2014 Guestbook
Comments and Responses

How should health officials handle off-the-wall social media responses to their Ebola posts?

name:Barbara
This guestbook entry
is categorized as:

      link to Outrage Management index      link to Pandemic and Other Infectious Diseases index

field:State health department risk communication specialist
date:October 22, 2014
location:Colorado, U.S.

comment:

What do you recommend for handling aggressive, uninformed, rumor-mongering, paranoid, etc. comments on social media?

Almost everything that CDC is posting on social media about Ebola ends up having these kinds of responses. If the general public reads these, does the social media post do more harm than good?

Are we just expanding their opportunities, and audience, for their vitriol? After all, a post on CDC’s Facebook page will get them a lot more attention than if they just post on their own pages.

peter responds:

I think the CDC and other official and mainstream sources of Ebola information are far wiser to give extremists access to the social media they control (like the CDC’s Facebook page) than to deny them access.

To explain why, let me start by subdividing the people whose comments you call “aggressive, uninformed, rumor-mongering, paranoid, etc." into two rough categories: those who have something to say that’s worth listening to, and those who don’t. I’m going to argue later that the first category tends to be bigger than we imagine. I think the mainstream has important things to learn from people on the fringes, both generically and with specific reference to Ebola. But let’s put that aside for now and assume that we’re talking about people whose comments are, as the Supreme Court used to say about pornography, of “no redeeming social value."

Letting fringe opponents rave

Now that social media are a fact of life, people with fringe viewpoints have a choice: how much to talk to people who already share their views, and how much to reach out to the mainstream. When they talk to fellow True Believers, they’re in an echo chamber. When they reach out, there’s some chance, though in many cases not much chance, that they’ll encounter something that will actually change their minds a bit – information they didn’t know or viewpoints they hadn’t considered. So the effect on them is all to the good.

What about the effect on everybody else? Of course extremists reach out looking for converts. No doubt they find some – people who were already leaning their way, mostly, but maybe also a few people who had no idea yet which way to lean and happened to encounter a fringe viewpoint before they had learned enough to know it was fringe. But there are decades of research on how exposure to extreme viewpoints affects most people whose own views (even half-formed views) are quite different. In a word, they’re repelled.

When we encounter an opinion we sort-of agree with – that is within our so-called “latitude of acceptance” – our own opinion moves toward the one we just heard: “That’s basically what I think too.” But when we encounter an opinion we disagree with, one that’s outside our latitude of acceptance, our own opinion moves in the opposite direction. The process of rejecting what we just heard, deciding it’s mistaken or even crazy and not at all what we believe, moves our own opinion further away.

That’s why I have long advised clients managing controversies to try to make sure their most extreme opponents show up for the public meeting. A moderate opponent may say lots of things that are within the latitude of acceptance of many in the audience, thus luring them into opposition as well. But most of what an extreme opponent says is outside the audience’s latitude of acceptance; the way she says it may also be unacceptable to many. So her advocacy boomerangs: “I’m not like Susan.”

Bottom line so far: I’ll bet that most people accessing the CDC Facebook page become less critical of the CDC and less frightened about the very small possibility of a domestic Ebola epidemic after reading the ravings of someone whose views are way out on the fringe.

But there’s an important exception. While people are quite capable of casually dismissing an “Ebola extremist” as too crazy to take seriously, they do not want those in authority to do what they’re doing. There’s a seesaw at work here. At a public meeting, for example, many in the audience may feel free to roll their eyes when “Susan” (my hypothetical extremist) makes the same point she made at the last meeting and the one before that, a point most people feel the company or agency has already addressed satisfactorily. But if the company or agency blows Susan off, then audience members are likely to switch seats on the seesaw, viewing Susan less as a nutcase and more as a whistleblower.

If the people running the meeting understand risk communication, therefore, they will ally with Susan against the rest of the audience on behalf of the importance of respectfully hearing her out, even to the point of letting her hijack the meeting. And in their responses to Susan’s tirades, they will do their best to acknowledge the validity of some of what she says. It’s okay if the audience thinks they’re being too soft on Susan. It’s far worse if the audience thinks they’re being dismissive or contemptuous of her.

If it comes to that, I’d rather see CDC exclude extremist comments from its Facebook page than see it respond to those comments dismissively or contemptuously.

In fact, the biggest value of letting extremists do their venting in mainstream social media is the opportunity for everyone to watch while those in authority are more patient, more respectful, and more responsive than we think we would have been in their shoes.

The evidence from studies of social media consumer complaints is instructive here. These studies have consistently shown that complaints tend to go viral and win adherents when the organization being complained about is unresponsive – either literally (no response at all) or figuratively (a dismissive, disrespectful response). What happens when the organization responds quickly and empathically? Much of the time, even the complainer backs down, sometimes expressing gratitude for an unexpectedly decent response. When the complainer doesn’t back down, but rather ignores a pretty good response or dismisses it as pitifully insufficient, the tone of everybody else’s comments tends to turn against the complainer. “Don’t you see they’re trying to set it right?” “Didn’t you notice they explained why they can’t do what you’re asking?”

Note that being responsive, respectful, empathic, etc., doesn’t mean saying critics are right about things you’re sure they’re wrong about. That’s not honest, not sustainable, and not good outrage management. But it does mean looking for things they really are right about, or partly right about, and focusing more on validating their valid points than rebutting their invalid ones.

Of course an unsatisfiable consumer differs in many ways from an Ebola extremist – someone who thinks the U.S. Government launched the Ebola epidemic in West Africa on purpose, for example. But the principle is the same. If the CDC is responsive rather than contemptuous, the audience will be free to boomerang away from views that are outside its latitude of acceptance. Proponents of such far-out views will thus do the CDC position much more good than harm on its Facebook page.

Your sites, their sites, neutral sites

I’ll go further: The more the CDC and similar organizations can do to attract opponents to the social media they host, the better. When my corporate clients are trying to address a controversy, here’s my three-part advice on what to do with their website:

  • Create a Q&A forum on your site in which people ask you questions – including hostile questions – and you respond. This is a dialogue with you. Keep it open to people you’d prefer not to hear from. And keep your responses respectful, even if their comments aren’t. Look for things to tell them they’re right about.
  • Create another forum on your site in which you rarely if ever participate, and then only briefly to direct people to a relevant webpage you think will shed light on the subject. This is a dialogue about you. Host it in a wide-open way, editing only when you must (for profanity, libel, excessive length, and the like). Read it and learn from it, but stay out of it.
  • Add links from your website to every relevant resource, including those most strenuously opposed to your position. Your goal is to become the hub of choice whenever people want to find their way to any information about the controversy, even information you consider misinformation. Why go to (or launch) XYZCorpSucks.com when XYZCorp.com has it all?

Clients rarely follow this advice totally. The closer they come to following it, I think, the better able they are to manage the controversy. I would love to see the CDC follow this advice as well.

I would also love to see the CDC and organizations like it venturing out onto the extremist-controlled social media – responding to fringe critics in their own venues. But that’s harder to do. For one thing, extremist social media are at least as likely to exclude moderates (and especially officials) as moderate social media are to exclude extremists. If they let you on, they may edit you unfairly. If they don’t edit you, they’ll almost certainly ridicule you. And the dynamics I described taking place on the CDC Facebook page – an audience repelled by extreme viewpoints outside its latitude of acceptance; a seesaw audience reaction that turns against a critic who seems not to notice a respectful response – are far less likely to take place on a site whose “audience” is mostly fellow extremists.

It can be an illuminating experience for officials to be outgunned and outnumbered in an extremist website discussion. And on occasion it can be illuminating also for the extremists, especially the less extreme “extremists” who lurk on extremist social media sites, wondering whether or not that’s where they belong. But visiting extremists’ social media is a lower priority than letting them visit yours.

Visiting social media that aren’t especially extremist but aren’t “official” either is a pretty high priority, I think. And this is where the CDC and similar organizations fall down most damagingly. Maybe they have no choice. Consider just one category of neither official nor extremist social media, the websites of newspapers and broadcast stations. There have already been tens of thousands of U.S. news stories about Ebola, provoking hundreds of thousands of online comments. Most of the comments on an Ebola news story aren’t actually about the story; they use the story as a taking-off point to comment on Ebola itself – the science of Ebola, the politics of Ebola, or whatever else about Ebola the story triggered in the commenter’s mind. Even on a strictly factual story, the comments are often “aggressive, uninformed, rumor-mongering, and paranoid.”

It is more the exception than the rule for the CDC or other official sources to participate in this dialogue. They rarely contribute a comment on the content of a story, and almost never contribute a comment on an extremist’s comment.

Obviously official opinions are amply covered in the news itself. But they are almost entirely missing from the comments sections. I wish they weren’t – but I do understand what a Sisyphean task it would be to try to participate in every social media dialogue. Just monitoring the dialogue so the CDC knows what people are saying is already a big, big job.

All the more reason, then, to respond well when an extremist pays you the compliment of bringing the dialogue to you.

It would help if the CDC were comfortable letting individual employees – even those without much Ebola expertise – join in the dialogue, commenting freely “as someone who has worked at CDC for years.” There would be some horrible mistakes that sounded embarrassingly semi-official, of course. But I think empowering your workforce to participate in the social media dialogue about your organization will have better outcomes, on balance, than the only possible alternatives: greatly delayed and excessively bureaucratic participation emanating from an authorized headquarters “Social Media Spokesperson,” or no participation at all.

Like my advice about opening your website to hostile commentary, my advice about letting your workforce comment freely on other people’s sites is usually way beyond my clients’ latitudes of acceptance. I have to be careful how I express this recommendation, lest clients rebound against what they see as my extremism.

Learning what fringe opponents have to teach

So far this response has accepted the hypothesis that “aggressive, uninformed, rumor-mongering, paranoid” social media commenters have nothing useful to say.

Now I’m going to challenge that hypothesis.

Nearly all public health professionals are most comfortable and most skillful trying to arouse health concern in people who are unduly apathetic. That’s the bulk of what the CDC does as a communicator: working to persuade apathetic people that they should worry more and do more about smoking, drinking, overeating, etc. In my language, the CDC is pretty good at doing precaution advocacy about risks whose hazard is higher than their outrage, but not so good at doing outrage management about risks whose outrage is higher than their hazard. On issues that go both ways – vaccination, for example – the CDC would much rather regale us with stories about how serious vaccine-preventable infectious diseases can be than try to respond sensitively to our fears about possible vaccine risks.

As I have argued again and again, when you’re on the alarming side of a risk controversy you have a lot of leeway to dramatize, maybe even exaggerate – but when you’re on the reassuring side, you need to be scrupulous (“meticulous,” even) about acknowledging the alarmists’ part of the truth, even when the alarmists are a lot less than half-right.

The CDC is used to being on the alarming side. I have sometimes been critical of what I saw as credibility-damaging distortions in the CDC’s efforts to warn people about high-hazard, low-outrage risks – for example, the CDC long cited its (now abandoned) estimate of 36,000 U.S. flu deaths per year as a reason why everyone should get a flu shot, without acknowledging that 90 percent of those 36,000 deaths were elderly. Still, being on the alarming side really is a license to dramatize vividly, and maybe even a license to cherry-pick the facts that serve your dramatic purpose (but not a license to misstate those facts). The CDC’s communications are likeliest to misfire when it’s in the uncomfortable, unaccustomed position of trying to calm people down – for example, when it’s talking about vaccine safety.

When it talks about Ebola in West Africa, the CDC is on the alarming side, and it does okay. If anything, I think it hasn’t gone far enough in its efforts to dramatize this potentially dire threat to global security. The alarm bells are way too soft, and most Americans are still under-reacting. Still, I think CDC Director Tom Frieden did more than any other individual to convince the U.S. government to “surge” its West Africa epidemic aid.

But pretty much everything the CDC has had to say about Ebola in the United States has been an attempt to reassure, not to warn. Starting with Kent Brantly and Nancy Writebol, the first Ebola sufferers airlifted intentionally to the U.S. from West Africa, there were more than a few people worried that bringing Ebola to America might be a mistake. The number of such worriers increased when Thomas Eric Duncan surfaced in Dallas, increased again when a nurse who had treated Duncan was infected, and again when a second Duncan nurse was diagnosed with Ebola after flying from Dallas to Cleveland and back.

The CDC has consistently responded to the worriers by publicly insisting that their worries were baseless. If it hasn’t actually accused the worriers of panic or hysteria, the CDC certainly hasn’t defended their concerns as rational.

The single biggest mistake the CDC made in its Ebola preparedness efforts was its decision that it would be safer for healthcare workers to use the infection control equipment and protocols they were already familiar with than to gear up quickly for more protective equipment and protocols that also required more training and more care to implement properly. CDC Director Tom Frieden said that any American hospital would find Ebola “easy to stop by using gloves and barrier precautions”; it was just a matter of deploying familiar equipment and protocols “meticulously.” He was so confident this was true that when the index patient (Duncan) was diagnosed in Dallas, the CDC didn’t offer Texas Health Presbyterian Hospital Dallas much on-the-ground infection control help, didn’t push it to upgrade to more protective equipment and protocols, and didn’t include healthcare workers as even “low-risk” contacts of Duncan as long as they were wearing “appropriate” Personal Protective Equipment (PPE) and didn’t report any specific misstep (like a needlestick) while wearing it.

The CDC was slow to correct this error. Even after one nurse was confirmed as infected despite her PPE, the CDC continued to let other nurses in the same category travel, thus exporting Dallas’s Ebola fear (and conceivably its Ebola infection) to Ohio. Only on October 20 did the CDC finally change its mind and recommend more protective PPE and procedures, despite the added training burden. Now that the CDC is recommending more protective PPE, its overconfidence has shifted from healthcare workers following the old guidelines to healthcare workers following the new guidelines. As far as I can tell, there still isn’t a CDC risk category for healthcare workers who treated or are treating Ebola patients wearing what is now considered appropriate PPE. Time will tell whether that, too, is an error.

So what does this have to do with allowing extremists on the CDC Facebook page, and listening hard to what they have to say? For months now, an assortment of critics have been insisting that the CDC’s standards for hospital Ebola PPE weren’t stringent enough – that it needed to recommend more protective equipment, more protective protocols, more extensive training to be able to use the equipment and protocols, and tougher monitoring to catch healthcare workers who were inadvertently infected before they could spread the disease further.

I think the decision-makers at the CDC may well have considered these critics to be extremists, perhaps even “aggressive, uninformed, rumor-mongering, paranoid” extremists. The CDC doesn’t seem to have been listening to them. And it turns out the critics were right.

If the CDC had been listening harder to its extremist critics, it is just possible that it would have corrected its error sooner.

More broadly: In its efforts to sound the alarm about Ebola in West Africa, the CDC has been insisting that we need more resources, warning that it will be a long fight, and sometimes even admitting that the epidemic is out of control and we’re in unprecedented, new territory. But in its efforts to reduce alarm about Ebola in the U.S., the CDC has insisted – and to a large extent continues to insist – that we know how to control it, that we will stop Ebola in its tracks, and that there is no reason for the American public to worry.

Because it is on the reassuring side of the Ebola-in-the-U.S. controversy, I believe the CDC needs to be much more accommodating than it has been of fringe worries. Could Ebola mutate and become airborne? Could I catch it from my pet? Could someone transmit it with symptoms so mild nobody knows yet they have it? These are sensible questions. They are being asked not just by fringe extremists, but also by moderate skeptics, Ebola newbies, and even CDC fans. The CDC’s overly reassuring, overly simplistic answers aren’t dispelling concern. They are arousing more concern, and more mistrust as well.

What should the CDC do instead? Admit that there is much we don’t know about Ebola; admit that there have been surprises, errors, and misjudgments; admit that there will probably be further surprises, errors, and misjudgments to come. People will find these admissions alarming, of course – but less alarming than the “we know what we’re doing” rhetoric that now sounds patronizingly oversimplified.

Again, what does this have to do with welcoming extremists on the CDC Facebook page? Two key points:

number 1
The CDC needs practice talking to people who aren’t just anxious about Ebola, but are also mistrustful of official Ebola reassurances. Plenty of non-extremists share the extremists’ concerns, and want to see officials sharing those concerns. The more the CDC welcomes extremists on the social media it controls, and the more it learns how to respond empathically and respectfully to their criticisms, the better job I think it will do of talking to the general public via the mainstream media.
number 2
The extremists have been asking some good questions and voicing some valid objections right along, and they still are. They go too far, of course. They segue too readily from skepticism to paranoia; they sometimes misinterpret human error as conspiracy; they cut public health too little slack. But they are in some ways the CDC’s conscience, in other ways its loyal opposition; they voice the self-doubts that officials may have suppressed in their urgent need to act. To respond to them empathically and respectfully, the CDC will need to listen to them better. And when it does that, it will learn things that will help it protect American lives.

When I’m talking to outrage management clients, I almost always put more stress on #1 than on #2. I hesitate to tell clients too aggressively that some of what the critics they consider extremists have to say will actually help them do a better job. It’s tough enough to convince them that they need to be seen listening and responding respectfully to the extremists in order to help reduce public and stakeholder outrage. I let them imagine for a while that listening and responding respectfully is mostly theatre, a tactic to calm the public. I don’t need to forewarn them that they will probably end up with a better project as a result, not just a calmer public. I wait till later for that lesson to sink in, when I help them compile a list of improvements they should now give their critics credit for pushing them to make.

But so much is at stake this time. As the epidemic in West Africa worsens, the U.S. will need to face the prospect of more “sparks” flying from there to here – and, worse, from there to other countries in the developing world, less capable than the U.S. of extinguishing those sparks. To cope with what may be a much worse crisis than we have confronted so far, we will need a CDC that understands not just how to talk to critics, but also how to listen to them. I can’t think of a better place to start than the CDC Facebook page.

  List of Ebola Risk Communication articles.

Coping with Ebola stigma

by Peter M. Sandman and Jody Lanard

name:Brett
This guestbook entry
is categorized as:

      link to Pandemic and Other Infectious Diseases index

field:Public health
date:October 11, 2014
location:Australia

comment:

With the recent extraordinary upsurge in cases of Ebola in West Africa and the cases in Texas and Spain, it seems to me that issues of managing suspected or confirmed cases of Ebolavirus disease (EVD) will continue for some time in developed countries.

How do we avoid the vilification and ostracism of nationals from West Africa, or indeed all Africans?

Ebola provides a perfect storm for outrage. It is dramatic, horrifying in its possible presentation, and it has had catastrophic projections of its potential. It is unfamiliar and – with an incubation period of up to 21 days – can “lurk amongst us" as an unseen threat.

Of course the reality is more benign: Cases are not infectious while the infected person is well; hemorrhage is uncommon; transmission is not “easy.” We have already seen overreactions in the U.S., such as armed guards for well contacts.

And I fear for the African community in Australia if Africans are unreasonably regarded with extreme caution, as potential transmitters of a deadly illness. I would hate to see them feeling reluctant to mention their travel history to immigration or to triage in an Emergency Department (ED) for fear of being unnecessarily isolated. Of course EDs and immigration need to identify genuine contacts of EVD, but this should be based on rational risk assessment.

peter and jody respond:

There are four things going on here, and the way to start, we think, is by teasing them apart:

  • Caution – avoiding situations or people you reasonably (even if not always accurately) think might be dangerous.
  • Stigma – avoiding situations or people you have no rational reason to consider dangerous because they give you the willies.
  • Soft racism – feeling more caution or more stigma about “them” (in this case, black Africans) than you feel about people of your own kind under equally risky conditions.
  • Hard racism – taking advantage of other people’s caution and temptation to stigmatize to advance your preexisting agenda of racial hatred.

