard that you consider serious. But apathetic people aren’t likely to find their way to your site. So activists and health educators must do their recruiting elsewhere – relying on newspapers and broadcast news to get people interested enough to go to a meeting or a website. But as a communication tool for those who are already involved, the Web is unsurpassed. Outraged stakeholders use it especially for three tasks:

  • To collect intelligence about the “enemy”
  • To build alliances with similar groups around the world, and borrow their strategies and tactics
  • To keep their own constituency fired up and up to speed.

The third is the most obvious; the advantages of a website over a pamphlet or a newsletter are legion. But the other two uses of the Web are also very important. It is commonplace today to go to a local public meeting about the emissions of an XYZ Company factory and find local citizens citing chapter and verse about what XYZ did in Sri Lanka, what it promised in Chicago, and how the locals stopped it in Buenos Aires.

I think the Web is least important in outrage management – trying to reduce people’s concern about a hazard you consider minor. The key strategies of outrage management are things like apologizing for misbehaviors and giving away credit for achievements – things that are a little easier to make yourself do and a little likelier to help in person than on a website. I do advise my corporate clients to create special pages on their sites devoted to the controversies in which they have become embroiled. Ideally, these pages reiterate the outrage-reducing messages you are trying to communicate through more personal media; ideally they include plenty of background information (including the bad stuff), plenty of links (including the activist sites), and plenty of opportunity for feedback (including forums where critics and the company can interact). The goal is to get interested and concerned people to go to xyz.com instead of xyzsucks.com when they want to know what’s going on. But for outrage management, the Web is a secondary tool … at least so far.

Your other question concerns the mental models approach to risk communication, pioneered by Granger Morgan and others at Carnegie Mellon University. What is most basic about the mental models approach is its emphasis on the fact that people are not blank slates. They already have opinions, values, feelings, information, and misinformation relevant to the risk issue at hand. All this pre-existing content affects how they will respond to your communications – so obviously it should affect how you frame your communications! This fact is obvious, but it is nonetheless ignored far too often by communicators excessively focused on what they want to say, and insufficiently focused on what their audience wants to hear, needs to hear, or expects to hear (not to mention what it wants to say back).

My approach to risk communication is certainly grounded in the same fundamental reality that the mental models approach is grounded in: the need to pay attention to your publics; to see them as real people, not stick figures. My focus on acknowledging people’s grievances is one example of this; so is my recommendation to give people credit for the things they made you do. A third example is my emphasis on correcting misimpressions explicitly. To move people from X to Y, I urge clients, tell them why they think X and why X is a reasonable thing to think; then explain how you came to realize that Y is actually closer to the truth. Don’t just say Y-Y-Y-Y-Y.

One area where the mental models approach does much better than I have done has to do with framing effects and heuristics. The elegant research of Kahneman, Tversky, and others on how people process and organize (and distort) risk information is much more systematically integrated into the mental models approach than into my approach.

Another huge contribution of the mental models group has been to develop, test, refine, and disseminate a series of procedures for finding out the mental models of specific groups of people with respect to specific risks. They have by far the best tools for doing this. And they have considerable evidence that it’s worth doing, that our intuitions about what other people think are often way off. I usually settle for pushing my clients to think about what’s going on in the minds of their publics and stakeholders. I believe that’s at least half the job. But the mental models group has taught us how to measure it as well.

Talking about risks that have never happened

Date:May 19, 2004
Location:Michigan, U.S.

What I would add to this site:

I think the site is great, the questions and responses provide a lot of insight…


Sir, I was recently asked how would one communicate the risk of an event or threat that has NEVER occured in recent history? I thought for a moment and tried to remember a situation that has not occured in somewhere in the world. I had to ask myself, would I use an example of another country and their experiences or could I just say “the risk of an event occuring is greater than ‘zero’.”

Peter responds:

Talking about risks that have never happened is more common than one might imagine. Accidents, for example, are all more or less unique – exactly what happened at Three Mile Island had never happened before and has never happened since. So are terrorist attacks. Estimating the probability of either one is mostly an exercise in guesswork.

The most important thing to say is the one you mention: “The risk is greater than zero.” Or, in more normal language: “It could happen.” Except for physical impossibilities, nothing is zero risk – which means that blanket assertions like “X is absolutely safe” or “The XYZ Corporation will never compromise on safety” are foolhardy. Nothing is absolutely safe, and we must constantly compromise safety against other goals. (When my daughter Alison had just got her driver’s license, I urged her not to compromise on safety. She rightly pointed out that leaving the driveway required compromising safety against transport.) As I tell clients endlessly, if you don’t want people unreasonably demanding zero risk, stop unreasonably implying you can provide it.

Of course the fact that something has never happened can be persuasive evidence that it probably won’t happen. But don’t overplay your hand. Put the reassuring information in a subordinate clause: “Even though it has never happened, it could happen.” You give us the data with which to reassure ourselves, but you do not overreassure us. Even so, be careful about your claim that it has never happened. If we find a precedent you missed, your credibility will suffer, and so will your ability to reassure us. If there is a semi-precedent – something similar sort-of happened – you'd better talk about it.

Other things that might be worth saying:

  • Here’s why we think it’s unlikely.
  • Here’s what we’re doing to reduce the risk still further.
  • Here’s what we’re doing to estimate the risk more precisely.
  • Here’s what we’re doing to be ready in case it happens.
  • Here’s what you can do.
  • We wish we could rule it out entirely – but we can’t!

Is outrage part of risk or part of risk perception?

name:Tim Evans
This guestbook entry
is categorized as:

      link to Outrage Management index

Field:Consultant – sustainable solutions for
organic resources, soil scientist.
Date:April 6, 2004

expanded author info:

The objective of TIM EVANS ENVIRONMENT is to help clients to create cost-effective solutions for wastewater, biosolids and other organic residuals that are sustainable and appropriate to their needs and local situations.