Let’s dispose of the hard racism first. (If only we could!) We read with horror and revulsion the blogs of white supremacists and anti-immigrant fanatics who are using Ebola as yet another reason to vilify black people. We can’t seem to muster any empathy for hard racists.

(We actually have a dear friend who is one, who reads and sometimes writes for those blogs we despise. Yet in her personal interactions with people of color she is decent, friendly, empathic, and thoroughly I–Thou. She’s a hard racist in principle, for whom we feel no empathy in principle. People are complicated.)

Much too often, officials send anti-stigma messages that seem aimed at proving that they themselves are not racists. To do that, they lump the putrid hard racists in with the other three groups. This is especially unfair to those who are simply being cautious. But it also backfires on those who are guilty of stigmatization but not of racism. You can’t entice people away from stigmatizing others by stigmatizing them as race-haters. The overcautious and the stigmatizers need respectful, empathic help bearing their fear, not further alienation.

One important way to reduce the size of this horrible problem is to drive a wedge between the opportunistic haters and the genuinely fearful stigmatizers.

We feel compelled to add another example of hard racism coming out of this story: the kneejerk criticisms of Texas Health Dallas Presbyterian Hospital right now for supposedly giving Thomas Eric Duncan lower-quality treatment than other Ebola patients got in American hospitals because he was a poor black Liberian without insurance – criticism that rarely even mentions that all the other patients arrived already diagnosed with Ebola, while Duncan came into the emergency room saying he had had no contact with any Ebola sufferer.

To help tease apart the other three groups, try this test. You meet four people at a party (in Australia or the U.S.):

  1. A non-black nurse who volunteered to work with Ebola sufferers in West Africa, and has just this week returned home.
  2. A West African who just this week traveled here to visit friends and family.
  3. A non-black nurse whose volunteer work ended more than a month ago.
  4. A West African visitor who has been here for more than a month.

All four tell you they’re “safe” – the recently returned volunteer because she was meticulous about her PPE; the recently arrived West African because he didn’t have any contact with sick people; the other two because they’re still healthy way past Ebola’s maximum 21-day incubation period.

If you’re nervous about both #1 and #2, you’re simply skeptical – in our judgment, rationally so – about whether you can fully trust that someone who was recently in West Africa won’t be mistaken, dishonest, or in denial about whether s/he might have been infected … or even whether s/he is really feeling well. If you’re nervous about #2 but not #1, that sounds like it might be a soft racial thing. If you’re nervous about #3 and #4, you’re guilty of stigmatization. And if you’re more nervous about #4 than #3, the stigma probably has a racial component.

Does soft racism deserve the same contempt as hard racism? That’s a tough call, and it’s not a question we feel prepared to answer as aging white risk communication consultants. Soft racism certainly does harm to its targets.

For what it’s worth, we think it’s important for society to take the same precautions against returning volunteers as against visiting West Africans. Our hackles go up when we hear about politicians who are attending welcome home parties for the former while agitating to close the border against the latter.

At the same time, we’re inclined to cut some slack for individuals who find themselves almost involuntarily shying away from West Africans (or even all Africans) out of unconscious or preconscious Ebola fear, even if they’re not similarly shying away from returning volunteers, who are far less easily identifiable in a crowd. We accept that this is a kind of racism, however soft. It certainly adds to the pain of a group of people who are already targets of racism, not all of it soft. But we find it far less culpable than fully conscious discriminatory policymaking.

Caution versus stigma

The most important distinction is between caution and stigma.

Caution should be encouraged – even (we believe) if it goes beyond the level of caution officials are recommending. Despite profound uncertainty about how Ebola may behave under unprecedented conditions, public health agencies and their faithful reporters have been awfully absolutist in their assertions:

  • that people with Ebola cannot (ever?) transmit the disease before they are symptomatic;
  • that Ebola is (always?) transmitted through direct contact with bodily fluids;
  • that Ebola symptoms (always?) come on so abruptly that symptomatic people are highly unlikely to be out and about; etc.

The first assertion arguably justified a Dallas emergency room staff’s decision to send Thomas Eric Duncan home because his fever didn’t yet reach the CDC temperature criterion for “symptomatic,” 101.5 °F.

The second assertion arguably justified local officials’ decision, after Duncan was belatedly diagnosed with Ebola, to force Duncan’s family to stay in the contaminated apartment for days without any infection control gear.

The third assertion arguably justified Duncan’s belief in the first few days of his disease that he probably didn’t have Ebola, since he wasn’t yet feeling too sick to function.

In hindsight, the first and third decisions were obviously medically unwise; we don’t know yet about the second, though it was certainly incredibly insensitive.

In recent days the U.S. (among other countries) has ramped up its Ebola precaution-taking. Some of the precautions smack of Reassurance Theatre. Taking people’s temperatures in airports, for example, isn’t likely to do much good if they’re traveling before they start getting feverish or if they’re swallowing lots of Tylenol to hide their early low-grade fever. Still, in principle ramping up precautions makes sense to us – both for governments and for individuals.

Some precautions (governmental and individual) may do real harm, and the damage has to be weighed against the benefits. But rational precautions, even if they do harm, shouldn’t be stigmatized as stigma.

That said, the distinction between caution and stigma is fuzzy. It is not completely irrational to want to shy away from people who fit the profile – yes, that word, “profile” – of a potential disease-carrier.

Infectious disease stigma has a long, long history. Leprosy and AIDS are just two of the most obvious examples. And ignorance almost invariably plays a role in stigma. In a 2012 article on the lessons of infectious disease stigma, Sara Gorman points out that as late as 2009 “one in five Americans believed that HIV could be spread by sharing a drinking glass, swimming in a pool with someone who is HIV-positive, or touching a toilet seat.” Gorman also notes: “Emerging infectious diseases in their early stages, especially when modes of transmission are unknown, are especially vulnerable to stigma.”

So what distinguishes stigma from caution, albeit ignorant caution?

It’s partly about how justified or unjustified the ignorance is. If there’s not a lot of evidence yet, and if it’s not crazy to think the dominant expert view of a risk is shadowed by uncertainty and might turn out wrong, then it’s more caution than stigma to reject that view and take precautions the experts consider unnecessary. But if the evidence against the precaution is strong, and yet people persevere in taking the precaution despite knowing the evidence is strong, it starts looking more like stigma.

Even more fundamentally, caution is mostly intellectual. It’s a person’s cognitive assessment (however mistaken) of what’s dangerous and what’s safe. Stigma is more intuitive; at the start of this response we called it “the willies.” Someone just feels like certain sorts of situations or people are risky, without necessarily believing there’s any evidence behind the feeling.

In fact, stigma is often more unconscious or preconscious than conscious. Most people who are currently avoiding West Africans or Africans because of Ebola don’t actually believe they will catch the disease if they get too close. It’s more that West Africans remind them of Ebola. (How awful this must be for West Africans: People just look at them and unconsciously think of disease and contamination!)

We hope this brief effort to sketch in the distinction between caution and stigma has convinced you it’s a fuzzy distinction!

The 2009 swine flu pandemic was first identified in Mexico, where it initially looked much more severe than it later turned out to be. Not surprisingly, early U.S. responses to swine flu included measures that targeted Mexicans and Mexican-Americans. Both of us engaged in separate email discussions of the boundary between caution and stigma in such measures – Jody with a Huffington Post contributor who had written an article about the racism and swine flu, Peter with a Texas risk communication practitioner and commentator who had interviewed an eminent scholar on swine flu stigma. (The interview is no longer online.) Neither discussion led to a satisfactorily clear-cut distinction.

During the 2003 SARS epidemic, to cite another example, Chinese restaurants and other Chinese-run businesses were shunned in the U.S. because customers were afraid of catching SARS. Caution or stigma? Mostly stigma, we guess (and with some soft racism mixed in) – but not entirely.

Even though we’re unaware of any documented SARS transmission in Chinese restaurants, the kitchen of a Chinese restaurant wouldn’t have been a surprising place to find recent travelers from mainland China, where SARS was most prevalent. The risk of catching SARS in a Chinese restaurant in the U.S. was surely very low. But wasn’t the risk of catching SARS in a Mexican or Italian restaurant even lower? So, many people reasonably felt: Why not eat Mexican or Italian food for a while, in an “abundance of caution”?

Many Chinese-Americans and Chinese people living in the U.S. shied away from crowded Chinatowns during that period, fearful of encountering recently arrived Chinese who might have been infected with SARS. Most of the public blame for SARS-related stigmatization of Chinese people was put on people of other races. But most of the actual drop in business was due to Chinese-on-Chinese avoidance. That’s presumably not about racism, but the mix of caution and stigma is impossible to disentangle.

And now some examples of the fuzzy caution-or-stigma border from Ebola itself:

number 1

In West African neighborhoods of the U.S.:

Long before most Americans were paying attention to the horrendous West African Ebola epidemic, West African communities in the U.S. knew it was happening. They were faced with the dilemma of how to deal with travelers – with neighbors just back from visits to Africa, and with Africans visiting their families here. There was surely an element of caution in many people’s reluctance to welcome such travelers or welcome them back; you couldn’t know for sure what they might have been exposed to over there. But there was an element of African-on-African stigma as well.

In a West African community in New Jersey, for example, locals are keeping a distance from recent arrivals.

Emmett Trinity, president of the Liberian Community Association of North Jersey, said he and his friends have already been taking precautions against contagion. They don’t shake hands or give welcoming hugs to a visitor from the homeland, or any New Jersey neighbor who has returned from a trip there, he said.

Instead, they maintain that reserve until the traveler has made it past the 21-day incubation period for the virus.

“We let them know, ‘We’ve got our eyes on you’ – not in a demeaning way, or a negative way, but in a precautionary way,” he said. “They understand. We let them know, ‘Hey, this is a serious issue. This is not a game. This is not a joke.’”

That sounds like mostly caution – imposing a neighborhood quarantine on travelers from epidemic countries. But what about this? After news broke of the U.S. Ebola case in Dallas, the New York Times reported from a West African neighborhood in Philadelphia:

Kellita Whisnant, a Liberian immigrant, has seen business plummet since the Ebola outbreak intensified over the summer. She taped a poster about Ebola near the cash register to help dispel myths and changed the name of her restaurant from Mama Ti’s African Kitchen to Mama Ti’s Kitchen and Deli. But it has not seemed to help.

“Women are calling me and saying, ‘Kelly, we’re not going to be at the restaurant because my husband is leery about Ebola,’” Ms. Whisnant said Wednesday. “It hurts.”

That sounds like mostly stigma.

number 2

In Spain:

After a Spanish priest with Ebola was evacuated from Sierra Leone to Madrid, one of the hospital workers involved in his care caught the disease. A cascade of egregious errors resulted in her remaining in her community for almost a week after she developed symptoms. Now Madrid is seeing Spanish-on-Spanish caution/stigma, targeted at the staff from Carlos III Hospital, where she became infected, and even at their families:

The panic has also invaded the personal lives of medical staff. “Their children are not being invited to birthday parties and their friends are canceling their joint vacation plans,” explains Juan José Cano, from the Satse nursing union at Carlos III. “They have become ‘the Ebola nurses,’” he says. “It’s very, very unfair.”

Unfair or not, this isn’t panic. We agree that it’s pretty extreme caution to worry about exposure to the asymptomatic children of asymptomatic colleagues of a symptomatic healthcare worker. But for people new to Ebola, who haven’t learned or don’t trust the experts’ assurances, pretty extreme caution is also pretty rational. Still, there is clearly more than a little stigma at work here as well, with no racial undertones as far as we can tell.

number 3

In Australia:

On October 9, a furious Australian politician, Bob Katter, said it was “unbelievable and incomprehensive” [sic] that an Australian nurse volunteer was permitted back into Australia after working in Sierra Leone without a mandatory, supervised, 21-day quarantine. The nurse, who is white, developed a fever after her return. She has since tested negative for Ebola.

Not wanting to let volunteers back into Australia even after a 21-day quarantine would be a clear example of stigma. Wanting to impose the quarantine on all volunteers is a higher level of caution than Australian officials are currently implementing – which is exactly why Katter was voicing his objections. It seems more like caution than stigma to us, but many Australians certainly saw it as stigma.

Imagine a non-African who doesn’t know how to distinguish West Africans from other Africans, and isn’t exactly sure which African countries have Ebola hot zones and which don’t. Such a person might be rationally, if ignorantly, avoiding all Africans. That’s mostly caution, we think, but with maybe a little stigma and a little soft racism also in the mix.

You write that you worry about Africans or African-Australians in Australia being “unreasonably regarded with extreme caution,” and possibly hiding medically important information “for fear of being unnecessarily isolated.”

Liberians in the U.S. are worried about that too:

The stigma around Ebola is such that some people may not want to admit they feel sick, said [Abdullah] Kiatamba, who runs African Immigrant Services, a nonprofit group in Brooklyn Park [Minnesota].

“The fear is, ‘If I tell them, they are going to call the newspaper on me and by the time they find out I don’t have Ebola it will have been all over the news,’” he said. “But everybody’s got to start talking to each other. This is getting serious. This thing is just a plane ride away.”

But distinguishing an unreasonable degree of extreme caution from a reasonable abundance of caution is a judgment call, and very vulnerable to hindsight bias. The clearest sign of unreason here is the racial element you picture – if West Africans and African-Australians are being treated differently at airports and in emergency rooms than others who have been in West Africa – non-black returning medical volunteers, missionaries, businesspeople, etc.

We would be comfortable if everyone coming here from Liberia, Sierra Leone, and Guinea (everyone – returning volunteers, West Africans, officials, diplomats, bureaucrats, soldiers) were required to report daily to a local health department for a temperature check and symptom review until 21 days after leaving West Africa. (And by the way, we hope officials are reconsidering the 101.5 °F temperature cut-off in many screening guidelines. Lower it!) We would also require the same daily check for healthcare workers who have had contact with Ebola patients, regardless of their PPE. And we would be comfortable if everyone who failed the check were isolated and monitored until the doctors knew for sure that they did or didn’t have Ebola.

This might be overcautious. It might even be onerous. But we think it qualifies as caution, not stigma or racism (or panic).

As the public becomes more and more attentive to the unacceptable risk of allowing uncontained, unmonitored Ebola “sparks” to land and start to spread in non-epidemic countries, caution, stigma, and racism will all become more and more intrusive.

The more sparks there are, the more the rational demand for precautions will increase, the more stigma will adhere to people from “those places,” and the more opportunity hard racists will have to recruit from the other groups. If sparks do start to fly, it will be ever more important to show empathy and respect for the fearful, and not to drive them toward the opportunistic haters.

Responding to stigma

So what about honest-to-God pure stigma – like avoiding West Africans who left West Africa more than 21 days ago and are still healthy, or even avoiding people of West African descent who haven’t been to West Africa in generations? Unlike caution, stigma does no good, just harm. It needs to be discouraged.

But gently, empathically.

As you point out in your comment, Ebola has a lot of what we call “outrage components.” link is to a PDF file  Among others, it’s exotic, memorable, dreaded, catastrophic, and unknowable. So when Americans suddenly found out that a man with Ebola had been loose in Dallas, many of them temporarily overreacted. This temporary OMG overreaction is called an “adjustment reaction.”

Adjustment reactions come in waves, in sync with newsworthy developments. They are actually good teachable moments, if officials are respectful rather than contemptuous of their frightened, temporarily hypervigilant publics.

In 2004, when many experts feared that an H5N1 avian influenza pandemic might be imminent, we fleshed out our previously skeletal concept of the pre-crisis or crisis adjustment reaction in a three-page handout. link is to a PDF file A year later, Peter wrote a short column covering much the same ground.

It’s not an overreaction to be very upset that Ebola is already devastating three countries in West Africa, and it’s not an overreaction to believe that it may pose a significant global risk if it spreads further. But it is an overreaction to imagine that one case in Dallas means every West African immigrant or visitor is an imminent threat to America’s wellbeing. And it’s certainly an overreaction to be afraid of sharing a bus with a person of African descent.

Adjustment reactions are common – maybe even inevitable – when people first learn about an upsetting risk that could turn out serious. And adjustment reactions are useful; they’re a vicarious rehearsal that helps people gear up for the crisis that may be coming.

People going through an adjustment reaction put aside their everyday concerns to some extent, for a time, making room for the new issue on their worry agendas.

  • They become hypervigilant, scouring the environment for evidence that the crisis has arrived, and sometimes imagining that they have found such evidence.
  • They rehearse in their minds what they’ll do when the crisis comes, and sometimes they start doing it even though the crisis hasn’t come yet.
  • They seek and absorb information. If their fears are treated with respect by officials, they are more likely to learn from those officials. If officials accuse them of panic and hysteria, they will learn from someone else.
  • Some of what they do – stigmatization, for example – is unwise, unnecessary, and unfair.
Then they calm down.

Accusing people of panicking when they are simply going through a temporary, common, and useful adjustment reaction is patronizing and insulting. Accusing them of racism is worse.

Just as SARS stigmatization was often Chinese-on-Chinese, Ebola stigmatization is often African-on-African. In West Africa, orphans whose parents have died of Ebola are often rejected by their communities, as are Ebola survivors. This might be partly ignorance; it might be partly skepticism that the experts know enough to be sure that the orphans and survivors aren’t infected. But mostly it’s stigma.

And when Ebola spreads to non-Africans, so does Ebola stigmatization. As we were completing this response, we read a wonderful article about Judge Clay Jenkins, the senior Dallas County official who visited the quarantined family of Thomas Eric Duncan, Dallas’s Ebola patient, in their contaminated apartment. He wore no PPE. To his surprise, his wife was leery of letting him back into their house. At the school his daughter attends (and where his wife volunteers at lunchtime), parents kept around 100 children home the next day – about nine times the usual absentee rate.

However natural and useful adjustment reactions are, stigmatizing others is still painful and harmful to its targets. It can also be harmful to its practitioners. As you point out in your comment, the agony of stigma can drive people to hide their travel histories … or their symptoms. That endangers everyone.

The best response to people whose adjustment reaction to Ebola includes stigmatizing West Africans is to:

  • Respectfully validate that the feeling is normal and understandable. Lots of people are doing it, including people of West African descent.
  • Point out that it is substantively unjustified. Even people who might have had contact with Ebola sufferers aren’t a risk if more than 21 days have passed and they’re healthy now.
  • Mention that it has cruel impacts on the those being stigmatized. It is painful to be feared and avoided by so many others.
  • Appeal to people’s altruism, asking them to try to get past their impulse to stigmatize, because it is unnecessary and causing harm.
  • Predict that they will probably get past it soon, since people normally get used to new risks and then moderate their early overreactions.

And ask more of people. Recruit their empathy and altruism by asking them to proactively support those who are suffering from stigma, the way faith groups have been doing in Dallas for the family of Thomas Eric Duncan. Some people may want to go out of their way to patronize West African businesses or sit near a West African fellow passenger on a bus. Some may say something to express their solidarity. Some may donate money to help people who have lost their jobs because of stigma. Any action on behalf of “the other” helps us to see “the other” as real, and human, and suffering.

Discouraging stigmatization is important. But stigmatizing stigmatization is bound to backfire. The only answer we know is to validate the impulse to stigmatize instead of attacking it, and then – as empathically as you can – to help people through the adjustment reaction that is causing them to stigmatize others.

  List of Ebola Risk Communication articles.

Responding to a claim for damages you consider bogus

name:Melanie Goetz
This guestbook entry
is categorized as:

      link to Outrage Management index

field:Public education
date:October 7, 2014
location:Colorado, U.S.

comment:

As you might know, when a public water utility flushes its piping system it can turn water a brownish color for a period of time. Most utilities perform this maintenance item in the spring to help maintain the water pipes. People who are made aware of the problem and are educated about not doing any whites in the washing machine are fine with giving the water a little time to return to clear running water. The water is safe to drink – although sometimes not too aesthetic, depending where a home lies on the main water line.

Over the years we have seen where people will try to blame the water utility for stained clothing. One such incident recently came up where a person in an apartment claimed that it stained their set of expensive white bathrobes, etc., and that they incurred $975 worth of damages. The landlord for the apartment complex (water is paid through one invoice to the complex) bought the person a new washing machine and hot water heater. The landlord has now come back to the water provider wanting reimbursement.

The utility’s board doesn’t believe that any of the brown water would have caused any damages to clothing – or especially to appliances. They don’t want the unhappy apartment owner to bring in stained clothing, don’t want to set a precedent, and don’t believe the brown water would have caused such an issue. It lasted for only a few hours and no other person in the apartment complex had any issues.

That being said, what is the best way to communicate to the apartment landlord, the apartment dweller, and the rest of the customers?

peter responds:

The landlord has already bought the tenant new appliances. Presumably s/he did that without prior consultation with the utility, and only now is asking for reimbursement. I find myself wondering why the landlord was so generous – why s/he bought the tenant new appliances in response to a complaint about something that obviously wasn’t the landlord’s fault. For that matter, I wonder why the tenant sought new appliances from the landlord rather than the utility in the first place. Something here feels like I don’t have the whole story … and maybe you don’t either. But let’s put that aside.

You say the utility “doesn’t believe that any of the brown water would have caused any damages” to clothes or appliances. I can’t quite tell how solid this contention is. Is the utility saying it “couldn’t have happened,” period? Or is it saying it “probably didn’t happen”? Is there indisputable science that brown water can’t permanently ruin a bathrobe, a washing machine, or a water heater? Is that outcome so vanishingly unlikely it’s virtually impossible? Or is it only unusual, a little surprising?

I think it’s important not to sound like you’re claiming “impossible” when the science says only “surprising.” If that’s what’s happening, the utility should modify its position. The fact that nobody else has complained is relevant but not necessarily dispositive. If the claim is merely surprising rather than impossible, I’d suggest checking proactively with other residents of the apartment complex. Of course there’s some risk that checking will motivate new bogus claims. But if there’s something systemic that happened when you flushed your piping system, you ought to want to know it … and compensate for it.

But let’s put that aside too, and assume the utility is certain that the claim is bogus. If so, it should stand tight on that position. If the brown water couldn’t have been responsible for the damage the tenant reported, and if the utility didn’t make any reimbursement promises or near-promises that the landlord or the tenant relied on in good faith, then I wouldn’t reimburse the claim. It’s not usually a good idea to “fix” (or compensate for) a non-existent hazard as part of an outrage management strategy.

Managing outrage while saying no

That doesn’t mean there’s no role here for an outrage management strategy. There’s a difference between saying no empathically and saying no nastily or bureaucratically. Here’s my attempt at an empathic no:

I know you were hoping we would reimburse these costs. And we would if we thought the brown water was responsible. In fact, we would even if we thought the brown water might be responsible. Our scientists say that’s flat-out impossible. I know you disagree. You’re looking at a ruined bathrobe and two ruined appliances and you’re convinced it’s our fault. But we have to go with what our scientists tell us. I realize that can’t be much satisfaction to you.

I would recommend keeping to yourself your suspicion that the landlord and tenant are not just mistaken but trying to put one over on you. And I’d also recommend expressing a lot of empathy for how upsetting it is to some people when their tap water turns brown, especially if they don’t know why it turned brown, don't know how long it’s going to stay brown, and don’t know if it’s dangerous to health or harmful to clothes (or appliances).

Which raises a different possibility. I’m assuming that the utility has no real alternative to flushing the pipes every spring and turning some people’s water brown for a while. But the utility certainly has a choice whether to warn people or not: “We’ll be flushing the pipes at this time on this day. It may turn the water brown for a few hours. It’s not harmful, but you may not want to wash your clothes or dishes right then….”

If your policy is and remains not to forewarn people – no anticipatory guidance link is to a PDF file – that reflects a decision that you’d rather blindside a few people who get upset than forewarn everybody. Given that you had the choice, I think you have some responsibility to the people who were blindsided and got upset.

I still wouldn’t pay out on a bogus claim. But I’d certainly apologize for having blindsided them. And I’d ask if they’d like to be put on a special list of people to be called every spring before the pipe flushing starts.

Along the same lines, I was struck by your statement: “People who are made aware of the [temporary brown water] problem and are educated about not doing any whites in the washing machine are fine with giving the water a little time to return to clear running water.” In all my years, I have never been “educated” about not doing any white laundry for a time after a water utility flushes its pipes. My wife says she hasn’t either. Maybe the landlord and tenant haven’t either. So it’s not just a matter of warning people when the brown water is coming; it’s also a matter of teaching them to avoid even temporary discoloration when the time comes by not washing their whites.

You might think again about the pros and cons of notifying everyone before the annual spring brown water flush. An analogy here is pesticide spraying on lawns. There are three effects when a lawn care company posts a sign informing passers-by that pesticides have recently been applied:

  • The signs increase the concern of people who haven’t previously considered that lawn pesticides might be harmful, or who wouldn’t otherwise have realized that this lawn had recently had pesticides applied.
  • The signs reduce the anger and fear of people who already consider lawn pesticides harmful, are anxious to minimize their exposure, and are infuriated when the absence of information makes that difficult.
  • The signs lead some people to consider anew the possibility that lawn pesticides might be dangerous, and then shrug off their concern and take a shortcut across the grass. The act of doing so sizably reduces their concern; they have just communicated to themselves that they’re not worried about lawn pesticides.

I don’t have data to prove it (and many lawn care companies disagree), but my intuition is that the first effect is a lot smaller than the other two put together – and thus that the signs reduce overall societal concern about lawn pesticides. (Whether you think this is a good effect or a bad effect depends, of course, on how dangerous you consider lawn pesticides.)

The same reasoning holds for brown water. I’m pretty sure forewarning people would do more reputational good than reputational harm.

Fanatics, attentives, and browsers

One of the things I couldn’t tell from your comment is whether this controversy is getting any attention, and if so how widely.

In terms of my fanatics/attentives/browsers distinction, are you talking to just the landlord and tenant, the two obvious fanatics? Or are there attentives in on the discussion as well – such as other residents of the apartment complex, and perhaps even some more distant neighbors following it via social media? Is there any mainstream media coverage bringing the controversy to the attention of browsers?

The bigger your audience, the better the case for bending over backwards to be responsive. Even if you’re convinced the complaint is bogus, you might even want to consider compensation, with appropriate language so you’re not setting a legal precedent:

Our experts tell us there’s no way our water damaged Mr. X’s two appliances, or even permanently stained his bathrobe. But obviously something happened, and it happened at the same time as we were flushing the pipes, and the landlord reimbursed the tenant in good faith. Our lawyers are worried that we shouldn’t set a precedent. So let’s be clear. We’re not setting a precedent. We don’t plan to buy new appliances or new clothes for lots of people every spring when we flush our pipes. But this one time, we want to go beyond our obligations and make the landlord whole again.

Your goal is to help the two fanatics feel that they succeeded in getting the issue properly settled. Failing that, your alternative goal is to help the attentives and browsers feel that the fanatics were well treated and if they don’t think so it’s their problem.

If the mainstream media are covering the story, that means the browsers already know that there was a brown water problem but the utility says it didn’t do the damage the landlord and tenant are claiming. The downside if you decide to reimburse the landlord is that the browsers may decide the utility’s a chump. The downside if you stonewall is that the browsers may decide the utility is arrogant and unresponsive. Which is a bigger downside? It depends whether you think most people’s attitude toward the utility tends toward greed (take advantage if they’re a chump) or toward outrage (get even if they’re arrogant and unresponsive). (For more on outrage versus greed, see my 2002 column on “Lawyers and Outrage Management.”) I’m inclined to think stakeholder outrage is a bigger problem than stakeholder greed, so there’s a good chance the utility’s reputation will take a bigger hit from looking arrogant and unresponsive than from looking like a chump.

Even – perhaps especially – if the whole world is watching, the utility may not want to offer compensation for damage it is certain it didn’t cause. It should still try to be empathic, responsive, and even apologetic in its rhetoric. Again, ameliorating the fanatics’ outrage may not be feasible, but it’s still worthwhile to convince the attentives and browsers that the utility is trying, not just blowing off the complaint.

The same analysis holds vis-à-vis the attentives if you have social media coverage – including the “social media” of apartment complex bulletin boards – but no mainstream media coverage, and thus few if any browsers.

What if the entire audience for this controversy is one landlord and one tenant? Then the business case for being responsive – for a reimbursement check or at least an empathic comment – is much weaker. You have less to lose by being unresponsive. That’s why I’m glad social media exist. They improve the business case for corporate responsiveness.

Of course even if your entire audience so far is one landlord and one tenant, it might not stay that way. It wouldn’t take much to provoke a broader controversy: one tweet, one YouTube or Facebook post, even one handwritten note on the apartment complex laundry room wall. In a world where social media access is so easy, it pays to be responsive even when nobody’s watching. Consider how many nasty “private” letters from corporate spokespeople to upset customers have ended up going viral. And don’t rule out the mainstream media either. It’s at least conceivable that there’s a newspaper letter-to-the-editor about this controversy in the utility’s future, or even a call from a local reporter.

Assigning blame for Toledo’s water emergency

name:Melanie Goetz
This guestbook entry
is categorized as:

      link to Crisis Communication index

field:Public education
date:August 9, 2014
location:Colorado, U.S.

comment:

In several states the reporting on the Toledo Ohio water crisis (blue-algae bloom) seems reasonable – for example this Denver Post story. But then I read this type of conspiracy reporting, which makes it all seem the “fault” of industry without any regard to the roles the public plays with the blooms.

What are your thoughts on handling this type of conspiracy reporting, much to the detriment, I believe, of public knowledge? Should we ignore it? Educate people? Should something have been done in the beginning of the outbreak? Perhaps Toledo should have explained the reasons for blue-algae blooms, including the role people have played in the blooms?

I am curious and frustrated. Perhaps you can shed some light on this one?

peter responds:

Here’s a quick summary for readers unfamiliar with Toledo’s water crisis of early August 2014. Toledo is located where the Maumee River flows into Lake Erie. Like many other bodies of water around the world, Lake Erie is periodically hit with excessive “blooms” of algae, fed by nutrients (especially phosphorous) that end up in the lake. Some kinds of algae produce toxic substances called cyanotoxins that are hazardous to health; one of the most common and most dangerous of these cyanotoxins is the microsystin family.

In early August 2014, a microsystin-emitting algal bloom was hovering right over the intake pipe for Toledo’s municipal water system, miles offshore. As a result, there was more microsystin in the water than the utility’s filtering system could cope with. So for two-and-a-half days 500,000 people in Toledo and surrounding parts of Ohio and Michigan were told not to drink the water. Then the bloom moved a bit, the utility beefed up its filtering system, and the levels of microsystin in Toledo’s water were pronounced safe again.

The brief crisis raised lots of risk communication issues, several of them reminiscent of the West Virginia water crisis I wrote about a few months ago. Once again, there was no regulatory standard to rely on. Once again, some of the key information sources were less than candid or less than empathic or both. Once again, there was considerable consumer skepticism about whether the danger was really past.

But I’ll focus here on the specific question you’re raising about Toledo’s algal bloom: Who got the blame? You think some of the coverage made the crisis “seem the ‘fault’ of industry without any regard to the roles the public plays with the blooms.” You describe this sort of coverage as “conspiracy reporting.”

The example you cite comes from a free online publication called “Natural News,” supported by ads for various naturopathic remedies. The article is entitled “The truth you're not being told about the Toledo water crisis in Ohio: Chemical agriculture poisoned the water.” It is bylined “by Mike Adams, the Health Ranger.”

Despite his obvious bias, Adams gets the basic process right, I think:

What’s happening is that all the fertilizer being dumped on nearby farm fields causes phosphorus runoff. This phosphorus runoff winds up in Lake Erie where it feeds the algae, resulting in algal blooms that produce the toxins. These toxins contaminate the drinking water supply and have led directly to the current water crisis.

Weirdly but not surprisingly, Adams seems to think that only phosphorous from conventional “chemical” farming causes algal blooms, as if manure runoff from organic farms were somehow phosphorous-free. He uses Toledo’s crisis as a peg for an off-the-shelf broad-brush indictment of the chemical industry and chemical agriculture:

In the same way that the public is not told the truth about cosmetic products causing cancer and aspartame causing neurological disorders, they will never be told that chemical agricultural practices poison the water supply. If people knew the truth, after all, they might demand a stop to those practices….

Everything we're seeing now – Ebola outbreaks, weird tropical viruses, the Plague, superbugs, flesh-eating bacteria and water supply toxins – are all just signs of how humanity has damaged and imbalanced the ecosystem. And until we stop the mass poisoning from agriculture and industry, it’s only going to keep getting worse….

As this mass extinction is taking place, keep in mind that there are droves of “chemical denialists” who claim all these agricultural chemicals are harmless. These are the same people who also claim GMOs are harmless, in case you're curious. They’re the pushers of atrazine, glyphosate, 2,4-D, Agent Orange, DDT, neonicotinoids and other deadly chemicals….

The algal blooms of Lake Erie are Mother Nature’s way of sending us a Biblical-scale warning sign: We must stop our destructive ways or we will sooner or later have to drink our own poison.

More interesting to me is Adams’s belief that the link between agricultural runoff and algal blooms is a bit of a secret:

I find it absolutely astonishing that I was unable to locate a single news story in the mainstream media which made this connection between agricultural runoff and the Toledo water crisis. Every single MSM story I found simply blamed the algae, as if Mother Nature has gone bad and is trying to kill everyone. In reality, it’s mankind that’s gone bad and is poisoning the planet. Algal blooms are just the symptoms of an ecological imbalance.

This article amply justifies the label you gave it, “conspiracy reporting.” Adams clearly sees an industry conspiracy to profit from poisoning the planet, and a media conspiracy to keep silent about it.

But Adams occupies a remote corner of the media universe. Granted, it’s a pretty big corner; the market for anti-chemical fear-mongering is substantial. And I don’t doubt that an occasional Google searcher finds his or her way to Natural News and misses the signals that the information on this site is filtered through a distinct ideology. But surely most of Adams’s readers are true believers already. The same is true, of course, of farm industry publications. Followers access these publications to get the pre-filtered news they want. Outsiders access them (except by accident) to see what that side is saying.

I don’t see much risk that Adams and his colleagues are undermining the public’s understanding of algal blooms. And I don’t see much point in rebutting him. I have two rules of thumb with regard to rebutting extremists:

  • If they’re talking mostly to each other, leave them alone. Your response won’t be welcome and won’t be useful.
  • If they’re talking to a broader audience – at a public meeting, for example – validate the ways in which they’re right or partly right. Save your rebuttal of the ways in which they’re dead wrong for later. Better yet, trust that if you’re balanced and reasonable while they’re off-the-wall, most people will figure it out for themselves.

Adams isn’t talking to a broader audience. But if he were, there are things he’s saying that I would want to validate.

He’s wrong that chemical agriculture is solely responsible for algal blooms (and the decline of Western Civilization). And he’s wrong that the mainstream media have totally ignored the link between agriculture and algal blooms in general and Toledo’s August 2014 bloom in particular. But I think he is half-right on both points … closer to right than you seem to think.

Is agriculture the culprit?

I’m not certain what you mean by “the role the public plays with the blooms.” If you mean that runoff from people’s neighborhoods and runoff from agriculture (fertilizers, feed lots, etc.) are about equally responsible, that’s not what I’m reading. There seems to be something like unanimity in all the sources I checked (even most farm industry sources) that agricultural runoff is principally responsible for the algal blooms in Lake Erie. Decades ago emissions from factories and sewage treatment facilities were major factors, but these “point sources” were regulated, whereas agricultural “non-point sources” were much less regulated. So now most of the phosphorous in the lake comes from agriculture, with runoff from lawns, streets, and other sources distinctly secondary.

Here for example is the one-paragraph explanation from an FAQ on “Harmful Algal Blooms,” posted by the Great Lakes Environmental Research Laboratory of the National Oceanic and Atmospheric Administration well before Toledo’s crisis. More than most one-paragraph explanations, this one bends over backwards to acknowledge that agricultural runoff isn’t solely to blame, but still makes it clear that agriculture is the biggest single causal factor:

What causes an algal bloom?

There is no single factor which causes an algal bloom. A combination of optimum factors such as the presence of good nutrients, warm temperatures and lots of light all encourage the natural increase in numbers of blue-green algae in our waterways. Nature mostly takes care of the temperature and light, but the increased presence of nutrients such as phosphorous is largely due to poor farming practices such as high use of fertilizers and presence of livestock near water supplies, as well as effluent and run-off from towns and cities near waterways. The ponding of water and reducing river flow rates tends to improve the light and sometimes the nutrient environment for algal growth making water turbulence a major factor in bloom development. Pesticides and other chemicals may affect the natural grazers which would otherwise control algal growth and their presence increases the risk of blooms.

But saying that agricultural runoff is the main source of the excess phosphorous that leads to algal blooms isn’t the same as saying that farmers and chemical fertilizer manufacturers are simply the bad guys, as Adams seems to believe. For a much more thoughtful article than Adams’s, look at “Cause of Lake Erie’s Harmful Algal Blooms Gains More Certainty,” by Codi Kozacek, published in Circle of Blue in April 2014 – that is, before Toledo. (Circle of Blue is an independent source of online global water news, green-leaning but fact-focused, funded mostly by foundations.) According to Kozacek, recent research attributes Lake Erie’s worsening algae problem chiefly to changes in agricultural practices that were initiated for good reasons (including good environmental reasons), but had the unanticipated effect of increasing the amount of dissolved reactive phosphorous – the kind most likely to promote algal growth – ending up in the lake. No bad guy, in other words, but a big problem nonetheless.

For those who insist on a bad guy, there are lots of candidates:

  • Agricultural chemical companies and Big Agriculture are to blame for opposing regulations, often successfully, and for poor farming practices.
  • Small farmers are to blame for the same sins. (Small farms are said to produce more runoff per unit of production than big farms, on average.)
  • Municipal utilities are to blame for not improving their water treatment facilities to cope better with cyanotoxins.
  • Local governments are to blame for permitting development in what used to be wetlands that helped filter the phosphorous before it got to the lake.
  • Federal and state regulators are to blame for not imposing tougher regulations, and for not rigorously enforcing the regs they’ve got.
  • We’re all to blame for global climate change, which means more and stronger storms washing more phosphorous into our waterways.
  • We’re all to blame for not demanding cleaner water, or for “demanding” cleaner water without being willing to pay the price.

The last bullet may be what you mean by “the role the public plays” – in which case I largely agree with you. Of course that doesn’t necessarily make the public the bad guy either. Not every problem is worth solving. There may be a case to make – though it is seldom made explicitly – that an occasional algal bloom isn’t too high a price to pay for not having to fight with farmers and chemical companies, foot the bill for utility upgrades, etc. After all, Toledo was without potable water for just over two days. Harmful algal blooms aren’t rare, but they’re not everyday occurrences either. When they start happening often and everywhere, then we should do something about them. In the meantime, don’t we have more pressing problems? As I say, that viewpoint isn’t often espoused explicitly. But it seems to be, de facto, what most people actually believe … possibly even people in Toledo after a couple of days without potable water.