I heard you at a WEF conference [Water Environment Federation] and have met your work again via the work of Ned Beecher et al. related to public attitudes to biosolids. I have just reviewed a paper that was submitted on this work and concluded that one of the difficulties to reading it was constantly testing whether the words “risk” and “hazard” were being used in the classical sense or not.

People who are familiar with risk assessment will be accustomed to definitions such as the following, all from ISO/IEC Guide 51:

  • Harm – physical injury or damage to the health of people or damage to property or the environment.
  • Hazard – potential source of harm.
  • Risk – combination of the probability of occurrence of harm and the severity of that harm.
  • Safety – freedom from unacceptable risk

[ISO/IEC Guide 51:1999 Safety aspects – Guidelines for their inclusion in standards]

When you say risk = hazard + outrage I think you are actually saying perceived-risk = risk + outrage. If that is correct can I make a plea that you consider changing your terminology such that “risk” and “hazard” are used as in the ISO/IEC Guide 51 because I believe it would make it easier for readers?

I think the distinction of “risk” from “perceived-risk” is extremely valuable and shall be raising consciousness of it this side of the Pond.

I have been involved with an initiative partly inspired by the National Biosolids Partnership, we are calling it the Sustainable Organic Resources Partnership and one of our earliest planned projects is measuring public attitudes to use of organic resources on land to get an objective handle on the outrage factors in order that we can address them through communication and/or changing practices.

I don’t mind this being posted on your site, but I would be very grateful for some feedback about whether you agree about facilitating understanding by using standard terminology.

Peter responds:

I agree that my use of unconventional terminology – or, rather, my misuse of conventional terminology – is a nuisance. Even I have trouble staying internally consistent. When I’m not focusing on the hazard-versus-outrage distinction, I find myself writing about “the risk of EMFs” or “the risk of biosolids” meaning just the probability and severity of harm. It’s only when I turn to the seriousness of the risk that I start parsing it: “Well, in hazard terms it’s a pretty low risk, but in outrage terms….”

So why do I resist abandoning my “Risk = Hazard + Outrage” formula? Partly, of course, it’s just too late. What would I do with all those articles and books and videos that pivot on the formula? But I have two better reasons for sticking to my terminological guns.

First, we need to keep remembering that there is no way to assess a risk except by perceiving it. Your proposed formula, “Perceived Risk = Risk + Outrage,” seems to suggest that risk assessment experts have some way of getting their risk data directly, while the poor public is stuck perceiving the risk and therefore gets it all muddled with outrage. This isn’t just an abstract point about epistemology. A lot of research has demonstrated that technical experts are just as vulnerable to perceptual and cognitive distortions as non-experts. My favorite example: Experts judge the risk of a technology to be less serious when they consider the technology’s benefits substantial, as if they were unconsciously struggling to avoid facing the high-risk high-benefit dilemma.

I think it is important to stay symmetrical in our comparisons of expert and non-expert risk assessments. If you want to assert that expert perceptions (and their accompanying distortions) are systematically different from non-experts’ perceptions (and their distortions), that’s okay by me. Or if you want to say that experts have different values than non-experts, or different definitions of risk, that’s also okay. But any formulation that implies that experts have a handle on “risk” itself while the rest of us only have our “risk perceptions” is dangerously misleading.

My second point is an empirical observation: What people mean by risk does in fact include the factors that I subsume under the term “outrage” – even after they understand the data. Terrorist attacks, for example, are a smaller hazard than automobile accidents. But they are a bigger outrage, and we know why: voluntariness, control, dread, morality, familiarity, and other outrage factors make it so. It is true that high outrage tends to lead people to overestimate the probability of getting killed by terrorists, just as low outrage tends to lead people to underestimate the probability of getting killed in an auto accident. (Note that both, not just the first, are perceptual distortions.) But here’s the important point. After you teach people the data about terrorism and auto fatalities and successfully correct their misperceptions, they will still assert that terrorism is the more serious of the two risks. They will explain that being targeted by people who hate you and want to kill you is worse than being vulnerable to mechanical failure and human error. They will express a willingness to endure far more expense, inconvenience, and loss of freedom to deter terrorism than to reduce the highway death toll. And they will think you a very strange sort of expert if you don’t see why.

Outrage does cause us to misperceive hazard. But independent of the misperception, outrage is also part of what we mean by risk. So it should be part of our definition of risk … not just our definition of other people’s risk perceptions.

Like you, many of my clients are much happier seeing outrage as part of “risk perception,” not as part of risk itself. Despite this, they often manage to learn to treat outrage as legitimate, as something people rightly take seriously rather than as something people ought to stop feeling. But I think their “perception” frame makes it harder for them to accomplish this transition.

The risk assessment profession has agreed on a set of definitions that works well for technical tasks, but tends to encourage risk assessors to see outrage as merely a source of distorted risk perception. The public considers outrage a part of risk. Paradoxically, then, viewing outrage as merely a source of misperception is in fact a misperception of outrage. I don’t mind if risk assessors hold onto their definitions when their focus is technical – as long as they understand that their definitions diverge from the way the rest of us use the words and the way we respond to the realities the words represent.

Tim responds:

Somehow it is comforting that the terminology is a problem for you as well. I am not suggesting that “perceived-risk” [my terminology] is less valid than risk [ISO] – they are different and both need to be considered. An actuary can calculate risk of auto accident and uses that to calculate insurance premiums. If actuaries worked on “perceived-risk” the insurance industry would collapse because premium income would be out of balance with claims. However if we (society) want to reduce death and injury from auto-accidents we need to take account of “perceived-risk” and influence the outrage. Similarly skin cancer through exposure to sun, the numerical risk is high but people don’t believe it and like to be tanned – apparently Australia has worked on this for 20 years or more and increased “perceived-risk” to an extent that un-tanned is now fashionable and skin-cancer has dropped. Several countries have done the same for tobacco.