Does the media coverage assign blame properly?

What bothers you is that some news stories blame only agriculture. That’s true of Adams’s screed, and others like it. More damagingly, it’s true sometimes of mainstream media articles that aren’t mostly about the causes of algal blooms, but say something about causes in passing. An article with just a sentence or two about the source of the problem is likely to pick on the biggest source and leave the others out. So you sometimes see just a passing reference to “farms” or “agriculture” or “fertilizer runoff.” I don’t have much objection to this, and I’d have no objection at all with the addition of some qualifier like “main” or “principal.” But I take your point that people may end up with an oversimplified impression that the agriculture and agricultural chemical industries are the bad guys.

Now give some thought to what bothers Adams: that some news stories neglect to blame anybody, as if algal blooms were a purely natural phenomenon. (Adams says virtually all mainstream media content does this – but Adams is obviously fond of hyperbole.) Or – and this is almost the same thing – some stories throw their hands in the air, implying or even claiming that the question of causality is so complex as to be virtually unanswerable.

Let’s take as our case-in-point the article you cited as your “good” example – John Seewer’s August 4 Associated Press story as published in the Denver Post. This article runs 14 paragraphs. Five of them have something to do with explaining what caused the bloom. Here are all five:

“This is not just one community issue, this is the whole lake,” said state Rep. Dave Hall, who wants to bring in experts to look at the cause of the blooms and how they’re influenced by weather, farm runoff, manure management and wastewater treatment facilities.

“I don’t think you’re going to change things overnight,” Hall said. “There’s not a silver bullet because I think there have been practices that have been in place for years that’s caused us to get to this point.”

Gov. John Kasich told The Associated Press it’s not clear yet whether the algae bloom centered where Toledo draws its water was entirely to blame for fouling the city’s drinking water or if changes also are needed with the water-supply system.

The state, he said, will conduct a review of what happened, including taking a look at Toledo’s aging water system and continuing to figure out how to reduce pollution that feeds algae in the western end of the lake.

Ohio’s Republican Sen. Rob Portman, who was behind a bill that will bring more money for monitoring the algae in the Great Lakes, said more research is needed to understand what’s behind the blooms and how to control them.

Hall, Kasich, and Portman all want more research. Hall wants to bring in experts to figure out how much blame to apportion to weather, farm runoff, manure management, and wastewater treatment facilities. The only thing he’s sure of is that whatever is to blame, it has been around for a long time and we can’t expect to change it overnight. Kasich wants to conduct a review to find out how much blame to put on the utility system for not being able to handle so much microsystin. And Portman just wants more research.

Adams would presumably agree with me that this AP story – the one you liked – falsely implies that we don’t already know agricultural runoff is the main source of algal blooms in Lake Erie.

Most stories about Toledo’s water crisis say comparatively little about the causes of the crisis – especially those written while the crisis was ongoing and the water still wasn’t safe to drink. This is understandable. The big news in Toledo, obviously, was “Don’t drink the water! It’s poisonous!” Especially in the local media, the most important angles were topics like these: How long was it dangerous before they announced the ban? What is my risk if I drank some already? What symptoms should I be on the lookout for? Can I brush my teeth, shower, use my swimming pool, wash my dishes? Is it okay if I boil it? How long is the ban likely to last? What are they doing to solve the problem? How will we know when the water is safe? Where can I get bottled water in the meantime? Is anybody seriously ill as a result? Is there price-gouging going on? What about my nearby town which also gets its water from Lake Erie? What about my child’s goldfish that’s swimming in it? And on and on and on….

Of course people also wanted to know what made the water poisonous in the first place. But how far back along the causal chain did they want to go? It’s a poison called microsystin. It comes from algae in the lake. The algae are right near the water system’s intake pipe. The algae are “blooming,” producing more microsystin than usual. The bloom is caused by too much phosphorous in the lake. And, finally: Here’s how phosphorous gets into Lake Erie….

Maybe the reporters covering the crisis could have said a bit more about where the phosphorous came from. Maybe the key information sources (the mayor, the water system, etc.) could have emphasized that topic a bit more. But “a bit more” is about the most you can expect – in this or any crisis.

Crisis communications are mostly about the crisis. They’re not mostly about why we had a crisis, what we could have done to prevent the crisis, or what we can do to prevent future crises. Those are all important stories after the crisis is over (for people who are still paying attention). They’re secondary stories while the crisis is raging. And a source who kept trying to put them front-and-center in mid-crisis would seem weirdly off-topic, both to the reporters covering the crisis and to the public trying to cope with it.

So your complaint – that mid-crisis stories sometimes blame agriculture in an oversimplified way – is justified. So is Adams’s complaint – that mid-crisis stories sometimes ignore the question of blame altogether or shrug it off as too complicated to resolve.

I spent some time looking at the coverage in the Toledo Blade, for example. On August 4, after the crisis was over, the paper ran a long editorial entitled “Clean up Lake Erie – now.” The editorial emphasized: “This is not a matter for endless further hearings, studies, debate, and incremental gestures. It is a matter for immediate mobilization by state, local, and federal officials….”

And the editorial was admirably clear about causation: “The chief contributor to toxic algae growth is phosphorus-laden runoff that enters the lake from rivers and streams, notably the Maumee River. The major sources of this runoff are excess fertilizer and manure from farm fields and large livestock feeding operations.” After advocating tougher runoff regulations, the editorial then turned to other sources of phosphorous in the lake, recommending an upgrade in the city’s sewer system and an end to dumping silt from Toledo’s shipping channel into Maumee Bay. And it added: “In a larger sense, elected officials at all levels need to stop denying, and start responding meaningfully, to the effects of human-made climate change – yet another factor in the formation of toxic algae blooms in Lake Erie.”

But when I searched the Blade website for “algae agriculture” on August 8, I got 74 hits – two from after the crisis (including the August 4 editorial) and 72 from beforehand – none from mid-crisis. Searching for “algae farm” did a bit better, with 119 hits, including a Day Two lede story by Tom Henry that included this solitary paragraph:

The cause of the microcystis algae bloom is primarily phosphorus from farm fertilizer runoff, and the amount of phosphorus determines the bloom’s size. Scientists are also learning that another farm fertilizer, nitrogen, affects the size and composition of the annual bloom.

That paragraph was the only causal explanation I found in that day’s Blade; I saw nothing else in Henry’s long lede story or a half-dozen sidebars and commentaries.

When I searched on Google instead of on the Blade website, I found more than a dozen news stories and editorials exploring the implications of the Toledo crisis – from the vantage point of a different city a day or two after the crisis had ended. Several explored a variety of factors that contribute to algal blooms. And several quoted farm organizations at length about the things they’re voluntarily doing or willing to do to manage runoff better.

I didn’t find a single story in which any farm organization claimed that agriculture isn’t a major source of algal blooms.

But I did find stories in which farm organizations complained that other sources weren’t getting their fair share of the blame. The Detroit Free Press, for example, ran an August 7 story entitled “Farmers: Imposing mandates on us won’t solve the Lake Erie algae crisis.” Aside from reporting agriculture’s preference for voluntary rather than mandatory improvements, the article also noted:

Farm leaders bristle at being singled out as a main cause of the algae problems, noting several other factors:

  • Stronger and more frequent rainstorms in the spring make fertilizer and manure runoff harder to control. And hot summers have stoked the algae blooms on the relatively shallow western basin of Lake Erie.
  • Invasive species such as zebra and quagga mussels filter the water in a way that sets the stage for the algae blooms.
  • Outdated municipal sewer systems and failing septic systems also add nutrients to the lake, particularly during heavy rains.

You will probably like this quotation less, from a Milwaukee Journal Sentinel editorial entitled “Could we be Toledo’d in Wisconsin?

But are there lessons for us in Toledo’s crisis? Yes. Just like here, Ohio officials tiptoe around agriculture’s culpability. They lump the runoff that comes off streets as roughly equal to that of farm runoff. It is not: Every major water quality study (of big river basins) done by the Wisconsin Department of Natural Resources in recent years shows that farm runoff is the biggest contributor of phosphorus which, as a fertilizer, does a great job of growing algae.

The goal, obviously, is coverage that allocates the blame for algal blooms thoughtfully – which I think would mean that agriculture would get most but not all of it. I found a number of stories and editorials I thought did that pretty well, though none in Toledo in the middle of the crisis.

And then there are three quite different ways of getting it wrong:

  • Blaming only agriculture (your complaint, and agriculture’s).
  • Blaming nobody (Adams’s complaint).
  • Blaming everybody equally (the Journal Sentinel’s complaint).

I think you’re right that the public needs to understand that problems like Toledo’s algal bloom are not simply attributable to bad behavior by “industry” or “agriculture” or “polluters.” We all play a role. And I think Adams is right that the public also needs to understand that industry/agriculture/polluters really are responsible for a big share of many big problems, including this one, and that they too often succeed in resisting solutions that impose regulatory burdens they prefer to avoid.

I suspect most adults know this already, at least in principle. But it would probably do some good if crisis news coverage – when the most people are paying the closest attention – would make both points more explicitly.

Should a manager respond to the complaints of a demoted employee who quit?

name: Denise
This guestbook entry
is categorized as:

      link to Outrage Management index

field:Communications
date:August 7, 2014
location:U.S.

comment:

I read your thoughts on employees and layoffs, from years past.

I wanted to get your thoughts on a situation at a governmental agency where an employee was demoted and her pay was decreased, and she ended up working in the same department under the person she was previously supervising.

The demoted employee resigned and wrote a letter to the Board stating the unfair treatment and how much she liked working for the agency.

It’s freshly over now, but the letter keeps surfacing and there is definitely some distrust now from the Board of the management’s leadership. I’m unsure about the other 50 employees and their thoughts.

Given that perhaps it wasn’t handled well, is damage control in order (perhaps writing a letter to the Board) or should the manager let it go?

peter responds:

It’s very hard for me to judge from your brief description what I would do in this manager’s shoes. But here are some tentative reactions.

I can’t tell whether the demoted employee was unfairly treated or not. Demotions are uncommon; poor performers who can’t be fired typically keep their wages or salaries, though they may be punished in other ways in hopes that they’ll quit. I haven’t a clue whether this particular employee’s work was actually inadequate, nor whether her demotion was against the organization’s rules or customs.

As for ending up working for someone who once worked for you, I can see how that might be awkward, but it doesn’t seem automatically unfair to me. In the private sector it’s pretty common, though it’s usually the result of a promotion, not a demotion.

Putting all that aside, the three most important facts are these:

  1. An employee who was demoted and then quit wrote a letter to the Board that sounds like it was cogent and balanced, praising the agency but criticizing how her manager treated her.
  2. The letter is out there. Her former colleagues have access to it. It “keeps surfacing.”
  3. The result has been some tension between the manager and the Board, and perhaps between the manager and other employees.

Given these facts, I think the manager should say something, both to the Board and to the other employees.

I’m actually less worried about the Board than about the other employees. If as you say the Board now has reservations about the manager’s leadership, it’s arguably up to the Board to ask the manager for his or her side of the story. If the Board isn’t pursuing the matter, the manager has several reasonable choices: let it go; say something informally to a Board member or two in the hope that it will filter back to the rest; write a letter to the Board; perhaps even ask the Board for some kind of formal investigation to put the issue to rest. Which choice is wisest depends on facts I don’t have.

But if the agency’s 50 remaining employees are still buzzing about the controversy – even occasionally – then it’s almost certainly bad management to say nothing. One key exception: There may be legal reasons why the manager must keep mum about a personnel matter that could lead to litigation. But assuming the manager is free to talk, he or she should do so … and of course it would be foolish to explain things to the workforce and not to the Board.

The vehicle could be a letter to the Board that’s subsequently (or even simultaneously) made available to the employees, on an intranet or a bulletin board or whatever. Or if the employees meet routinely for other purposes, the issue could be raised and discussed at a meeting; that might mean two letters to the Board, one before the meeting so the Board isn’t blindsided, the other afterwards to report on the meeting itself.

I hasten to add that the manager’s main goal should not be to rebut the departed employee’s complaints. That would only fuel the controversy. The manager’s best hope of putting it to rest is a scrupulously fair, two-sided presentation. The manager should:

  • Acknowledge that there has been some buzz about the departed employee, her treatment, and her letter to the Board.
  • Summarize the facts as neutrally as possible, in terms the employee would find acceptable if she were there.
  • Explain both sides: “This is why I did what I did…. This is why she felt I was unfair….”
  • Bend over backwards to acknowledge the ways in which the employee was right or partly right, and the ways in which the situation wasn’t well handled.
  • Discuss any lessons learned: “Here’s what I think I would do differently next time….”
  • Also discuss what hasn’t changed: “It’s still our agency’s policy to….” “I would still feel it was the right thing to….”
  • If possible (in a meeting, for example), allow for some discussion – but put a time limit on the discussion from the outset.
  • Express hope that everyone will now be able to let it go.

Is this making a mountain out of a molehill? Would the manager be better off saying nothing?

The argument for saying nothing used to be stronger than it is today. “Don’t feed the fire,” the argument went. “Small controversies die a natural death if you don’t give them fuel.” I’m not sure that was ever true in small, tightly knit organizations with high-functioning rumor mills. But today it’s not true in any organization. If people aren’t comparing notes over the water cooler, they’re comparing notes on Twitter and other social media.

As you wrote, the departed employee’s letter to the Board “keeps surfacing.” Odds are it will keep right on surfacing until people feel they know the whole story.

Responding to videos of people in your industry torturing animals

name:Terry Sim
This guestbook entry
is categorized as:

      link to Outrage Management index

field:Editor, Sheep Central
date:July 23, 2014
location:Australia

comment:

I am a journalist working for a new online sheep industry news service in Australia, Sheep Central. I thought it a good idea to get your response on the industry reaction to the latest PETA campaign against the wool industry.

PETA has filmed instances of cruelty to sheep in several shearing sheds, collected across three states over an eight-month period, and concluded with statements that people should therefore not buy woolen garments. This campaign could potentially have more effect than the anti-mulesing campaign, because all sheep are shorn, but not all are mulesed.

Reaction from the industry has varied:

  • The RSPCA and state departments of agriculture have said they will investigate the claims of cruelty, though it seems PETA won’t release all information around the incidents and the filming.
  • Federal Minister for Agriculture Barnaby Joyce said neither he nor the government condoned mistreatment of animals. But he questioned the bona fides of the video – how and where it was produced, whether permission for filming was given, whether the cruelty was immediately reported, whether the Australian Workers Union was notified, etc. He also stated that filming people against their will is illegal, and that an emotional response without full investigation does not result in better husbandry practices. “It just reinforces the belief that PETA is an extremist group that wants to end livestock production and to irreparably damage the economy and the reputation of Australian farmers.”
  • Australia’s Wool Producers body said any shearer mistreating animals and not adhering to the highest animal welfare standards did not deserve a place in an Australian shed. The body also supported the RSPCA investigation, asked all woolgrowers to take a zero tolerance approach to poor animal welfare practices, and encouraged anyone to report animal cruelty to authorities. “The industry will take the necessary steps to ensure very rare behavior like this ends.”
  • The research, development and marketing body Australian Wool Innovation said it categorically and unequivocally condemns the mistreatment of animals, and has invested $2.8 million in training more than 4000 shearers and shedhands in animal welfare world’s best practice, and more than $7 million in the past five years.
  • The Shearing Contractors’ Association of Australia said it applauded the PETA investigation and has contacted all members to reinforce the need for zero tolerance towards animal cruelty by employees in the workplace. SCAA said it will review training procedures and materials to ensure trainees are aware this behavior is intolerable. But it also reminded PETA subscribers that wool producers in Australia are striving to improve their industry as fast as possible so that it is 100 percent compliant with international animal welfare standards. SCAA also said wool was still one of the most environmentally sustainable mass-market fibers on the planet. To choose synthetic fibers over wool, it said, would cause greater harm to the planet’s ecosystems and the environments that all animals have to exist in.
  • References have also been made in the media to an “ag-gag” law being prepared by the Victorian Government to make illegal the making of such footage.

What’s your opinion of this industry reaction to this issue, particularly the kick-back by Barnaby Joyce? Should the industry take solace in the fact that the footage was perhaps illegally obtained? What form should the industry’s reaction to PETA take? What action by the industry will have some counter-impact on consumers?

peter responds:

The bottom line is that there are now videos circulating of Australian sheep shearers torturing sheep. Nothing can keep that from damaging the reputation of the wool industry, and rightly so. Some responses can ameliorate the damage, and some will make the damage worse. No response can make the damage go away.

caption:
A still from one of the PETA videos

Excessively mild language

I used “torturing” instead of “mistreating” in the previous paragraph on purpose. I think the industry should use highly emotional terms like that too – not every time, but often enough to drive home that it really understands and really takes seriously the awful behavior shown in the videos.

On the whole the responses I have seen from industry and government sources are substantively appropriate, rightly focusing on how unacceptable the sheep shearers’ behavior is. (Barnaby Joyce’s response is an exception. I’ll get to him later.) But to me they sound a bit perfunctory, almost grudging.

Consider this fairly typical July 14 media statement from WoolProducers Australia, headlined “Woolgrowers reject animal cruelty”:

WoolProducers Australia has condemned the actions outlined in footage aired last week by PETA as unacceptable.

WoolProducers Australia’s president Geoff Fisken said there was no excuse for mistreatment of animals – not in agriculture nor in domestic situations.

“We are as appalled by the footage as any person responsible for the care of animals would be anywhere. The majority of woolgrowers are not in the business of treating animals like that and nor are professional, fully qualified shearers.

“If I saw this behavior towards animals on my farm, the perpetrators would be sacked immediately. Correct treatment of animals is not optional and as an industry, we demand high standards of animal welfare because it is right.

“We ask all woolgrowers to take a zero tolerance approach to poor animal welfare practice and take the necessary steps to ensure rare behavior like this ends.”

This isn’t awful. “Condemned” and “appalled” are pretty good words, though “zero tolerance approach to poor animal welfare practices” sounds a bit bureaucratic to me.

In fact the overall tone of this statement, and of the others you sent me and those I found online, comes across to me as more bureaucratic than horrified. I can tell that the industry wants me to know it doesn’t condone torturing animals. But I don’t get the feeling that Geoff Fisken could hardly make himself watch the footage, or that he had trouble eating or sleeping afterwards, or that he was shocked to find out the levels to which some sheep shearers could sink, or that watching made him ask himself hard questions about whether he was doing enough to extirpate this horrible evil from his industry.

At least part of the problem is that people expect pro forma rhetoric from industry associations in situations like this. So unless the language is emotional enough and personal enough to register, we hear what we expected to hear.

By the way, this statement isn’t on the WoolProducers Australia website. You sent it to me. As of July 23, in fact, there is nothing on the WoolProducers Australia website about the PETA videos, and nothing recent about any animal cruelty issue.

What accounts for the mild language? Maybe the people writing the industry’s statements really aren’t horrified at the behavior shown in the videos, just embarrassed. Maybe they’re condemning it only because they feel they have no choice. Or maybe they’re genuinely horrified but trying not to appear to be on PETA’s side, thereby irritating their industry supporters, members, or constituents. Most likely – whether they’re genuinely horrified or not – they feel their job right now is to calm the waters, in part by keeping their vocabulary unemotional.

But the core audience for these statements is members of the public who are genuinely horrified, and who are looking to see if industry and government officials are too. I’m not suggesting they should fake it if they’re not. But there’s no value in expressing horror in such mild terms that you sound like you’re faking it.

Five options when under attack

In a 2012 Guestbook entry on “Arousing ‘counter-outrage’ about where your activist opponents get their funding,” I wrote:

Whenever a big company is under attack, it has four strategic options. In order from most to least fruitful, they are:

  • Acknowledge and improve
  • Defend
  • Hide
  • Counterattack

Now I want to add a fifth, this time in order from least to most fruitful.

number 1
Counterattack. (“PETA broke the law to get those videos.” “It is trying to damage Australian agriculture.” “It’s a bunch of radical extremists.” Etc.) As I said in 2012, counterattack is usually the least effective response to criticism. If you’re a parent, you know how ineffective it is. If you’ve just found illegal drugs in your teenager’s bedroom, it won’t help for him to accuse you of invading his privacy. Perhaps if the organization under attack has a really damning charge with which to counterattack – for example, if the wool industry could prove that PETA’s anti-wool campaign was secretly financed by the synthetics industry – then it might be worth trying. Even then I’d favor an “acknowledge and improve” approach instead.
number 2
Hide. (I don’t know if there are any Australian wool industry organizations that are sitting this controversy out, hoping it will go away. The odds are good that some of them are.) When an organization is barraged with criticism, trying to keep as low a profile as possible is a natural temptation. And disappearing from a controversy isn’t always foolish. It can work for organizations that are peripheral players and won’t be missed; it can work for small brushfires that look like they might extinguish themselves if you don’t feed them any oxygen. But when people are paying serious attention to you, saying something is usually wiser than saying nothing. The most foolish way of “hiding” is aggressively refusing to play a role: “I won’t dignify that accusation with a response.”
number 3
Change the subject. (“Wool is an environmentally better fiber than synthetics or even cotton, so people who care about the environment should keep wearing wool.”) This wasn’t on my 2012 list, but it should have been. Once again, we know as parents that changing the subject rarely does the trick. If you’re angry at your daughter for flunking her math test, it won’t help for her to point out that she makes her bed every morning without complaint.
number 4
Defend. (“These are rare, isolated incidents.” “Our industry spends a lot of money training sheep-shearers in world class animal welfare standards.” Etc.) As part of a mea culpa, it is legitimate to point out the ways in which you’re not as bad as your critics maintain. But when defending is the main thing you’re doing, you just sound defensive. Perhaps the most common defense strategy is also one of the least effective: to fasten on your critics’ false or exaggerated claims and rebut those, ignoring their valid claims. Years ago when I was training the complaints department of a railway company, I used a tape of a customer complaining that her train was 45 minutes late. The call center operator had accessed the records to prove that the train was actually only 41 minutes late. It’s not hard to guess how this rebuttal affected the customer’s outrage.
number 5
Acknowledge and improve. (“The PETA videos show that we still have a job to do stopping animal cruelty in our industry.”) Instead of rebutting your critics’ invalid or exaggerated criticisms, admit the valid ones. Once you get the knack, it’s not that hard to convert “defend” messaging into “acknowledge and improve” messaging. Instead of claiming that animal cruelty is rare in your industry, for example, say that “Even once is too often – and PETA says it found 19 instances of animal cruelty, far more than anyone should consider acceptable!” If people think that number’s pretty small, great; it’s not for you to say. Similarly, talking about what you have done in the past to address the problem is bound to sound defensive. But talking about what more you’re going to do now sounds responsive, especially if you describe it that way: “PETA deserves credit for pushing us to do more. And here’s what we propose to do in response….”

Most of the industry and government statements I’ve seen about the PETA videos employ a mix of strategies. That’s tolerable, as long as “acknowledge and improve” is the main one.

Actually, I haven’t seen much yet in the way of industry pledges to do more to put a stop to animal cruelty. The “…and improve” part of “acknowledge and improve” is pretty weak so far. And as I already noted, the “acknowledge” part tends to be blander than it should be. Still, the industry deserves credit for spending more time acknowledging than defending, changing the subject, hiding, or counterattacking.

The single best paragraph I’ve seen so far came from Jason Letchford of the Shearing Contractors’ Association of Australia. “The SCAA applauds the investigation by PETA and believes that the work by such organizations is necessary to remind all industries around the world to be vigilant against complacency, when it comes to animal rights and welfare,” Letchford stated in a media release. “That said, the Association appeals to PETA subscribers to understand that wool producers in Australia are striving to improve their industry as fast as possible, so that it is 100% compliant with International Animal Welfare Standards.”

All in all, the industry hasn’t done a bad job of responding.

The exception is Federal Minister for Agriculture Barnaby Joyce, who has spent more time counterattacking than anything else. Here are some excerpts from Joyce’s July 11 statement entitled “Footage of sheep shearers”:

Among the questions that need to be answered [about the footage] are where did it happened; when did it happen; who took it; what authority did they have to film the workers on the farmer’s property; were there any other factors involved; did they immediately report the incident; are they in possession of any other footage; did they hold a court order; and did they tell the Australian Workers Union (AWU) of their actions so other shearers were aware they were being filmed?

There is no doubt these images are disturbing, but it is important we do not tarnish the whole industry based on the practices of a few and select pieces of footage that are yet to be investigated.

I do not condone the method by which this footage was obtained as it sets one group above the law in how they act and I understand it was filmed over a period of seven or eight months.

When bad practice is identified it should be reported. Otherwise it can be seen as not so much an attempt to end the cruelty, but rather another mechanism to attack rural industry in Australia.

It is against the law to go on to private property and film people against their wishes. It is against the animal’s interest to hold this footage till the time of most convenient political effect.

An emotional response without full investigation, including why it has taken so long for PETA to release the footage, does not result in better husbandry practices. It just reinforces the belief that PETA is an extremist group that wants to end livestock production and to irreparably damage the economy and the reputation of Australian farmers.

Joyce’s statement also says some things in defense of the Australian wool industry: how much it spends on animal welfare, how important it is to the economy, how unfair it would be to judge an entire industry by a few bad individuals. And it has a pro forma acknowledgment that “I don’t, and the Australian Government does not, condone the mistreatment of animals.” But its main thrust is to attack PETA.

I think the response of a Green Party minister, Shane Rattenbury, is right on target: “Barnaby Joyce needs to stop blame shifting and deal with the real issue here – the Australian public have a right to feel confident that the animals involved in their food and clothing production are treated humanely.”

Government ministries/departments of agriculture are famously more in bed with the industries they oversee than, say, health departments. But support as one-sided as Joyce’s does an industry more harm than good. Too many people react to comments like the ones quoted above by thinking “What a jerk!” and worrying that apparently the fox is guarding the henhouse … or in this case the sheep-shearing sheds.

Activist lawbreaking and activist extremism

There is a long and honorable (even glorious) tradition of activists and journalists breaking laws in order to bring serious societal problems to public attention. The lunch counter sit-ins in the early days of the U.S. civil rights movement come to mind. So does Edward Snowden’s release of information about secret U.S. government surveillance of its own citizens.

How justified you consider the lawbreaking depends on how serious you think the problem is and how serious you think the legal violation is. Snowden obviously violated much more serious laws than the lunch counter demonstrators did, and arguably did serious harm in the process – though I personally think his goal of outing the extent of U.S. government surveillance and provoking a privacy-versus-security debate (which he certainly achieved) justified the damage.

The case for justification is unarguably strong, it seems to me, when the laws that are violated in the process of revealing a problem are laws that were promulgated precisely to avoid having the problem revealed. That’s the situation with regard to “ag-gag” laws that criminalize the videotaping of animal cruelty on the grounds that the videos may damage the companies on whose premises the cruelty takes place. There are many such laws in the U.S., and I was sorry to learn that Victoria is considering one as well. Very few people other than the industry and its apologists really think it’s a good idea to make it a bigger crime to trespass or use false I.D. in order to stop animal cruelty than to trespass or use false I.D. for some more personal, less pro-social reason. When animal rights groups bomb laboratories and the like, they lose all but their most radical supporters. But I doubt they lose any public sympathy at all when they violate a law against photographing animal cruelty!

Still, an activist or journalist who breaks any law, even an ag-gag law, pays several prices:

  • The risk of prosecution and punishment, of course – which in the case of some U.S. ag-gag laws can lead to being labeled a terrorist forevermore.
  • The risk of lost moral high ground. There are those who think no goal justifies breaking even a minor law. There are those who think some goals (like exposing animal cruelty) simply aren’t important enough to justify lawbreaking. And even those who see exposing animal cruelty as a higher priority than respecting legal niceties may still think less of the perpetrators than if they had stayed within the law.
  • The risk of diminished legal usefulness. In some situations illegally obtained evidence is still usable in court or regulatory proceedings. In other situations it isn’t. (But if the publicity leads to tougher standards and tougher enforcement, the lost ability to prosecute the videotaped shearers probably isn’t too high a price to pay.)
  • The risk of diminished credibility. If you broke the law to get your evidence, you’re obviously willing to cut corners. So how can we be sure that you didn’t falsify the evidence as well? (For the record, if PETA did falsify evidence – or even gild the lily with a little creative photoshopping – that’s extremely unwise as well as unethical. If they’re caught, their cause loses big time! There’s a huge ethical difference between illegally obtaining valid evidence and illegally falsifying evidence.)
  • The risk of distraction – more attention to your lawbreaking may mean less attention to your cause.
  • The risk of lost campaigners and/or lost contributors – people who won’t break the law for you, or even associate with you or contribute to you if you break the law. (Of course others may find it exciting to break the law in a good cause. In general, when organizations get more radical they alienate more contributors than they attract, but attract more campaigners than they alienate.)

If I were advising PETA, I’d certainly point out these prices, although I’m pretty sure PETA has already decided they are prices worth paying.

But the wool industry and its supporters gain nothing and lose much if they focus disapprovingly on PETA’s lawbreaking. They can ignore the lawbreaking, focusing instead on the serious problems the lawbreaking exposed. Or they can point out the lawbreaking without disapproval: “PETA has convincingly revealed that our industry hasn’t yet got where it needs to get in making sure that animals are properly treated. The horrible torture of sheep in these videos is something we needed to know. And it’s something the public deserves to know. If PETA broke some fairly minor laws to get the proof, so be it. That changes nothing about the important evidence PETA has unearthed.”

I have long advised my clients to shrug off minor lawbreaking, such as when demonstrators trespass on private property, and to discourage the police and other officials from overreacting to such infractions.

Big-time lawbreaking that endangers people’s safety or does serious property damage is a different story. The company may have no choice but to call the cops. When that happens, it should bend over backwards to distinguish the activists’ viewpoint (which is a legitimate part of the debate no matter how radical) from their behavior (which crossed the line). I have had a number of timber industry clients over the years that were victims of serious activist vandalism. In each case, I urged the company to remind the activists – publicly – how many legal avenues were available. “They have a position that deserves to be heard, and there are many ways for them to make sure they are heard, from news conferences to lawsuits to legal demonstrations. Vandalism is not the right way. We hope they will come to next Tuesday’s meeting and express their views freely.”

Dangerous and harmful behavior needs to be stopped. But civil disobedience that breaks small laws in order to reveal a problem or dramatize a criticism should usually be tolerated, especially by those who are the source of the problem or the focus of the criticism. When someone is attacking you, I tell my clients, deal with the attack on the merits. Don’t look for ways to complain that they’re attacking you the wrong way.

Activism is an ecosystem. There need to be moderate animal protection groups like the RSPCA that would never break the law, as well as more radical animal rights groups that are okay breaking the law (some laws, anyway). The existence of the radical groups strengthens the hand of the moderate groups. The radicals’ niche in the ecosystem is to stay pure (that is, radical) and refuse to compromise. The moderates’ niche is to make the deal for half a loaf.

Of course it’s too much to expect the radicals to see it that way: that their job is to help the moderates win halfway victories. But that’s how it is. My clients let me push them toward moderate change largely because there are outsiders demanding immoderate (that is, more fundamental) change. As I wrote in a 2011 Guestbook entry:

It is the nature of extremists not to understand that their main contribution is to inspire, legitimize, and empower moderates. The moderates end up cutting the deal and getting the credit. The extremists end up feeling like they failed. But even if the moderates don’t publicly acknowledge their debt to the extremists, they should realize the extent to which moderate clout piggybacks on extremist threat. And the corporate and government establishments that end up reforming their policies in response to moderate critics shouldn’t forget that they were willing to listen to the moderates largely because extremists loomed in the background.

PETA is a fairly radical organization, not just in its willingness to break some laws but more importantly in the ideology on behalf of which it does so. And just as the wool industry shouldn’t point to PETA’s lawbreaking disapprovingly but might want to do so without disapproval, the same goes for PETA’s ideological radicalism. I wouldn’t do it right now, while there’s a bright spotlight on cruelty to animals in the sheep-shearing sheds. Right now it would feel like changing the subject even if it didn’t feel like a counterattack. But in a few weeks the time may come to say something like this:

PETA has been very clear that it is an animal rights organization, not an animal welfare organization. Most PETA campaigners take the position that animals shouldn’t be penned up, period – however humanely they are treated. They believe it’s wrong to treat animals as lesser beings than people – wrong to eat animals, wrong to do medical tests on animals, even wrong to take a sheep’s wool (however gently) without its permission, which of course the sheep cannot give. This is a coherent philosophical stance. It’s obviously not our stance. But we respect people who won’t eat meat or wear wool, whether they respect us back or not.

In short, PETA isn’t against wearing wool because it has learned that some sheep-shearing operations handle the animals inhumanely. It is against wearing wool because sheep are sentient creatures who should not be forced to give up their coats for the benefit of humans – especially when corporations profit from the coercion. You either believe that or you don’t. PETA does.

Most people don’t. But all people should hate to see animals mistreated. So PETA sensibly uses animal mistreatment to advance its cause.

Whether or not PETA succeeds in convincing anyone not to wear wool, it is successfully reminding everyone that sheep are sometimes cruelly mistreated in sheep-shearing operations. That’s unacceptable, not just to PETA but to almost everyone. Certainly it is unacceptable to our industry. For most of us in the industry, it is unacceptable because it’s bad for sheep. For all of us, even the most emotionally callous, it is unacceptable because it’s bad for business.

Our industry has worked for decades to improve animal welfare. The work has three prongs:

  • Policing our bad actors, weeding out of our ranks anyone who mistreats animals.
  • Training our people, making sure everyone in our industry knows what the standards are and how to implement them.
  • Raising the bar, moving toward ever-higher standards of animal welfare in our operations.

PETA’s videos prove that our work is far from done. They prove that even the first prong – policing the bad actors – is far from done. Horrible things still happen in our industry, and PETA caught some horrible things on tape.

Are those horrible things commonplace and perhaps even encouraged in our industry, as PETA sometimes claims? Or are they rare and getting rarer, as we claim? In this debate, the burden of proof is on us – and it won’t help to put out competing videos of well-treated sheep. What evidence do we have that we are really policing our bad actors, training our people, and raising the bar? And what improvements are we willing to make in response to the evils PETA has revealed? Here are some answers….

One of the main goals here is to remind people – very respectfully – that while they agree with PETA that cruelty to animals should be stopped, they probably don’t agree that Australia’s wool industry should be abolished.

Obviously my seven-paragraph model is long-winded. For many uses, the industry needs sound bites, not essays. But longer, more nuanced explanations of the industry position have real value too – internally as well as externally. I advise my clients to write the long explanations first, and then debate those long explanations: “Do we really believe X? Are we really going to admit Y? Can we really prove Z? Are we really willing to promise A, B, and C?” Then work on producing sound bites that capture your core messages.

For more on dealing with animal rights extremists, see my 2009 Guestbook entry on “Managing the outrage of extremists” – which is really about managing the outrage of the much larger segment of the public that is sympathetic to some of what the extremists are saying. It ends with two stories about PETA.

Readers may also want to check out Terry Sim’s article based mostly on this response.

“Don’t clean up the carcinogens in our park!” neighbors demand

name:Tony Jaques
This guestbook entry
is categorized as:

      link to Precaution Advocacy index
      link to Outrage Management index

field:Issues management consultant
date:July 20, 2014
email:tjaques@issueoutcomes.com.au
location:Australia

comment:

In response to Noel Turnbull’s post about the community not wanting regulators to implement remediation they believe is unnecessary, how do you deal with this problem?

You have written widely about the public not being concerned about real risks. But how do you deal with a situation where regulators want to spend public money remediating a problem where there is limited evidence that a real risk exists at all?

peter responds:

Tony Jaques and Noel Turnbull are two of the preeminent issues management experts among Australia’s public relations professionals. Tony runs a consultancy called Issue}Outcomes and teaches at RMIT University. His free bimonthly issues management e-newsletter, “Managing Outcomes,” is well worth subscribing to. Formerly communications head of Victoria’s Environment Protection Authority, and then CEO of the Turnbull Fox Phillips (later Turnbull Porter Novelli) PR consultancy, Noel also now teaches at RMIT. His blog is excellent reading. Both Tony and Noel have long been interested in the outrage management component of risk communication, and both have lots of relevant publications on their respective websites.

The Noel Turnbull blog post you’re referencing, posted on June 23, 2014, is entitled “A paradoxical risk communication problem.” It concerns a park in Noel’s neighborhood that was once the site of a Victorian Gas & Fuel facility. As a result of that long-ago industrial use, there are contaminants in the park soil. The local council is proposing to close the park, dig up the soil, remove the contaminants, put in new soil, and replant the grass and garden – all at public expense.

Under many circumstances, you’d expect to find local residents and park habitués demanding immediate cleanup of all nearby carcinogens, regardless of cost. The “paradox” Noel references in his title is the fact that this time the inevitable rally – which he joined – was demanding instead that the authorities leave the park the way it is. In the blog’s last paragraph Noel writes: “But most importantly the situation is totally paradoxical – the official body is saying the park is not safe and the people are saying it is. Not even Peter Sandman has had to deal that often with an issue as unusual as that.”

Of course there’s nothing unusual or paradoxical about people shrugging off a risk. That’s what the precaution advocacy component of risk communication is all about: Even a serious hazard can leave people apathetic when nothing about the situation provokes their outrage. But most of the obvious examples of high-hazard low-outrage risks are things like eating too much, exercising too little, smoking, and driving without a seatbelt – familiar, voluntary, chronic, morally irrelevant, etc. link is to a PDF file Industrial contaminants lurking beneath the grass and soil where innocents unknowingly play? That sounds like it ought to be high-outrage, whether the actual hazard is high or not.

But not always, obviously. I don’t know the circumstances well enough to say for sure why there’s more outrage about the proposed cleanup of Noel’s neighborhood park than about the contamination, but here are some guesses:

  • As Noel emphasizes: “About 80% of the cleanup cost will be borne by ratepayers and the chances of getting the full cost from the government, which once owned the site, are probably nil.” It’s always easier to get outraged about a problem someone else will pay to remediate than one you’ll have to pay for yourself.
  • The chief use of the park according to Noel is for dog-walking. So the problem isn’t mostly toddlers digging in contaminated soil; it’s dogs pooping in contaminated soil. That sounds like less of a problem.
  • There’s no smoking gun to rally around. Noel points out that “there was remediation some 30 years ago; what’s left is covered by half a meter of soil; there appear to be no cancer or other ill-health clusters around the area; and the garden has flourished.”
  • The opinions of scientists count for less and less in today’s world. We don’t much trust expert warnings anymore (or expert reassurances either). And of course we have never trusted government officials. So people mostly feel okay deciding for themselves whether the park is safe or not. They know they can’t actually tell, but they believe the experts and officials probably can’t either.
  • People may suspect that the remediation will take forever, that they could be forced to endure years living near an ugly hazardous waste site instead of an attractive neighborhood amenity. We all know what that would do to property values. Not to mention that digging up the contaminants could pose more risk than leaving them where they are.