Quantified risk [ISO] and perceived-risk are both important – and different. I intend to (continue to) raise awareness that quantitative risk assessment is not the whole answer, and that the “technical community” needs to take account of outrage factors and perceived-risk, to engage the wider stakeholder community, just as we are in the Sustainable Organic Resources Partnership, so that we defuse outrage that is misplaced. That is the only way to ensure we are spending our “environmental dollars” to best effect and developing sustainably; the alternative is that we are blown before the wind of high outrage scares, activists and sometimes people with dubious agendas. In the case of using organic resources on land, if they stink they will generate high outrage, the numerical health risk might be low but that is not relevant, the numerical risk of odor nuisance is high (adverse effect on quality of life) and that is the one that counts in this case.

Please don’t anybody think that I am suggesting for one minute that perceived-risk is less important than [ISO] risk – they both need to be managed.

Testing cows for BSE

Name:Michael McElvaine
Field:Public health veterinarian
Date:March 30, 2004
Location:Washington, D.C.


I have read much of your work for several years and agree with most of your statements and at least appreciate the intent of those points with which I sometimes disagree.

One of the big mis-truths currently being played out by such countries as Japan and some of our consumer interest organizations is that testing of cattle for BSE (using current technology) actually means that consumption of meat from these animals is ‘safe,’ at least in the context of the risk of BSE exposure and the possibility of nvCJD development.

There are several arguments against using the term ‘safe’:

First – it assumes a perfect test system: no false negative tests and no human errors.

Second – a true negative test only means that any infective prion to which an animal might have been exposed had not reached the specific brain tissue which is tested using the current test kits and systems. Since it may take 15–30 months or more after exposure for the prion to arrive at the specific tissue which is actually subjected to the test procedure, a presumptive negative test on an animal only means that there is no prion in the tissue tested. The presumptive negative test does not have the ability to assess whether a specific animal has been exposed and has the prion traveling through its body unless the prion has arrived at the tissue to be tested. We would expect a positive test if that were so. Countries and consumer groups who are demanding universal testing for BSE for the sake of safety of their meat supply are spreading misinformation and pandering to the public fears.

When you add this to the information you included in this article about the low prevalence of BSE in the US (even with recent evidence that the prevalence is greater than zero), the risk of BSE exposure to US beef consumers is very small. The current interim USDA and FDA regulations further decrease this risk. The risk is already so small that it is essentially impossible to measure a further reduction in risk. The demand from consumer groups for universal testing of all slaughter cattle for BSE is even more ludicrous given that the majority of cattle slaughtered for meat are less than 22 months of age. This suggests that we would be mostly testing animals which are too young for the prion to be detectable, even if it were present. What possible public health benefit can we gain from spending money testing animals that we know will be test negative?

I know that these arguments could be presented more coherently in an edited paper, but wanted to share them with you now in this less formal forum.

Michael D. McElvaine, DVM, MPH, DACVPM

Disclaimer: These opinions are strictly my own and do not necessarily represent those of the US Department of Agriculture.

Peter responds:

I really, really appreciated hearing from you. I can tell from my webstat software that lots of people at USDA are looking at the BSE risk communication column that Jody and I wrote – but yours is the first substantive response from inside the Department.

I accept and understand that any BSE test is only a snapshot of particular tissue at a particular time; a negative test is not a guarantee that there are no prions elsewhere in the animal. I accept also that false negatives and human error are real possibilities. And I certainly agree – strongly – that the word “safe” is always an over-generalization unless it’s qualified by a number or a comparison or at least an adverb. So it’s wrong to say that meat from an animal that has tested negative is safe, for the same reasons as it’s wrong to say that the American beef supply is safe. But surely it’s accurate to say that the American beef supply is SAFER (so far as vCJD is concerned) than the U.K. beef supply was during its BSE epidemic. And isn’t it similarly accurate to say that meat from a cow that has tested negative is SAFER than meat from a cow that hasn’t been tested?

On the relationship between age and testing, I have read that cows younger than 22 (or 20?) months have so far never tested positive for BSE. I’ll accept that most experts are fairly confident that testing young cows adds no significant margin of safety. That said, older cows do get into the food supply. Is there a case to be made that testing only older cows would create an incentive for cheating with respect to the cows’ age – that older cows would be misrepresented as younger to avoid both the expense/bother of testing and the risk of a positive test. Are we really so much better at carding cows than my neighborhood bar is at carding teenagers? It seems likely to me that universal testing is easier to enforce and harder to evade than age-triggered testing. Even if this is not true, the fact that it seems true to a lay observer is itself relevant. It’s probably easier to convince a mistrustful population that universal testing will protect them than to convince them that (a) young cows are not worth testing and (b) old cows won’t get passed off as young ones.

We may have a philosophical disagreement about when it is okay to “pander” to people’s concerns by doing reassuring things that aren’t necessarily cost-effective other than because they are reassuring. When my daughter (now an attorney) thought there might be goblins in the closet, it seemed sensible to me to turn on the lights, take her by the hand, and check the closet for goblins. I realized that the odds of finding goblins were slim, but this effort at transparent, accountable “goblin testing” seemed wiser than refusing to collect the data on the grounds that I knew the answer already even if my daughter didn’t – it offered a higher probability of everyone’s getting a good night’s sleep and a higher probability of my daughter’s deciding that there weren’t goblins in the closet after all (and calling off the nightly goblin hunts). Was this really pandering? I don’t generally favor unnecessary precautions as a strategy of reassurance, but I make an exception for precautions that are only data collection, not inhibitions on behavior. (If people think the Superfund site is giving them cancer and you’re pretty sure it’s not, don’t demand excessive cleanup of the site, but go ahead and do an epi study …. IF the study seems likely to answer the question. And design the epi study with public credibility in mind.)