Perhaps most important, there seems to be a risk communication seesaw operating here. If local residents are ambivalent about whether the park should be cleaned up or not, the council’s one-sided insistence on a cleanup would predictably have provoked the locals to dig in their heels. The seesaw response truly is paradoxical. We resolve our ambivalence by taking the “other side” from the one the authorities are taking. If the council had insisted instead that remediating the park was simply too expensive and people would just have to live with the park’s modest dose of carcinogens, park users might very well have rallied on behalf of a cleanup.

Better yet, the council could have moved to the fulcrum of the seesaw, voicing its own ambivalence about whether or not a small but real risk justified an expensive cleanup. That would have encouraged community members to move to the fulcrum as well. Occupying the fulcrum together would have meant working together to resolve their shared ambivalence about the shared dilemma. That in turn would have encouraged minimal outrage about either the contamination or the cleanup, and maximal attention to the data: How small a risk is it really, and how expensive a cleanup? The fulcrum of the risk communication seesaw is where adults live – where outrage tends to be low and data-reliance high.

One of the most famous examples of moving toward the fulcrum was the so-called “Tacoma Process,” initiated by the U.S. Environmental Protection Agency in 1983. (I was a peripheral player.) The focus was an arsenic smelter operated near Tacoma, Washington by the ASARCO mining and minerals company. There’s no question the smelter’s emissions were hazardous. But the smelter was an important local employer, and it was fairly clear that the cost of serious emissions reduction would probably force the plant to close. (Companies routinely voice this threat, of course, but in Tacoma it looked more-than-usually valid.) Instead of simply deciding what arsenic standard to promulgate, EPA head William Ruckelshaus decided to launch an experiment in participatory democracy, asking the people in the community and the workers at the smelter to help him figure out the right compromise between jobs and environmental health.

I attended some of the meetings EPA hosted. They were often raucous; even at the fulcrum of the seesaw, participatory democracy isn’t necessarily gentle or even thoughtful. And arguably the process let ASARCO off too easily, as advocates of various positions went after each other instead of the company. The Tacoma Process obviously didn’t quell everybody’s outrage. Still, nearly everyone who watched or participated in the process came away realizing that the dilemma was indisputably difficult. Many people attended Tacoma Process meetings wearing one-word buttons on their chests. Some said “Jobs.” Some said “Health.” Some said “Both.” There wasn’t a “Wow, this is a toughie” button – but most people got it that what to do about the ASARCO smelter was genuinely a toughie.

It’s not that rare for communities to oppose a cleanup that regulators want to do. People in the Seattle-Tacoma area were split pretty evenly in the ASARCO jobs-versus-environment debate. But a few years later when EPA tried to force a locally popular chain of restaurants to stop offering its featured dish, wood-smoked salmon, because of the carcinogenicity of wood smoke, the locals united behind the restaurants. To this day, in fact, proposed restrictions on wood smoke tend to arouse “Don’t Tread on Me” outrage in even the most reliably crunchy-granola environmentalists. Most communities, even communities that consider themselves environmentally conscious, are often willing to sacrifice marginal environmental benefits for other sorts of benefits that they consider bigger – if and only if they’re not outraged about the environmental insult.

Managing the seesaw better is just one of many strategies the council might have used if its goal was to convince park neighbors and park users to support the cleanup. For a convenient list of some of the others, see my recent Guestbook entry on “What’s in the precaution advocacy toolkit?

What if you’re on the other side of this sort of debate, aiming to avoid a cleanup you consider excessive?

As you might expect, canny companies sometimes make use of the fact that locals don’t always care as much about environmental protection as they do about other priorities. My favorite example: I worked with a mining company that was the Principal Responsible Party for a hazardous waste cleanup in rural Anaconda, Montana. The key question was whether regulators would let the company cap the site with the waste in situ, or would force the company to dig it all up and deposit it elsewhere, a much more expensive proposition. The regulators were ambivalent themselves about whether an offsite remedy was really needed, and were therefore quite likely to be responsive to community wishes. So the company worked hard to keep local outrage about the waste low.

One of the things it did was to say to the community – openly and frankly – that it was hopeful that the regulators would accept an onsite remedy, and wanted their support for that outcome. Noting that the tech specs for capped hazardous waste sites were remarkably similar to the tech specs for golf courses (manage water intrusion, replace your divots, etc.), the company pledged to build the community a Jack Nicklaus golf course on the site if the regulators decided an onsite remedy was sufficiently protective.

The remedy decision was still up to the regulators, of course, based on technical criteria (hazard criteria, in my jargon). But instead of dealing with an outraged community demanding an offsite remedy, the regulators faced a community likely to become outraged if denied its golf course. Since the regulators were undecided about what remedy to require, community sentiment was bound to be highly influential, and in this case community sentiment favored an onsite remedy. So the regulators approved the cap, the community got its Nicklaus golf course, and the company saved a lot of money.

Assuming the hazard was sufficiently low that an onsite remedy was appropriate, this was a win-win outcome for community and company. Of course if a capped site would have posed an unacceptable hazard, the company’s effort to seduce the community with the promise of a golf course would have been unethical. I think it would have been unsuccessful as well: Opponents of the onsite remedy would have had a stronger case, the community would have become outraged at the company’s attempt to “bribe” them to sacrifice their health and their children’s health, and if all else failed the regulators would have had the hazard data they needed to insist that the company remove the waste instead.

I don’t know how much hazard is posed by the residual waste under Noel’s neighborhood park. But if he’s right that the hazard is acceptably low, the community’s preference (as park users, park neighbors, and taxpayers) to have the park left as it is should be honored. And if the hazard is unacceptably high, the council needs to hone its precaution advocacy skills.

What’s in the precaution advocacy toolkit – and what’s the right mix of tools?

name: Thomas Bergbusch
This guestbook entry
is categorized as:

      link to Precaution Advocacy index

field:Economist (once worked in disaster communications)
date:July 12, 2014
location:Canada

comment:

Very interesting clarification in your recent reply to Charlie Morecraft, “Scared safe.”

But it raised an issue, perhaps one you have answered already, with respect to the appropriate mix of strategies to influence people to change their behavior or demand change, not go into denial, etc.

If I have been following you correctly, there are three elements in the precaution advocacy toolbox:

number 1
Fear appeals, useful but temporary (or targeted) in effect.
number 2
Outrage provocation (subject to the law of conservation of outrage).
number 3
Positive messaging. If outrage is a “stick,” is not positive messaging a carrot? Selling a brighter future, talking about entrepreneurial opportunities, depicting a healthier and wealthier and more secure life for our descendants – that is a carrot.

But what is the appropriate mix of these three approaches? (Perhaps I have missed some.) I understand that every situation is different, but is there some guiding rule as to how one might apportion use of these strategies? Just as there is a limit to how much someone can be outraged, is there a limit to how much people can be motivated by a combination of these different kinds of appeals?

peter responds:

I have no quarrel with the three precaution advocacy approaches you list: scaring people; provoking a different sort of outrage, such as anger; and motivating precautions with positive goals. (My personal favorite example of the positive approach right now: “Take care of your health so you live to see your grandchildren grow up.”)

As you anticipated might be true, your list is incomplete. Here are a few more tools in the precaution advocacy toolkit:

number 4
Appeals to needs. Appealing to people’s needs is often more powerful than appealing to their emotions, in part because it can be done more subtly. Thus much advertising suggests that buying a particular product is likely to make you richer, more successful, more popular with your friends, more loved by your family, etc. People aren’t necessarily convinced by the ads that the product will work as promised. But if the need to be rich, successful, popular, or loved is strong, then appeals to that need can get people to buy without any cognitive change. The downside is that people feel foolish doing things to satisfy needs they don’t actually satisfy – a feeling we call cognitive dissonance. So either you have to follow up with a better reason to continue doing the recommended behavior, or you have to keep triggering the need. That’s why advertising depends so heavily on repetition.
number 5
Rewards and punishments. Kids brush their teeth to get parental praise or stickers or permission to stay up a little longer. Adults stay under the speed limit to avoid tickets. A big reward or a big punishment works straightforwardly; people do what they have to do to get the reward or avoid the punishment. Small rewards and punishments, on the other hand, are more like appeals to needs. If the reward or punishment is big enough to motivate the desired behavior, but not big enough to make the behavior feel sensible, cognitive dissonance kicks in, and people search for longer-lasting rationales for the new behavior. If they don’t find any, they stop doing it. But if you have a case to make for the precaution you’re pushing, then reward or punishment is a good first step.
number 6
Third-party endorsements. Take this vitamin because renowned medical school experts say everyone should take it. Reduce your carbon footprint by following the same household routines your favorite movie star follows. Tornado-proof your house the way six of your neighbors have already tornado-proofed theirs. Refuse to buy foods with genetically modified ingredients because people in your crowd all believe GM foods are dangerous. Doing things because someone else (or everyone else) is doing them may feel fine. But quite often third-party endorsements also arouse cognitive dissonance; they’re sufficient to motivate the behavior but not sufficient to make the behavior feel sensible. In that case you must either keep bombarding your audience with endorsements or segue to more sustainable reasons for the behavior.
number 7
Foot-in-the-door. Appeals to needs, rewards and punishments, and third-party endorsements are all foot-in-the-door strategies – that is, they’re good first steps but they’re likely to arouse cognitive dissonance. The most basic foot-in-the-door strategy: Simply ask people to do something really easy – maybe just sign a document lots of people have already signed that says they believe a particular precaution is wise. If this foot-in-the-door behavior is easy enough, and benign enough, they probably don’t need much of a reason to do it. They’ll do it because you asked nicely and they don’t want to be discourteous. Then pivot on this “behavioral commitment,” praising what they’ve already done and suggesting some other, slightly more difficult things they’ll probably want to do too, since this is clearly an issue they care about…. (For more on how cognitive dissonance can be used to motivate precautions, see Brian Day’s book chapter on “Media Campaigns.” link is to a PDF file
number 8
Precaution advocacy through outrage management. Quite often what looks like a precaution advocacy problem is really an outrage management problem in disguise. That is, the problem isn’t so much that people aren’t outraged enough about the risk; it’s more that they’re excessively outraged about the precaution. If industrial employees refuse to wear their safety gear, for example, they could be insufficiently worried about workplace injuries (so you need to do precaution advocacy about injuries) – or they could find the safety gear uncomfortable or geeky or hard to work in (so you need to do outrage management about the safety gear). Similarly, a doctor trying to talk a patient into a colonoscopy has to decide if the problem is mostly insufficient outrage about colon cancer or excessive outrage about the procedure.
number 9
Efficacy messaging. One of the most common reasons why people don’t take precautions is because they don’t know how. Or they think they don’t know how; they’re experiencing performance anxiety about the precautions. Or they think the precautions won’t work anyway, so why bother. These are all efficacy problems. Of course teaching people how to take a precaution and convincing them that they can do it and it will work aren’t effective messages if they’re not even worried about the risk yet. Precaution adoption occurs in stages, link is to a PDF file and the right messaging changes as people move from stage to stage. Talking prematurely about efficacy is an error. But a far more common error is to keep telling people how dangerous the risk is long after they’re already convinced that it’s dangerous, but far-from-convinced that they can do anything effective to protect themselves.

This is still not a complete list. For more tools that belong in your precaution advocacy toolkit, see the Precaution Advocacy Index, especially my 2007 article “‘Watch out!’ – How to Warn Apathetic People.”

I don’t have a good answer to your question about the appropriate mix of approaches for an effective precaution advocacy campaign. It’s not just that every situation is different, though that’s certainly true. It’s also that the right approach (or the right mix of approaches) changes as people move through the precaution adoption process.

But I do have one useful rule of thumb: Don’t think of your audience as a tabula rasa. Instead of focusing on the overbroad question of how best to communicate about this risk and this precaution, focus more on the narrower question of how to do so to this audience.

That means thinking hard (and maybe even doing some quick-and-dirty research) about your audience’s preexisting perceptions, misperceptions, beliefs, attitudes, values, feelings, and experiences that are relevant to the risk you’re trying to warn them about and the precautions you’re trying to convince them to adopt. More often than not, you’ll find that you have several different audiences – different not just in their demographics but in their psychographics, in the way they already see the issues you want to talk to them about.

Then, for each audience, classify all this preexisting psychological material into two categories: the factors that predispose these particular people to do what you want them to do, and the factors that predispose them to avoid doing what you want them to do. Call the first category the appeals: the reasons people already have for going your way. Call the second category the barriers: the reasons they have for resisting.

The most effective precaution advocacy doesn’t just talk about the recommended precautions and the risk they’re meant to mitigate. The most effective precaution advocacy talks chiefly about the appeals and barriers most relevant to those precautions in the minds of a particular audience.

In general, I think, appeals matter more than barriers. You want to remind your audience of the reasons they already have for doing what you propose. And you want to do everything you can to reinforce those reasons in their minds. But sometimes the barriers are uppermost in people’s minds, and they’re in no mood to think about the appeals until you’ve done something to address the barriers: ameliorate them, circumvent them, at least acknowledge them.

In a nutshell, precaution advocacy isn’t mostly talking about risks and precautions. It’s mostly talking about appeals and barriers. Go where that takes you – to fear appeals or other sorts of outrage provocation; to positive messaging; to foot-in-the-door approaches like appeals to needs, rewards and punishments, or third-party endorsements; to outrage management about the precaution; to efficacy messaging; etc.

“Scared Safe?” – pros and cons of fear appeals in employee safety

name:Charlie Morecraft
This guestbook entry
is categorized as:

      link to Precaution Advocacy index

field:Safety
date:June 10, 2014
location:Florida, U.S.

comment:

I just found your ridiculous article on the web about scare tactics.

My talk points out that what is scary is having an accident. Destroying your family because you refused to follow procedures or use safety equipment is scary. If you had taken the time to watch my video you would have realized that.

Instead you sit there and criticize. Tell me, what have you done in your life to prevent people from being hurt?

As far as the money goes, again if you had done your research you would have found out that a large percentage of the money goes to charity. I speak to police, firefighters, and military all over the world without charge, paying my own way.

From those that have been given much, much is expected. What exactly have you done???

peter responds:

Readers unfamiliar with Charlie Morecraft should check out his website and some of his YouTube videos (or the videos he sells).

In 1980, Charlie’s website explains, Charles T. Morecraft worked at an Exxon refinery in New Jersey. With more than 15 years of on-the-job experience, he “knew all the safety regulations and he knew all the shortcuts around them too.” The website continues:

In 1980, shortcuts nearly cost him his life when a routine job turned tragic. Burned over 50% of his body, Charlie spent five years in the hospital. His family fell apart. He lost everything. “All for what?” is the question he continues to ask himself, and you, today. Charlie, a dynamic speaker who touches an audience through his autobiographical story, emphasizes taking responsibility for one’s actions and one’s safety. Standard training meetings, videos and seminars demonstrate how to follow safety procedures. Charlie Morecraft tells you why you should.

I’m pretty sure the anger at me in Charlie’s comment must refer to a 2005 article by Dave Johnson, longtime editor of ISHN (Industrial Safety and Hygiene News). The article, entitled “Scared Safe?”, discussed the pros and cons of fear appeals as a way of motivating employee safety.

I was on the “pro” side. So was Charlie, of course. But the article started with a provocative challenge, insisting that most safety experts are leery of scare tactics:

[L]et’s face it, most safety and health pros (and we surveyed about 80) take a dim view of shock therapy for safety’s sake.

Scare tactics are crap, cheap, lazy, transparent, self-serving, short-term, sophomoric, hokey, cruel, exploitative and manipulative, say our survey respondents. And they’re just warming up.

Later in the article, Dave quoted from “Fear of Fear,” a 2003 website column that I had written jointly with my wife and colleague Jody Lanard, in which we complained that even though government officials want the public to take precautions, they are unduly frightened of frightening people with emphatic warnings. He ended his article with our conclusion that “There is only one thing worse than being criticized for ‘unduly’ frightening people – and that is being criticized for failing to warn people.”

“Scared Safe?” was initially part of an ISHN “e-zine” that was emailed to subscribers to the regular magazine. It wasn’t part of the magazine itself, but it was posted on the ISHN website, where it remains.

I posted it on my website as well, with Dave’s permission. I think Charlie must have seen it there and jumped to the conclusion that I consider his lectures and videos crap, cheap, lazy, etc.

For the record, I think fear appeals are a useful way to motivate people to take precautions. And Charlie Morecraft’s sustained success as a motivational speaker is evidence that he is effective not just at frightening his audience about workplace risks, but also at inspiring them to pay increased attention to safety.

I haven’t seen follow-up research on whether Charlie’s presentations and videos actually translate into sustained improvements in safety performance, but I have no reason to doubt that they do. I don’t have any research on whether my presentations and videos lead my audiences to do better risk communication over the long haul either.

That said, there are drawbacks to fear appeals. I have written about these before, most recently in a 2011 Guestbook entry on “Scaring people into getting their flu shot.” As I wrote then, “there is an extensive research literature exploring the conditions under which fear appeals don’t work, or even backfire.” I urged interested readers to check out “an early and still wonderful introduction to this complicated issue,” Kim Witte’s 1992 monograph on “Putting the Fear Back into Fear Appeals.”

Among the drawbacks of fear as a motivator, these strike me as paramount:

  1. People get desensitized to fear appeals, so it takes more and more horrific messages to arouse sufficient fear to motivate action – and eventually nothing is horrific enough to do the trick.
  2. Excessively strong fear appeals may trigger a psychological circuit-breaker. People go into denial rather than experiencing the fear.
  3. People who feel highly efficacious can tolerate a lot of fear. But people who feel little ability to protect themselves – who feel that there’s nothing to be done or nothing they’re capable of doing – can tolerate less fear before going into denial.
  4. The sort of fear that can be aroused by communication (as opposed to experience) tends to be transitory. The new fear occupies our attention only until newer ones get piled on top, so if we don’t act fast we probably won’t act at all.
  5. It’s easier for fear appeals to motivate a one-time action (like getting a vaccination) than a long-term new behavior pattern (like obeying safety procedures).
  6. Not all fear appeals are credible. People look for reasons not to be fearful, and skepticism about whether the fear-monger is knowledgeable or unbiased is one likely rationale for continuing apathy.
  7. Fear appeals that strongly imply that the feared event is imminent and near-certain are falsifiable; when it doesn’t happen, the result can be “warning fatigue.”

Some of the factors on this list may diminish Charlie’s effectiveness; others probably don’t apply.

I also worry that Charlie’s emphasis on his responsibility for his own accident – and on all employees’ responsibility for making sure they obey safety rules – could be interpreted as giving employers a free pass. Of course Charlie is right that many accidents could be prevented if employees would focus more on safety. But many accidents could also be prevented if supervisors pushed speed and productivity less, if some workplace hazards were engineered away, if management did a better job of building a corporate safety culture, etc. I don’t know how much attention Charlie pays to these systemic factors.

Despite my quibbles, it is certainly true that people get accustomed to working in risky situations without anything going wrong. So they get careless … and then somebody gets hurt. In that extremely common situation, the jolt of a Charlie Morecraft presentation can only help.

On balance, I believe that scaring people about dangerous situations does far more good than harm. So does Dave Johnson. He listed Charlie (and me) on his January 2012 list of “leaders of the environmental health and safety world.” (Link goes to a Flash video.)

Raising outrage about economic inequality

name:Peter Lindfield
This guestbook entry
is categorized as:

      link to Precaution Advocacy index

field:Chair and CEO, Carlisle Institute
date:June 4, 2014
email:peter.lindfield@carlisleinstitute.org
location:Canada

comment:

I am interested in your advice on the dynamics of inequality in the U.S. and why (especially since the financial crisis of 2007) a culture of outrage hasn't emerged in recent years.

In fact, as economist Paul Krugman has noted, the most prominent outrage in the U.S. seems to come from the Tea Party, in favor of more inequality.

The lack of prolonged outrage with respect to economic equality in the U.S. is puzzling especially given the outrage over civil rights in the 1960s and 1970s and the public hostility over the war in Viet Nam. Why did the Occupy Wall Street movement fail to gain traction?

The enormous interest in and the popularity of French economist Thomas Piketty’s new book, Capital in the Twenty-first Century, has propelled the issue of economic inequality to the forefront of intellectual discussion in the U.S. And yet the interest in this issue may result in no additional impetus behind any sustained protest.

I’m writing an article on this and would much appreciate your views.

peter responds:

As I’m sure you realize, others would pose exactly the opposite question: Why are Americans so preoccupied with economic inequality? That preoccupation is expected of Europeans, but the U.S. is supposed to be an anti-socialist bastion of free enterprise. There are plenty of American economists to the right of Paul Krugman who argue that widespread outrage about the gap between rich and poor reelected Barack Obama in 2012, and prevented the enactment of economic policies that could have greatly benefited the poor (and the rich) by reducing regulation and taxation, encouraging innovation, fostering initiative, etc.

The left wonders (as you do) why Occupy Wall Street has pretty much died out, and why so few Wall Street honchos were actually punished for launching the Global Financial Crisis of 2007–2008. It wonders why Piketty’s book – which argues that unless the wealthy are taxed much more heavily than at present, increased income inequality is inevitable because capital accumulation is outpacing overall economic growth – has generated more intellectual debate than political action. It wonders why there’s more outrage coming out of the Tea Party than directed at the Tea Party.

The right wonders why Occupy Wall Street captured the public’s (or at least the media’s) imagination in the first place, and why our society continues to scapegoat the leaders of the financial industry for everything that goes wrong. It wonders why a leftist French economist could produce an American bestseller. It wonders why Tea Party candidates keep losing elections to Democratic centrists, and now appear to be losing primaries to Republican centrists as well.

For what it’s worth, here’s a Google Trends analysis of searches for the term “income inequality” from 2004 to the present:

Judging from Google searches, then, U.S. interest in income inequality was surprisingly flat through the worst of the economic crisis. It started rising in the fall of 2011, and really took off in the fall of 2013. The five months since December 2013 are the five all-time highest months so far.

Increased interest as measured by Google searches isn’t the same thing as politically potent outrage, of course. But it’s a long way from apathy.

So is the economic inequality outrage glass half-empty or half-full? Wall Street Journal editorialists complain endlessly that the President and his party are fomenting class warfare with get-the-rich rhetoric. Your complaint seems to be that there isn’t as much “class warfare” (not your term, obviously) as you think the situation justifies. Presumably there are analysts in the middle who take heart from both sides’ disappointment.

That said, I’ll respond to your question the way you have framed it. Why isn’t there more outrage about economic inequality? And – though you didn’t quite ask this – what can be done to foment more such outrage? If someone wants to raise the opposite question, how best to quell economic discontent, I might take a crack at that one too, even though I mostly agree with you that economic inequality is a serious and growing problem that merits the outrage you’re trying to arouse.

Kinds of economic inequality

One fruitful way to attack your question is to distinguish the various kinds of economic inequality. Although “income inequality” is by far the most popular term, I think some other aspects of economic inequality are likelier sources of outrage.

I’ll try to assess these various kinds of economic inequality solely in those terms: How likely a source of outrage are they? I don’t feel qualified to judge how valid a source of outrage they are. I’m nowhere near sure which kinds of economic inequality (if any) are worse than they used to be, or which ones are especially damaging to the country. I’ve read lots of articles that claim to prove how bad the situation is, and lots of other articles that claim to prove it’s not especially bad. (The recent debates over Piketty’s evidence are typical.) As usual with hot-button issues, both sides are inclined to cherry-pick their data. It’s rare to read anyone on either side who deigns to acknowledge that the other side is right about this or that particular point – at least not in newspaper op-eds or magazine articles, which is most of what I’ve been reading.

Experts may actually know which side is right about particular points. True Believers simply know which side they believe about all points. The rest of us are unsure what to think. Or we simply extrapolate from our own limited experience: “I’m doing okay so economic inequality isn’t a big national problem” or “I’m underwater so economic inequality is a huge national problem.”

Is this uncertainty part of the reason why popular outrage hasn’t grown as much as you wish it had? Maybe. Certainly it’s evidence that the people writing on both sides of the issue feel plenty of outrage themselves, too much to acknowledge the other side’s part of the truth.

Here then is my take on seven different kinds of economic inequality.

number 1
Income inequality

This is where the discussion almost always starts: Some people get more money than other people. I’m writing “get” rather than “earn” to avoid the implication that we receive the income we deserve. It would be hard to argue that a day trader, for example, “earns” (deserves) more money than a schoolteacher. But the widespread use of the term “earn” undoubtedly reflects what many people actually feel or at least half-feel: that you get what you earn and those without much income ought to go out and earn more. That feeling is a big piece of the challenge when you’re trying to arouse outrage about income inequality.

number 2
Outcome inequality

Since the unspent income of high-income people accumulates, whereas low-income people have no unspent income, wealth ends up more unequal than income. I think there’s more outrage potential in the unequal distribution of wealth than in the unequal distribution of income. But it’s tricky. The majority of Americans don’t much like estate taxes on the wealthy. People hope they’ll get rich too someday, and when they do they want to be able to keep the money and pass it on.

Also, the flipside of the fact that wealth inequality is higher than income inequality is that consumption inequality is lower. The more money you get, the less of it you spend. So your wealth accumulates. But meanwhile the way you live is less different from the way people with lower incomes live than it could have been if you’d spent your whole income. Technology and mass production have also reduced consumption inequality in many ways. Conservatives who want to suppress outrage about outcome inequality emphasize this democratization of lifestyle. The difference between a refrigerator and no refrigerator a few generations ago, they rightly point out, mattered a lot more than the difference between a Sub-Zero and a Frigidaire today. The TVs and cell phones of the poor are almost as wondrous as those of the rich. And almost everyone in the U.S. has indoor plumbing and potable water.

Still, high-income people live much better material lives than low-income people – and the difference in outcomes has more outrage potential than the difference in incomes. Liberals who want to trigger more outrage about outcome inequality should emphasize that increased wealth doesn’t just mean nicer homes, cars, vacations, and appliances; it also means better nutrition, healthcare, and education. Americans seem okay about the rich enjoying the fruits of their wealth – but not when necessities become luxuries and previously shared goods and experiences get stratified by wealth. Private schools, private parks, and concierge doctors arouse a lot of outrage when public schools, public parks, and public healthcare seem to be falling apart.

Does wealth inequality itself arouse outrage, even without explicit reference to schools, parks, and doctors? Watch this six-minute video on “Wealth Inequality in America.” It compares four distributions of wealth: (a) the equal, socialist distribution; (b) the somewhat skewed distribution that most Americans consider ideal; (c) The much more skewed distribution that most Americans think is the current situation in this country; and (d) the enormously more skewed distribution that shows our actual current state of wealth inequality. It’s a superb piece of outrage-arousing propaganda, as effective as any I’ve seen on this topic. But it’s just about money. For further enlightenment, read some of the comments on the video. Some are defensive, others discouraged. Not many sound roused to action.

number 3
Risk inequality

Risk inequality is a subset of outcome inequality. The poor lead riskier lives than the rich. Wealth buys protection: from illness, from pollution, from crime, from prosecution and conviction if you commit a crime, from unpleasantness of all sorts. Above all, perhaps, wealth buys protection from future poverty. Some people are one recession, lost job, or illness away from being on the streets. Many are one catastrophe away from a radical downshift in their quality of life. A few know they have an ample cushion, come what may.

Risk inequality is the sort of economic inequality to which the strategies of precaution advocacy apply most directly. The economic vulnerabilities of working-class and middle-class Americans – the holes in the safety net – strike me as powerful potential sources of outrage.

number 4
The rich are too rich

Economic inequality is typically framed in terms of rich versus poor. But if we’re going to dichotomize, much depends on where we draw the line. Focusing on the rich – the famous “1%” of Occupy Wall Street, or even the richest 0.1% or 0.01%, is obviously the easiest way to provoke outrage in everybody else. It’s them (the filthy rich) versus us (the not-filthy-rich).

American attitudes toward the very rich are very complicated. On the one hand, bashing the rich has a long history in this country; plenty of past politicians made it their trademark to a far greater extent than Obama. On the other hand, admiring the rich also has a long history. Today, too, you can make a case that many of the non-rich are consumed with envy of the rich and determined to bring them down. But then you read lists of the most admired Americans and find names like Bill Gates and Oprah Winfrey – people who accomplished big things, yes, but who also made big money doing so. Corporate CEOs, like politicians, are both much-admired and much-hated. Still, they’re an easy target.

number 5
The poor are too poor

Provoking outrage that the rich are too rich is hugely easier than provoking outrage that the poor are too poor – especially since most of the people you’re trying to get outraged are in the middle. Instead of dichotomizing the top 1% versus the bottom 99%, if we dichotomized, say, the top 80% versus the bottom 20%, we would be focusing our attention on the poverty of the poor. Intellectually and morally, that’s almost certainly where our attention belongs. But in outrage terms, getting the middle outraged at the top is a lot easier than getting the middle outraged on behalf of the bottom.

There are people who believe that economic inequality per se is a big problem, so any policy that lessens the gap between rich and poor is a good policy, even if it only impoverishes the rich without actually enriching the poor. But for those who think the big problem is poverty, impoverishing the rich is not a stand-in for enriching the poor. Redistributing wealth from rich to poor certainly does make the rich less rich. But whether it makes the poor less poor or damages the engine of everyone’s prosperity is a hotly debated question to which I don’t pretend to have the answer. Nor do I know whether (or when) “a rising tide lifts all boats.” I am pretty sure that redistributing wealth from the non-rich to the rich isn’t a good idea, and that seems to be what we’ve done in recent decades. But beyond that I’m out of my depth.

So are most of us. And maybe that’s the problem. We don’t know what should be done about poverty. We’re not convinced that soaking the rich is the answer, though some of us would like it to be. We’re not convinced that “trickle down” isn’t the answer, though many of us hope it isn’t. So our commitment to making the poor less poor remains purely intellectual, our commitment to making the rich less rich remains purely emotional, and neither finds much reflection in public policy.

I also need to acknowledge how self-indulgent this discussion of U.S. economic inequality would seem to billions of people in developing countries, to whom the U.S. “poor” look enviably well-off. If you think it’s hard to get middle-class Americans outraged about the poverty of the U.S. poor, try getting them outraged about poverty in Africa or Latin America. Many Americans are saddened by global poverty, and generous in their charitable contributions. But systemic change to reduce the disparities between rich countries and poor countries isn’t on our agenda. In fact, many of us resent the outsourcing of American jobs to impoverished people in the developing world.

Also worth noting is one of the key results of happiness research. (Yes, there is such a field of study, and it’s growing. See this Wikipedia article.) Increased income is correlated with increased happiness only near the bottom of the scale (up to about $75,000 a year, according to one 2010 study). Higher-income people don’t get any happier as they get richer. So if “gross national happiness” is the goal, alleviating poverty is a lot more fruitful than increasing wealth.

number 6
Opportunity inequality

What about the relationship between happiness and economic inequality? It turns out to be complicated. On the one hand, people tend to be happier when they set themselves high goals. In countries with more economic inequality, more people aspire to get rich – and the aspiration itself is conducive to happiness. On the other hand, upward social comparison – that is, envy – is often a source of unhappiness. Countries with more economic inequality have more people who feel bad about their inability to keep up with the Joneses; that’s why it’s easy to arouse their outrage at the super-rich.

In other words, feeling that you can get rich too someday is conducive to happiness, whereas feeling that you’re doomed to spend your life peering into the windows of people richer than you is conducive to unhappiness. Feeling that everybody is in the same boat – nobody’s really rich, nobody’s really poor, nobody’s ever going to be really rich or really poor – seems to lead to an intermediate outcome. Economic inequality provokes a lot of aspiration (which makes people happier) and a lot of envy (which makes people unhappier). Economic equality provokes less of both.

Which brings us to opportunity inequality, the flipside of risk inequality (#3). The rich aren’t just more protected than the poor from downside risk. The rich are also better positioned for upside opportunity.

Opportunity inequality is almost self-evident economically. The rich make money from their assets, not just from their labor; the first million is the toughest million. But it’s also true in a broader sense. Children with high-income parents don’t just inherit money. They also “inherit” other resources that help them seize opportunities: education, contacts, self-esteem, everybody else’s esteem, etc. As adults they often imagine they got where they are through merit. In the aphorism widely attributed to football coach Barry Switzer, “Some people are born on third base and go through life thinking they hit a triple.”

Most experts – not all, of course – believe opportunity inequality in the U.S. has increased in recent decades. That is, economic mobility has decreased. I’m not sure whether Americans actually have less economic mobility today than we used to have, but it’s pretty clear we have less than we now imagine we used to have. According to one 2012 study link is to a PDF file, 40% of American children born into the top economic quintile become adults in the top quintile. Worse, 43% of American children born into the bottom quintile are still in the bottom quintile as adults. Perhaps most tellingly, only 4% of those born into the bottom quintile ever rise to the top quintile. So much for rags-to-riches.

The U.S. also has less economic mobility than many other countries, including most of supposedly class-bound Europe. (In this respect Canada, where you are from, is much more like Europe than it is like the U.S.)

In general, countries with less economic inequality also have more economic mobility. That makes sense; it’s easier to rise from the bottom quintile to the top quintile if the quintiles are closer. But the U.S. has long nourished a national mythology – almost a civil religion – that it is an exception, a country with high inequality but also high opportunity, a country where people control their own destiny, where you may start out dirt poor but with determination, hard work, talent, gumption, and a little luck, you can end up filthy rich. Americans have traditionally been okay with income inequality and wealth inequality as long as there was plenty of opportunity at the bottom. Now it seems there isn’t much opportunity at the bottom after all, less than elsewhere and less than there used to be (at least less than we think there used to be). That makes the recent increases in income inequality and wealth inequality much less acceptable.

In short, opportunity inequality has enormous outrage potential. The problem is getting people to believe it. Surveys have traditionally shown Americans deeply committed to the American Dream. As a 2008 Brookings Institution study link is to a PDF file put it: “Americans have more faith than do people in other countries that they will receive economic rewards for individual effort, intelligence, and skills.”

But that may have changed. Here’s a stunning Gallup Poll graph:

Can an average American get ahead by working hard? In 1952, 87% said yes. In 1998, the number was down a bit to 81%. But in 2012 only 57% said yes, and in 2013 only 52%, a bare majority, believed in U.S. economic opportunity.

If you want to arouse outrage about economic inequality, focus on inequality of opportunity.

number 7
The system is rigged

Assuming it’s true that opportunity inequality in the U.S. is a growing problem (remember, not all experts agree with this assessment), a key question is why. There’s a large research literature on this question. Explanations include educational inadequacies, high levels of immigration, low levels of unionization, public health problems like obesity and diabetes, and of course income inequality itself (it’s harder to climb the economic ladder when the rungs are further apart).

But the explanation with the greatest potential for arousing outrage is that the system is rigged. It’s upsetting enough to think that the rich just happen to have greater opportunities than the poor, because of systemic problems that are getting worse. It’s far more infuriating to think that the rich have intentionally made it happen.

The argument that the system is rigged almost always focuses on the super-rich (the 1% or 0.1% or 0.01%) versus everybody else. It’s not usually argued (although it’s certainly arguable) that the system is rigged against the poor … only that it’s rigged on behalf of the rich. In fact, there is considerable outrage at the charge that both rich and poor are getting handouts at the expense of the middle class: crony capitalism for the rich; welfare, Obamacare, etc. for the poor; stagnation for the middle.

What’s infuriating isn’t just that the rich are selfish, doing everything in their power to protect and enhance their own wealth. The greatest outrage results from the claim that the rich have hijacked the government – that the United States is increasingly a plutocracy, run by its wealthiest few for their own benefit.

Exhibit A is political campaign contributions. It takes big money to win an election. So politicians bow to the wishes of those with big money to spend. Or worse yet, those with big money to spend simply pick out politicians who share their values and allegiances already, and pay their way into high office. According to this analysis, the super-rich are divided over how to treat the poor. The conservative super-rich see the safety net as a kind of coddling that undermines initiative and endangers the economic system, whereas the liberal super-rich see the safety net as noblesse oblige and perhaps a useful precaution against populist revolution. But both kinds of super-rich are united against systemic change that would endanger their wealth or their ability to garner more wealth – that is, their control of the system.

In sum, there is something of a disparity between the aspects of economic inequality that get the most rhetorical attention from activists and the aspects that are likely to arouse the most outrage in their audience.

The ideologues and activists who are most outraged about economic inequality focus a lot of their advocacy on these two claims:

  • Some people get paid obscenely more than other people. (#1 above)
  • Those at the bottom of the economic ladder lead appallingly difficult lives. (#5 above)

Both claims are clearly true. But neither has as much outrage potential as you might wish.

Among the claims with a lot more outrage potential, the biggest is this one (a combination of #6 and #7): The rich have hijacked the government and rigged the system in their own interests. They throw crumbs to the poor and leave the middle class to shift for itself. And to a large extent they have shut the door behind them. If you’re not already rich, your economic opportunity today in the United States is extremely limited.

If you want to arouse outrage about economic inequality in the U.S., I think that’s where you need to go (though only to the extent that you think it’s true, of course).

Three additional points

Besides focusing too much on low-outrage aspects of economic inequality and too little on those aspects with the highest outrage potential, what are some other barriers to arousing outrage about this issue, and how can these barriers be overcome? I will confine myself to three topics I think are important, though there are doubtless many others that also deserve attention.

number 1
Denial

In my basic risk communication typology, economic inequality is a precaution advocacy problem. You think the hazard of economic inequality is high. But people’s outrage about it is lower than you want it to be in order to get them to take action to address the hazard.

Whenever people aren’t as outraged by some situation as you think they should be, there are always two competing diagnoses about why:

  • Apathy – they don’t care enough to get outraged.
  • Denial – they care too much and can’t bear it, so they have tripped an emotional circuit-breaker, insulating themselves from feeling their outrage.

Of course there are other possibilities, such as ignorance (they don’t know it’s happening, and when they find out they’ll be suitably outraged) or disagreement (they don’t agree it’s happening, or they don’t agree it’s a bad thing). But apathy and denial are likeliest candidates here.

Denial can best be thought of as motivated apathy, even determined apathy. The litmus test to tell apathy from denial is to see how people respond to efforts to arouse more outrage. If those efforts tend to work – slowly and laboriously, probably, but at least the movement is in the right direction – then your problem is apathy. If your arousal efforts boomerang, on the other hand, if people actively resist getting outraged about economic inequality, resist even hearing about it, then you may be facing significant amounts of denial.

This boomerang effect isn’t just the way you can distinguish apathy from denial; it’s also why you need to make the distinction. When you say upsetting things to apathetic people, they get more upset – which is good, because it makes them likelier to take action. But when you say upsetting things to people in denial, you push them more deeply into denial – which is bad, because it makes them even less likely to take action.