It’s also worth considering the relationship between early responses to public concern and public demands for later responses. What tends to happen, I think, is that authorities are over-reassuring, over-confident, less than candid, and contemptuous of the public’s concerns in the early stages of a controversy. These official responses backfire, exacerbating the public demand for excessive precaution. And at least in democratic societies, that demand is ultimately acceded to. It seems to me that the countries with the most stringent – unnecessarily stringent – BSE standards are the countries that were over-reassuring and less than candid about their early BSE problems. I’d like to help the U.S. avoid going further down this road.

Michael responds:

For the most part, I believe we are in agreement; in a few places, we differ by a certain degree in opinion rather than true disagreement.

I do not dispute your suggested statement that the US beef supply is “safer” than the UK meat supply at the height of the epidemic. I would go even further and suggest that US beef continues to be safer since the latest data from OIE (27-02-04) reports 612 cases of BSE in the UK for 2003 and the cumulative case counts for both US and Canada since the start of data reporting is 2.

But I do not completely agree that meat from a cow that has tested negative is safer than meat from a cow that hasn’t been tested, since a negative test means at best a negative test. For an aged cow, say 30 months or more, you have scientific data to support the concept of “safety”. For a young animal that tests negative, then it is more of a leap to assume ‘safety’ since we really gain no information from a negative test, using the current testing system given our inability to detect the prion in an incubating case prior to the prion showing up in the specific brain tissue.

As for our ability to be sure about a cow’s age, the pattern of tooth eruption of the incisors provides a pretty good estimate of the age of the animal. The FSIS Docket 03-025IF, Prohibition of the Use of Specified Risk Materials for Human Food and Requirements for the Disposition of Non-Ambulatory Disabled Cattle (FR Vol. 69, No. 7, January 12, 2004, pp 1861–1874) discusses two methods for determination of the age of cattle being less than 30 months. The first is adequate documentation, the second is based on the eruption of at least one of the second permanent incisors teeth (permanent incisors of cattle routinely erupt from between 24 and 30 months of age). FSIS intends to use a combination of both of these criteria to judge whether an animal is under 30 months of age. Of course, if there is any financial incentive for misrepresenting an older animal as being younger, then the possibility of older animals slipping past the testing step is entirely possible (especially when there is a human factor involved).

Last year almost 29 million head of cattle under 30 months of age were slaughtered. The low-ball estimate for testing cost I have seen is $10 a head (I have never been able to determine if this figure is only for the actual test or whether this includes any costs for the time and labor involved in collecting the samples). I have seen estimates of the cost of testing that are several factors greater. By using this lowest cost estimate of $10 a head and last year slaughter number of 29 million, you have a cost of nearly $300 million dollars to achieve no added information about “safety.” The actual costs could be higher by several factors. I also accept that there are many arguments that could be put forward that $300M (or $600M or $900M) is not a large sum in relation to total sales values, consumer costs or other such comparison. The only thing you can gain from this is increased consumer confidence. The cost of universal testing has been adopted by the Japanese in large part due to a lack of consumer confidence in the information their public received from their government. I believe that the US consumer confidence remains high – without necessarily attributing credit solely to the response of the US Government agencies but also to the fact that the American public has become used to BSE and mad cow disease and the magnitude of this “outbreak” is only 2 animals so far.

Over-reacting to risk and irrationality

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      link to Outrage Management index

Field:Fed gov. information officer
Date:March 31, 2004
Location:Georgia, U.S.


It’s been more than a year since we last met in Atlanta, but your influence is powerful and positive (even when I think you overstate things, which I allege you do, at times, purposely to nudge us closer to the counterintuitive principles you espouse).

In regards to “When People Are ‘Over-Reacting’ to Risk” I always struggle with your assertion that people rarely are irrational in over-reacting to risk, though I think this essay includes examples of irrationality, broken down into helpful categories. People who are ignorant, for example, don’t have any data on which to draw bad conclusions, but they draw them nonetheless. That, to me, is an irrational response (assuming the behavior is not random). A consistent response in the face of ignorance is irrational because it cannot possibly afford much confidence. A rational human being would recognize that, and seek a basis on which to either change or reinforce his/her chosen response. To blindly persist, again, defines an irrational, e.g., unreasoned response. Regarding number 7 (“Are they emotional?”), while those who lack emotions may be psychopaths, those hopelessly dominated by them may be merely neurotic and another measure of irrationality in my book. Another possible category might be timidity or malleability. Media hype certainly influences pop culture, for example, and that, in turn, might steer the vulnerable into over-reacting to risk. I guess, though, the effect would be to assign them to one of the categories you’ve already identified. Ok, so I’m proposing a second tier of catalysts. Enough already. I often sing your praises and hope to spend time with you again and soon.

Peter responds:

I plead guilty to frequent hyperbole – sometimes strategic and intentional, but sometimes just reductionist enthusiasm. But hyperbole aside, I think the diagnosis of public irrationality is greatly overused, misapplied to risk responses that aren’t irrational at all.

Consider the first example you used: ignorance. On the most fundamental level, it seems to me, irrationality is about drawing conclusions that do not follow from one’s own premises. Ignorance is about not having any premises. (Misinformation is about false premises.) I learn that a nearby factory emits previously undisclosed amounts of dimethylmeatloaf. I know nothing of dimethylmeatloaf. But I have a rule of thumb that tells me polysyllabic emissions tend to be hazardous, and a second rule of thumb that tells me previously unacknowledged emissions tend to be hazardous, and a third rule of thumb that tells me it’s best to assume any chemical is hazardous until proven otherwise. You might argue that these rules of thumb are unsound, or that they are misapplied in this particular case, or that I ought to supplement and sometimes overrule my rules of thumb with specific information on dimethylmeatloaf hazards. Certainly I am ignorant about dimethylmeatloaf. But am I acting irrationally?

Ignorance is actually a wonderful example to ponder, since the essence of conservativeness (not to mention the Precautionary Principle) is the notion that caution is a wise response to one’s own ignorance. Risk assessors rename their ignorance “uncertainty” and quantify it, struggling to be knowledgeable about the extent of their ignorance. But ordinary people’s algorithms for coping with situations they don’t understand are intuitively conservative … and not, I think, irrational.

As for emotion, I agree that emotional responses to risk are not “rational” responses – that is, they are not derived from ratiocination, from thought. In some situations emotion is a wiser guide to action than thought; in other situations thought is wiser. Learning when to trust your gut and when to let your head overrule it isn’t easy – the algorithms here are very complicated!) But leaving aside the comparative merits of thought and feeling as guides to action, my categorical point is simply that emotion isn’t “bad thought” – it’s not thought at all. The concept of “irrational” is justifiably pejorative only if it’s confined to bad thought; framing effects, for example, are irrational because they distort efforts to think clearly. (By the way, Kahneman’s work shows that expert risk judgments are as vulnerable to this kind of irrationality as lay judgments; absence of emotion is no protection against the distortions of Kahneman’s heuristics.) Maybe we can use “arational” as a nonjudgmental term to mean a response that isn’t grounded in rationality and doesn’t claim to be … leaving open the question of whether in the case at hand a rational response would have been wiser or less wise.

It’s interesting that “irrational” means doing a poor job of thinking; we don’t really have a word for doing something other than thinking. By contrast, “unemotional” means doing something other than feeling; we don’t really have a word for doing a poor job of feeling, though psychiatrists talk about “inappropriate affect” a lot.

Dan responds:

Thanks for entertaining my argument so … rationally.

I appreciate the baggage that comes with a term like irrational: but also know (maybe at gut level) that some human acts are just that. While I really like your explanation of how caution is a logical default position for the ignorant, it would be a shame to starve in a room full of tomatoes, because you heard that all red fruits are toxic. Would that be a rational decision? I also like the suggestion that communication (which should provide a remedy for ignorance) offers hope for a healthy choice. But when it doesn’t, and the wrong choice continues to be favored, we can no longer excuse it as due to ignorance. Maybe then, another explanation kicks in, or maybe at some point, were forced back into that politically-incorrect, condescending label.

It seems as though you’re saying emotional imbalance can’t be labeled as irrational thought, because, as you point out, it isn’t a product of refined thinking in the first place. That doesn’t mean that thought isn’t involved, though, because we can (and I think do) articulate our feelings inside our heads, almost continuously. (I’m lonely and I’m sad and I’m mad as hell.) And the disjointed thought process that marks emotional upset is apt to lead to (gulp) irrational conclusions and behaviors.

I’m pushing you because I find the topic so fascinating. And I get the point, believe me, that we as opinion leaders are apt to blow-off anyone who doesn’t appreciate and embrace our brilliance with their one-hundred percent support and compliance. You are certainly helping us all see the world through others eyes. And that’s a wonderful gift.

peter responds again:

I like your tomatoes example. Yes, I’d have to say it’s irrational to take a known huge risk (starvation) in order to avoid an unknown and probably smaller one. But replace the tomatoes with mushrooms of unknown origin and consider how hungry you’d have to be, and how hopeless about other ways to find food, before you’d chow down.

It’s true that people think about their emotions. I’m not sure I can find a “pure” emotional or a “pure” cognitive response to any risk. But the distinction is still worth making – if only to keep us clear that being emotional isn’t the same thing as thinking badly.

I do understand that our differences are tiny compared to our shared effort to help our clients and principals see the world through their stakeholders’ eyes.

Corporate stonewalling and consumer warnings.

Field:I really do not have one
Date:January 25, 2004
Location:Indiana, U.S.


Dear Mr. Sandman Help! I had no other means of getting your attention. I debated on several introductions. I finally concluded to be up-front and honest and tell you what I need right from the start.

Just the fact that you are getting this is to my utter amazement. The strangest…no, WEIRDEST, occurrences have either led, or driven me to you.

You need some background. I am not a writer (That will become more and more evident). I am not any kind of an activist. I am simply a 45 year old, dowdy, overweight middle-class mother who is trying to enjoy what I have.

Why am I in your email? I wish I knew. I am about to tell you a situation that I can only imagine in YOUR world and realm of things is probably going to be considered at best “trite”. That is a chance I will have to take. For some reason I was led to you. I do not know why. I did not ask for this, I do not want it. I was given this and I am just trying to do the right thing. I have tried all the “right” channels and have been “blocked” by massive interference. I have hit nerves. The mere fact that a “threatening” stance was taken leads me to believe that the argument I have is viable. I just do not have the “power” to go any further.

This has to do with horses. Actually livestock. Come back! It goes deeper than this! No human lives are at stake. I do not think anyone has died because of this. BUT, please the message it sends out to the unaware public is so loud it is screaming!

More background. I have been raising and showing Quarter Horses since I was 9 years old. Have owned, raised, cared for and shown horses to national levels of competition. Passionate about horses, I have a never-ending quest to learn and study as much as I can just so I can “read” their minds and share their world. Husband; is a licensed chemical applicator. Holding a CCA license. Has worked in Chemical/fertilizer/herbicide industry for thirty years. Sells and applies all major brands of Chemicals for the fertilizer/herbicide industry.

Okay, what does that tell you? This is a family “in the know”. Two levels of expertise are apparent. Mine for horses and their care. Husband, for the correct usage of chemicals and the application of such. Bear with me…this is all going to come together. I said I was not a writer!

I love to garden. Horses and gardening are always at rivalry with each other for my time. Being born and raised in England I guess the gardening imprint holds fast. I love flowers, vegetables, trees, everything growing and again, I try to learn as much as I can to share their world. Even though we have access to chemicals that can grow 90 pound pumpkins or sterilize the earth (grubs!) we choose to do everything we can to stay organic. Where spraying for weeds, fence line control and the like is the norm, we choose to do battle with mowers and controlled burning. Until last fall.

This gets long winded, but if I have captivated your interest at all, you will need to know more about the grazing habits of horses that I am sure is more than you want to know.

I am going to stick with equines even though all livestock is really being addressed. I do not have much knowledge about other livestock, so I am going with what I know. Horses are herd animals. Domesticated for human use for untold years we have found ways to live with their instincts to make it work for both them and us. Those instincts, although somewhat subdued, are still close to the surface. Put a horse in a small enclosure. After a week or so look at the forage. There will be places where the animal has scoured the ground, yet tall, lush foliage stands untouched. Why? What decides to this animal what can be eaten and what should not be eaten? All indications point toward smell. Highly responsive to their olfactory instincts the sense of smell in equines is truly remarkable. This also takes on regional characteristics. Horses from the southwest usually do not care for apples. It takes years to de-sensitize them to finally get them to eat one! Why? Not sure. Just another fascinating fact.

Last fall, for whatever the reason, I enlisted the aid of Round-up to tackle my standing weed problem. These weeds were taking on “furniture” proportions and difficult to reach with equipment. A strip 120 feet by 6' was tackled. Having the “go-ahead” from Husband/Chemical applicator I was assured the product was safe and he mixed it (even cut it down somewhat from label indicators) and abided by the pull-back period, so on and so forth.

The 120 x 6' strip was also in the home of “Lewis”. Lewis was the product of many years of planning. His actual being was made by me. His mother was a horse I had owned and shown for 17 years. His father a multiple world champion. Everything was decided on for this horse. His color was even “Picked”. As a late two year old he was four days away from being sent to the trainer to start his career as a premier show horse. His life was a totally controlled environment. I monitored every thing in his life. Water, feed, hay, bedding, de-worming, inoculations, everything. This was August. He had been in this two-acre pasture his entire life.

It started quickly. He would suddenly lie down. Not to roll or rest, just down! His voice changed. Low and guttural. Rising temp to 107 degrees. Complete anorexia. Sparing you all the details…to summarize…he was critical. He was insured. The insurance company upon hearing the details and the ensuing lab reports (more on this later) gave us the go ahead to euthanize and they would pay on him. I had the money literally in my hands. A backhoe was called. Goodbyes were in order.

Decisions. I do not consider myself to be very intelligent. Average and perhaps a bit below by some standards. Maybe it is my acknowledgement of my inability to make a “educated” decision, that leads me to “go with gut instincts” the way I do. For a million right and wrong reasons I made the decision to let him pick his fate. I paved the way that if he had it in him he will fight to live. Every indication showed that he was a “dead-horse” walking; there was little or no hope for a future. He lives. That is not a good thing.

I really wish I were better at presenting this. I do not want to come off as a drama queen. If you are still with me…it is almost over.

Lewis was diagnosed with liver failure caused by a toxic assault. What was the toxin? Without a dead horse (complete liver and other organs needed) we could not tell. We had astounding blood tests, but nothing to pinpoint the actual chemical. What changed in this colt’s life that would have precipitated this? You see, if he had died it would have really helped everyone out. Monsanto could have retorted with…well he had a bad liver and it was just a coincidence that it blew at the same time as your application of round-up. I would have had no other choice than to agree. I would have had money to replace him or just blow in my grieving condition. The world will still spin and everything would progress as normal.

Did not happen.

His environment was controlled. I knew this had to do with the application of Round-up and I had to find out why. Husband response; totally safe, no way is it to blame…talk to Monsanto reps. I did. Nobody seemed to know much. They know a lot about the weeds it will kill, but the safety indications were pretty much…hearsay type stuff. Okay, go to Monsanto. Still here? It gets good now.

Where do I go from here? How do I tell you about the phone calls, Poison Control, FDA, reams of paperwork, arguments, interference, the flexing of Monsanto’s “muscles” and on and on… I can’t.

This is all I do know.

Round-up, by itself, does not contain any ingredients that will cause these symptoms in a horse/livestock. This is a proven fact. It is a benign substance to mammals. You can literally drink the stuff (I guess people have) and it will not produce these effects.

Okay…where’s the beef????

What is a fact is that, upon application, Round-up changes the chemical composition of a weed. When this weed is in the dying stage it SMELLS different. Horses/livestock can no longer differentiate the plant as a “toxic” weed. Round-up in itself, does not produce these effects, Round-ups latent or secondary effects are lethal. Monsanto’s line of defense? Round-up does not contain any harmful chemicals. Not responsible for what it does to a weed. Should not have toxic weeds in pasture. (EVERY pasture has a toxic weed!) Is this right? Is Monsanto off the hook? I would have NEVER used this product if I had known what it CAUSES to happen to a weed. There is no indication of this or anything on their labeling.

I know, I know. Not like I uncovered Love Canal or anything. Being that we did this to a horse (not just old paint tied to a tree) and we are more connected than most in both the horse and herbicide worlds makes me wonder about the rest of the unaware people in the horse/livestock world.

What do I want? Where am I going with this? What’s in it for me??? All good questions. I really have no hard and fast answers. Yes, I feel that I have been dealt a hard blow. Not only have I lost a potential superstar with years and untold thousands invested in him, but also now I am faced with looking at him at least twice a day, knowing he went from a commodity to a huge liability overnight. I cannot insure him (cancelled liver exclusion). I cannot sell him (Who would want a high maintenance horse?). I cannot use him (Livers only regenerate 50 to 60% max). I did this to him. I am responsible. That is my pity party. I would think that you would be realizing that these horses have a huge impact in our lives. I know…it is not a great undertaking. Looking at your end with demographics and market shares and all that stuff, the livestock owning populous is probably minute. Probably not worth the effort.

I came to you for reasons that still remain unknown to me. I was a “normal” person, just eking out an existence and trying to come to terms with a world that changes in the blink of eye. Perhaps that is my affinity for gardening and horses. They always stay the same. I could not let this thing rest. I tried! I really did. No way was I going to go head-to- head with a major Chemical Corporation. My husband even said in more than one occasion “if you keep up with this you are going to get me fired or killed”. Too many Erin Brockovitch movies? I thought the same thing until I saw how fast Monsanto got in my face when I got any support at all. They were quickly “cut off at the knees”. That was scary!

I am done. Hopefully this will be closure for me. I did what I thought was right. I do not think Monsanto is right. I think the product should be labeled with a warning. But, come on…a labeling change would cost them untold amounts, plus it sets them up to be responsible for a multitude of claims (I would be one of them!) of horses/livestock lost and loss of use (there have been many!). I just wanted to get this out of my system and like I said I was LED, more like DRAGGED to you.

Regardless, of what you do with this. Thank you for looking out for us. In a world filled with mad-cow, cloning, Mars and wars we need more people looking out for us. I am going to go back to complaining about our rotten Indiana weather, contemplating the latest diet rage and enjoying my horses and gardens. Thanks for staying with me through this. Amanda

Peter responds:

Let me make sure I understand your main point. (By the way, your writing is just fine – clear and human.) You’re not claiming that Round-up is dangerous to horses, or even that Round-up converts otherwise benign weeds into weeds that are dangerous to horses. What you think happened is that Round-up obscured the characteristic odor of a dangerous weed – a weed your horse Lewis knew not to go near until Round-up changed its odor, after which he ate it and was made very ill. You can’t prove this in part because Lewis is still alive (though not healthy), so autopsy proof is unavailable. Even if you could prove it, you don’t know whether Monsanto would be legally liable, since the Round-up itself didn’t hurt your horse.

But it doesn’t sound like your main interest at this point is getting money from Monsanto. You want the company to acknowledge that you’re right, and to put something into its Round-up instructions warning users that the product can obscure the characteristic odor of toxic plants it doesn’t kill, and can thereby mislead and indirectly endanger animals. Instead, Monsanto has stonewalled, making you angrier and angrier.

I have absolutely no expertise in toxicology or law. I can’t judge whether Round-up might have done what you think it did, and I can’t judge whether, if it did, Monsanto has any legal liability.

But if we assume that you are right about what happened and that Monsanto isn’t legally liable, then what you’re asking for seems entirely reasonable: an apologetic acknowledgment to you and a warning to future users. Unfortunately, it is all too easy to believe that a corporate management would stonewall instead, generating exactly the sort of outrage you are experiencing.

Stonewalling makes a kind of selfish sense, of course, if the company is actually liable, or if the warning would deter lots of potential users; that would mean money is at stake. But even when money isn’t at stake, even when acknowledging the truth won’t incur a new liability or damage sales, companies often prefer to stonewall. The attorneys suggest that it’s wiser to admit nothing, just in case they’re wrong about the liability. The marketing people would rather not put any additional warnings into the packaging, just in case they’re wrong about the impact on sales. The PR people advise that a negative news story right now isn’t good for the corporate image. And of course everyone shies away from imagining Lewis, the unnecessarily poisoned horse in your pasture – not to mention unknown poisoned livestock and wildlife elsewhere. Everyone feels less guilty pretending you’re an irrational hysteric than facing a problem that’s been missed or ignored for decades. And so a small hazard is allowed to grow into a big outrage.

I’m not saying this is what is happening at Monsanto. I have no information on that except what you’ve told me. But this is exactly what often happens – that I do know. If it’s what’s happening here, let’s hope someone at Monsanto will read this and rethink the policy.

In the meantime, I’m sorry to hear about Lewis, and I wish I could do more.

Really, really irrational stakeholders

Field:CDC / NCID communications specialist
Date:January 6, 2004
Location:Georgia, U.S.


I always love your and Jody’s essays, and, in “Barriers to Cross Species..” am glad to see you temper your stereotyping of scientists with an admission that some actually do possess an ounce of compassion. I continue to wrestle with the location of what I see as an essential middle ground for considering emotional vs. irrational responses. Near to the folcrum, the terms fit your description, but I would hold that at the extremes, emotional response can be irrational, by the measure of even the most passionate non-scientist. That acknowledgement requires, I think, a thoughtful and tailored response rather than blindly trusting the “formula”, e.g. seesaw approach, to help people arrive at a healthier mindset. The issue might be further complicated by the range of responses possible from the public, demonstrating heightened (even irrational) concern at one extreme, and stoic indifference on the other. Influencers, in these situations, likely transcend the risk at hand to include thought leaders toward whom population subgroups might feel an atypical level of devotion.
Happy New Year. I truly hope our paths cross in 2004.

Peter responds:

You’re right. Sometimes people really are irrational, and we should have said so.

People whose emotions are overpowering may not be able to think straight; they literally lose their normal reasoning skills, their ability to absorb and assess new information. Here we are in the realm of psychopathology: hysteria and beyond. When groups of people react this way all at once, panic becomes more likely, with potentially tragic results. We’re talking here about real hysteria and real panic, not the way normal people are labeled “hysterical” or “panicky” when they go through normal adjustment reactions to new stresses.

Also irrational are people on the other extreme, the ones whose emotions are so suppressed that they cannot imagine how normal people must be feeling; some have an almost psychotic belief in their own rationality. While these people may think they are basing their decisions on “the data,” they are missing crucial emotional data: interpersonal and social cues. (A subset of these people are at risk of becoming dangerously out of control if their emotions ever break through.) Again, we’re talking here about real extremes of absence of emotion, not the run-of-the-mill emotional insensitivity of our stereotype scientist.

From a communication strategy viewpoint, these extremes are important to watch out for in your target audiences and your colleagues. We think compassion and acknowledgment are crucial but not sufficient components of working with such people. Certainly calling them irrational doesn’t help, accurate though it is.

Misdiagnosing as irrational the much larger group of people with normal reactions can actually push some of them to the extremes. And it regularly pushes them to feel alienated and distrustful. One of our main goals is to help officials and scientists see this large middle group as normal and healthy, so they will address the public respectfully as the competent, resilient adults most of them are.

This answer was drafted jointly with Jody Lanard.

Mad cow risk communication

Name:Michelle Melendez
Field:State government information officer
Date:January 2, 2004
Location:New Mexico, U.S.


I appreciate recommendations on risk communication and am putting them to use in my op-eds. A lot of the recommendations are counterintuitive to public health officials, who are tempted to say how many more people die on the roads here than die from SARS, for example. I especially appreciate the lesson on watching our own outrage. I am feeling it with regard to mad cow disease. How do you think the USDA and FDA have handled the communications piece? To me, the more I hear Veneman tell me to eat meat because she is serving it for Christmas, the more I disbelieve her. Seesaw, right? But are there any examples of good risk communication regarding the beef? If so, did they come later in the crisis? Was damage already done?

Peter responds:

I’m toying with ideas for a mad cow risk communication column. If I write it, I expect I’ll call it “Knee-Jerk Under-Reaction,” which gives you some idea of my impressions.

My main criticism of the USDA so far is that it is being systematically over-reassuring – not just in tone, which is a nearly universal mistake, but even in substance. Without quite lying, USDA spokespeople keep perpetuating several misunderstandings (for example, that the mad cow they found is probably the only one we have). They are spinning the story so aggressively that if things turn out badly (another U.S. mad cow, for example), they will face charges of intentionally misleading the public. A related but less serious failing: The USDA is failing to empathize with the normal, indeed inevitable human emotional responses to the mad cow situation – anxiety at the thought of brain rot, disgust at the thought of calves denied their mothers’ milk and fed blood instead, shock at the thought that sick cows have been allowed to enter the food supply, etc.

I also think the USDA is being less than clear about its attitude toward its own new regulations and procedures – whether they’re an appropriate response to the BSE/CJD hazard and it’s sorry it didn’t adopt them sooner; or they’re unnecessary from a health standpoint but an appropriate response to public outrage (and the resulting economic hazard to the industry) and it’s sorry it didn’t adopt them sooner; or they’re a sadly necessary response to public hysteria and other countries’ trade barriers and it’s sorry it has to adopt them at all. (I vote for the second option; the look on some USDA faces at news briefings suggests they privately lean toward the third.)

I’m focusing on the USDA because I haven’t followed the FDA’s communication efforts closely enough to comment. I do wish the CDC (which you didn’t mention) had been involved more. This is only partly because I think the CDC usually does better risk communication than the other two agencies. I also think some human health aspects of the issue are getting insufficient attention. For example, the suspicion that CJD is actually common, and misdiagnosed as Alzheimer’s Disease, has been floated pretty often but hasn’t been responded to at all well, I suspect because it’s not the sort of question on which the USDA or the FDA has much expertise.

I don’t think the USDA’s risk communication started badly and got better. If anything, it was bad-to-mediocre at the start and got worse. For what it’s worth, it’s never too late to improve – but there are two big barriers to late-blooming risk communicators. First, for people to notice the improvement, you have to acknowledge what was wrong with what you were doing before. My clients usually want to sneak their improvements in instead, and that doesn’t work. Second, in order to be willing to improve you need to be willing to notice that you’ve been making mistakes. I haven’t talked with the USDA (yet, anyway), but my guess is the top people are pretty deeply entrenched in their own outrage and their circle-the-wagons attitude.

In fairness, the USDA has done some things very well. Its website has a huge amount of information, including the texts not just of its news briefings but also of key interview appearances by Secretary Veneman. As far as I can tell, it has been steadfastly honest about revealing information it would rather not have revealed (even if it then ignores the implications of what it has revealed) – starting with the early revelation that the BSE-afflicted cow was discovered by a fluke. It has also been unusually good about sharing preliminary information and even conflicting information, making clear that the answers are tentative but resisting the temptation to withhold them pending confirmation.

Does it matter whether mad cow disease is communicated skillfully? It probably makes little difference to public health; though the science of BSE and vCJD is still full of holes, the odds are very good that eating U.S. beef is safe enough – and certainly hesitating to eat U.S. beef won’t damage anybody’s health! The risk to the beef industry is a lot more serious than the risk to the public – but they brought it on themselves by lobbying successfully against the precautions that could have protected them. I’m most worried that a badly handled mad cow crisis could damage the government’s ability to credibly reassure people on other health issues. That certainly happened in the U.K. I think the USDA is playing fast and loose with credibility that it and its sister agencies will need in the coming years.

For an earlier perspective, see my review of Scott Ratzan's book on the U.K.'s mad cow crisis.

Copyright © 2004 by Peter M. Sandman

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