So you need to know: Are Americans simply apathetic about economic inequality, or are they in denial about it? (I’m leaving aside here the Americans you think are already appropriately outraged – those who your political opponents think are excessively outraged. We’re focusing on the people whose outrage you are having trouble arousing.)

Apathy is common, even universal; there are always apathetic people. Denial is rarer. But it’s common enough that we always need to look for it, lest we misdiagnose and therefore mishandle a precaution advocacy problem. For some years now I have argued that what looks like American apathy about global warming actually hides a lot of global warming denial. Many of the persuasion strategies of environmentalists, such as guilt-tripping people for their excessive carbon footprints, backfire because they exacerbate the denial. (See my 2009 column on “Climate Change Risk Communication.”)

Is the same thing true of American apathy about economic inequality? I suspect the answer is yes.

For more on how to prevent denial and how to lure people out of denial, see the “Climate Change Risk Communication” column or my 2003 column on “Fear of Fear,” coauthored with my wife and colleague Jody Lanard. For more on dealing with apathy, see my 2007 column, “‘Watch Out!’ – How to Warn Apathetic People.”

You should also check out the work of John T. Jost and colleagues on what they call “system justification.” (See for example this book chapter entitled “System Justification: How Do We Know It’s Motivated?”) link is to a PDF file Jost et al. argue that “people are motivated to defend, bolster, and rationalize the social systems that affect them – to see the status quo as good, fair, legitimate, and desirable.” Although “the strength of system justification motives is expected to vary considerably across individuals, groups, and situations,” they say, “people are prone to emphasize their system’s virtues, downplay its vices, and consequently see the societal status quo as better and more just than it actually is.”

What’s the motivation behind system justification? According to Jost et al., it’s mostly unconscious. System justification is “reassuring” and “palliative” because it “enables people to cope with and feel better about the societal status quo and their place in it … reducing negative affect associated with perceived injustice and increasing positive affect and therefore satisfaction with the status quo.” The authors add: “This idea bears some resemblance to Marx’s notion that religion is the ‘opiate of the masses.’” Elsewhere Jost references the Marxist idea of false consciousness. System justification, in short, helps the disadvantaged feel better about their disadvantages. Obviously it also helps the advantaged feel better about their advantages. Everybody’s happier believing that the status quo is just fine.

The price: Organizing people to change the status quo becomes more difficult. Jost et al. don’t offer many clues on how to undermine system justification. They do emphasize that understanding the motivational goals that system justification satisfies “can help to clarify the circumstances under which people will challenge or criticize the system.” What are those circumstances? People will abandon system justification, they say, “when justifying the system no longer satisfies epistemic, existential, or relational needs. This may occur when the status quo itself offers no stability or certainty or may even be regarded as a source of threat rather than reassurance, or when it has become counter-normative to stick with an old regime when a new one is gaining in popularity.” At that point “the motivational impetus of system justification tendencies would be low and people might even work to change the status quo.” I don’t find this terribly hopeful: People will stop justifying the status quo when it is about to topple.

The system justification theory posits that people aren’t simply unaware of economic inequality or uncaring about it. Many who seem unaware or uncaring are actually motivated to misperceive economic inequality or to under-react to it. In my terms, they’re not apathetic. They’re in denial.

number 2
Efficacy

Reinhold Niebuhr’s famous “Serenity Prayer” (popularized by Alcoholics Anonymous and other twelve-step programs) asks God for “the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

Although we may often fall short of this goal in our private lives, with regard to public issues most people are quite good at it, especially the first part: accepting the things we cannot change. We tend not to waste a lot of emotional energy on issues we feel unable to influence.

As I wrote at length in “Climate Change Risk Communication,” low efficacy is an important aspect of apathy and an absolutely crucial aspect of denial.

Low efficacy can lead to apathy. If I believe I can’t do anything about your issue, it is sensible for me to focus instead on some other issue I can do something about. That’s the Serenity Prayer in action. (But sometimes low efficacy is merely a rationalization for apathy. I tell myself there’s nothing I can do rather than admit I don’t really care.)

Low efficacy can also lead to denial. If I care deeply about an issue, the feeling that there’s nothing I can do can be extraordinarily painful, especially if it worsens other emotions like fear or guilt. Understandably, I may find these feelings unbearable. So I convince myself I don’t care. Writing about the nuclear arms race, psychiatrist Robert Jay Lifton called the result “psychic numbing”: denial rooted in hopelessness and helplessness.

This point from the “Climate Change Risk Communication” column is also worth reiterating:

The nature of journalism exacerbates the problem of low efficacy. The media tend to define their audience as, well, an audience: bystanders rather than players. What is sometimes called “mobilizing information” – information that would help the audience do something about an issue – is comparatively rare in hard news, relegated mostly to sidebars and features. (Decades ago when I was doing PR for activist groups, I used to try to persuade reporters to put my group’s phone number into the story, so interested readers could more easily call and get involved. I rarely succeeded.) Gerhart Wiebe coined the phrase “the syndrome of well-informed futility” to describe this effect of modern journalism on citizenship. Instead of feeling a civic obligation to do something about issues, we feel a civic obligation to know about them.

Efficacy, in short, is where apathy and denial meet. When people are comfortably aware of an issue and comfortably convinced that there’s not much they can do about it, they’re apathetic – and their feelings of low efficacy are part of their apathy. When people are so angst-ridden about how powerless they feel that they can’t bear it and go numb instead, they’re in denial – and their feelings of low efficacy are part of their denial. Efficacy messaging – offering people things they can do – is thus a doubly useful strategy: an important part of communications aimed at apathy and a crucial part of communications aimed at denial.

People’s feelings of low efficacy about economic inequality take several forms:

  • Powerlessness: There’s nothing I can do that will really help. (This is often called “self-efficacy.”)
  • Hopelessness: There’s nothing anyone can do that will really help. (The standard label for this one is “response efficacy.”)
  • Cluelessness: Even if I had the power, it’s not clear what the right thing to do would be. (Maybe we should call this “conceptual efficacy.” Even very powerful people often feel clueless about what to do.)
  • Ambivalence: I’m doing okay in the current system. I see how unfair it is, but deep down do I really want to change it? What can I do that isn’t hypocritical and won’t foul my own nest? (This isn’t really a kind of low efficacy, but it often masquerades as low efficacy, or provokes it; it’s certainly a major source of inaction.)

Efficacy may be an important explanation for why Occupy Wall Street lost steam. As the weeks wore on and the weather got colder, it became harder for people to hang onto their conviction that they were doing something useful. Many who departed went to work in 2012 political campaigns instead, which may not have been as symbolically pure but felt more concretely practical.

Those of us following Occupy Wall Street from the sidelines had the same problem. We may have agreed with the demonstrators, but we had trouble seeing pithy slogans, affinity groups, drum circles, and tent encampments as a path toward greater economic equality. Which is partly why we stayed on the sidelines.

Bottom line: Messaging about economic inequality needs to offer people things to do. I know how empty that advice sounds. It’s not like I’m about to roll out a pretested list of practical, meaningful, efficacious action items for fighting economic inequality. I have no list. But I do know that it’s hard to arouse or sustain outrage in people who have nothing useful to do with their outrage.

number 3
Mobilization … and patience

I have been grappling with this question the way you posed it: Why aren’t Americans more outraged about economic inequality? But maybe that’s the wrong question. Maybe Americans are about as outraged as activists have any right to expect them to be.

Maybe the right question is how can those activists mobilize people’s outrage more effectively. Maybe there’s ample economic outrage but inadequate channels for expressing it. This is one of the main points of Robert Reich’s 2012 book Beyond Outrage, which says in effect, “Yeah, of course you’re outraged about economic inequality. Now here’s how you can help build a long-term political movement to turn things around.”

Or maybe the activists just need to be more patient. As I have often told my clients, precaution advocacy is a slog. It typically takes a generation or more for a newly recognized risk to reach the point where effective precautions (hardhats, seatbelts, smoke alarms) are widely adopted. Economic inequality isn’t exactly a newly recognized risk. But if the real issue is inequality of economic opportunity, and if America truly was the “land of opportunity” until recent decades, then maybe there simply hasn’t been enough time for opportunity inequality to rise to the action stage.

I sent your question to my old friend Martin Oppenheimer, a sociologist and emeritus professor at Rutgers University. His email in response focused on both mobilization and patience:

Why is there not more outrage re: income inequality etc.? “More” than what? How do we measure the behaviors that constitute outrage? What are they? Strikes? Riots? Mass demonstrations? (How big?) Lynchings? Vandalism? Public statements? Petitions? (MoveOn creates petitions, many involving outrage, by the dozen every day!)

Let’s accept that there is outrage. One example: Last week there were strikes in many cities, plus many countries, of low-wage fast-food workers. I think that counts as “against income inequality.” Occupy Wall Street expressed anti-establishment outrage, if not always clearly. There have been a lot of statements by many public officials, including even Obama, expressing (at least in some cases like Elizabeth Warren) outrage. The interesting question is why now, and not two years ago?

I think it took Occupy’s message about inequality a while to marinate, about two years (including a lot of internet activity etc.) before the mainstream media and politicians began to realize that inequality was a useful handle and important.

So why not more outrage, and how do we arouse more? You can’t create a movement from the top by some sort of PR trick. Conditions are not sufficiently “ripe” to do more than what is being done, indeed by a lot of people right now – but they are small things and most of it is under the media radar. If I had some serious bucks, I would give the money to grassroots social change organizations. Actually, there is a kind of United Fund of the left that does that: It’s called Resist. The point is that the recipient organizations are not charities like soup kitchens or other kinds of band-aids. They are mostly not defensive, like the ACLU or Amnesty International. They are screened for actually (trying to) foment social change.

If I’m reading Marty right, he’s suggesting that outrage about economic inequality is sizable already and growing. What’s needed now isn’t some “PR trick” or psychological strategy to arouse more outrage. It’s grassroots political work and time.

Drinking water contamination in West Virginia: A badly managed crisis becomes an ongoing controversy

name:Ed Light
This guestbook entry
is categorized as:

      link to Outrage Management index
      link to Crisis Communication index

field:Industrial hygiene / public health
date:May 13, 2014
email:ELight@Building-Dynamics.com
location:Maryland, U.S.

comment:

In the aftermath of the West Virginia drinking water contamination incident, there is an ongoing crisis based on public perception. Risk communication to date has been limited to public officials and scientific experts providing their data and opinions to residents, who have not been directly involved in the assessment and mitigation process. As a result, many of these residents now refuse to drink the water, even though it is probably safe.

The CDC and other experts issued conflicting, theoretical risk assessments, which were essentially inconclusive. Although more relevant data could have been developed from an epidemiological study of Charleston-area residents who sought medical attention for symptoms attributed to drinking water, this was never pursued. Attending physicians could have been asked whether each patient’s reported symptoms were likely to be water-related, and those individuals could also have been asked to rate their exposure based on general descriptions of odor (i.e., strong, slight, or none) and pathway (i.e., ingestion, skin contact, or inhalation).

Such an analysis might find that symptoms likely to be water-related were only experienced at higher exposure levels, and that water without the characteristic odor should be considered “safe.” A skeptical public would probably find this information more believable than the opinion of outside experts.

On the exposure side, the public has been presented with sampling data from a limited number of homes reported as meeting “standards.” At the same time, some residents continued to detect the unique odor produced by the contaminant. If the endpoint of the crisis would be defined as no detectable odor, residents could verify this for their homes. Following the current approach, a never-ending numbers game has been created, undermining government and industry credibility, disrupting daily life, and downgrading the reputation of a region trying to attract new business opportunities.

Do you have any comments on these proposals, or on other risk communication lessons learned from this spill?

peter responds:

The morning of January 9, 2014, a tank of chemical foaming agents (used to wash impurities out of coal) at a Freedom Industries storage facility in Charleston, West Virginia leaked into the Elk River one mile upstream from the intake point for the water utility’s main treatment and distribution center. By the end of the day, the utility – West Virginia American Water (WVAW) – had warned some 300,000 customers not to use the water for anything except flushing toilets and fighting fires: not to drink it, cook with it, or bathe in it. The do-not-use advisory was lifted a few days later, after authorities decided the level of contamination had gone down enough. But many area residents are still unsure whether their water is safe to drink.

The main constituent in the leaking tank was 4-methylcyclohexanemethanol (MCHM), a chemical whose possible hazards have been little-studied. MCHM is one of more than 60,000 chemicals grandfathered into the Toxic Substances Control Act of 1976, which means it is largely unregulated. Prior to the spill, there was no regulatory or even advisory standard for how much MCHM is safe in drinking water, and very little evidence on which to base such a standard … though under pressure the U.S. Centers for Disease Control and Prevention (CDC) quickly came up with one anyway. What little is known about the health effects of MCHM comes largely from the Eastman Chemical Company, the only MCHM manufacturer in the U.S. After the spill, Eastman posted a batch of previously unpublished internal toxicity studies on its website.

The tank that failed – and in fact the entire facility – dated back to the 1940s and 1950s, originally owned by Pennzoil/Quaker State. It hadn’t been inspected by any state or federal environmental agency in years. The tank was encircled by a cinderblock containment wall that was also old, and also leaked, allowing MCHM to pool in the soil and then flow into the river.

Readers interested in more information on the Elk River spill can check out the Wikipedia article. I will focus here, as you suggest, on the risk communication lessons.

What kind of risk communication?

For as long as 300,000 people had no water for drinking, cooking, or bathing, this situation was of course a crisis (high hazard, high outrage). People had no way to know how dangerous the water might be; obviously the experts considered it dangerous enough to prompt the do-not-use advisory. And people had no way to know whether they might already be at risk from their exposure before they stopped using the water. Those with symptoms couldn’t tell whether the symptoms were “real” or psychosomatic; they couldn’t tell whether or when the symptoms would go away. Those without symptoms couldn’t tell what long-term impact if any their exposures might have.

At a minimum, life in the Charleston area was seriously disrupted. Even though an adequate supply of bottled water was trucked in, schools and businesses were closed, and people mostly stayed home, glued to their TVs, computers, and phones. The hazard component in my “Risk = Hazard + Outrage formula doesn’t apply just to health or environmental hazard. Inconvenience counts too, and so does economic damage.

But within a few days the water had been declared okay to drink. The flood of emergency room visits and poison control center phone calls slowed to a trickle. The short-term health effects of the spill were pretty much over. And there was a reasonably solid expert consensus that the long-term health effects would be unmeasurably small. Almost nobody predicted the long-term effects would be big. The experts differed mostly in how aggressively they acknowledged that they couldn’t really be sure, since there was no evidence one way or the other on MCHM’s long-term human health impact. As for inconvenience, the only people still inconvenienced were those who didn’t find the experts’ reassurances reassuring and were still reluctant to use their tap water. And the only ones facing continuing economic damage were Freedom Industries and WVAW.

The crisis, in short, ended in a matter of days. Assuming the expert consensus is right, it has morphed into an ongoing controversy: low hazard, high outrage.

So the risk communication challenge has transitioned from crisis communication to outrage management. There’s a long-term outrage management task now for the water company to get people comfortable drinking the water again; for the state government to rebuild or build public confidence in its environmental regulation; for defendants in the inevitable lawsuits to convince community members (jurors-to-be) that they didn’t mess up as badly as some may believe. (For environmentalists trying to leverage what happened into a push for tougher regulations and tougher enforcement, there’s a long-term precaution advocacy task too.)

To some extent this transition from crisis communication to outrage management is inevitable. When the hazard subsides in a high-hazard, high-outrage situation, the outrage doesn’t necessarily subside with it. Some people remain stuck in their fear, unable to convince themselves that the crisis is over. Others convert their fear into anger, often directed at the very same people and institutions they were relying on during the crisis. “Please protect me!” morphs into “Why didn’t you protect me better?” The natural history of many risks is divisible into three stages: precaution advocacy before the crisis, crisis communication during the crisis, and outrage management after the crisis.

But poor crisis communication during a crisis tends to lead to outrage that is higher than it needed to be, and that lasts longer than it needed to last.

The New York Times one-month-anniversary story on the Elk River spill was entitled “One Month After Toxic Spill, West Virginians Face ‘Crisis of Confidence.’” We have now passed the four-month anniversary of the spill, and the crisis of confidence continues. The amount of residual outrage in West Virginia remains high: people afraid to drink the water, worried about their long-term health, determined to punish the companies and agencies that they feel let them down. One sign of the continuing controversy: Some Charleston restaurants still advertise that they are cooking with bottled water.

At least in part, this residual outrage is a result of inadequacies in how the crisis was communicated.

So I want to focus my comments here on those inadequacies. I will save for another time the quite separate question of what Freedom Industries, WVAW, and various city, state, and federal agencies might do in the months ahead to ameliorate the outrage they continue to face in West Virginia.

Response to your comment – odor deserved more attention

I found your comment’s emphasis on odor extremely interesting.

You suggest that West Virginia authorities passed up an opportunity to do some “barefoot epidemiology” about MCHM. There was very little hard scientific evidence available about the chemical, but WVAW needed some seat-of-the-pants semi-scientific basis for determining when to tell people it was okay to drink the water. So the CDC had to concoct a “standard.” It based its standard on Eastman’s animal toxicity studies.

Instead, you suggest, it could have relied partly on the experience of area residents, asking doctors to keep track of what symptoms were reported by patients with what exposures, with their exposure levels measured (roughly) by how strong an odor they reported. (MCHM smells like licorice.) There’s a good chance this would have justified a locally based, locally credible conclusion that very few people felt sick when exposed to water that didn’t smell strongly of licorice.

That in turn would have justified an odor-based standard. It might have been phrased something like this: “Run the water from time to time. If you go 24 hours without getting more than a whiff of licorice, you can drink the water. If it smells strongly of licorice again later, stop drinking it until the smell has weakened again for at least 24 hours.” Or it might have been simpler and more cautious: “Don’t drink the water until you can’t smell it.”

As you know, odor is an unreliable signal of hazard. Some dangerous chemicals don’t smell at all, and some smelly chemicals aren’t dangerous. Some dangerous-and-smelly chemicals are dangerous at lower concentrations than they are detectable by nose; others are detectable at lower concentrations than they are dangerous.

But in outrage terms, we are hard-wired to get anxious when something that shouldn’t smell (like our water) emits a weird odor. Even if the experts had solid data proving the smelly water was harmless, it would have been difficult to convince people to shrug off the odor and drink the water. In the absence of data, it was probably impossible.

It would be irresponsible for the CDC or any expert to base a health recommendation on odor alone. The local epidemiological work you suggest could show only that water that doesn’t smell bad isn’t giving rise to acute symptoms like rashes or nausea. It couldn’t possibly shed light on whether water that doesn’t smell bad might still have long-term health effects such as cancer.

So the CDC would have had to take a two-pronged approach: one based on animal toxicology data from the manufacturer, the other based on local human epidemiology data. Only when the water met both standards would the CDC have advised the state government and the water company to lift the do-not-use order.

I agree with you that a recommendation grounded partly in local experience might very well have been more credible to local residents. It has the additional virtue of being individually actionable. “We’ll test the water in your neighborhood to determine when it meets the toxicology-based standard. You smell the water in your home to determine when it meets the epidemiology-based standard. Together, we’ll decide when it’s okay to drink the water.”

There are three “levels” of MCHM that played an important role in the West Virginia spill:

  • The concentration of MCHM in water that the CDC decided should be considered okay to drink, based on limited animal data, was one part-per-million (ppm).
  • The lowest concentration of MCHM in water that was detectable using the analytic methods available to WVAW and various government agencies was initially 10 parts-per-billion (ppb) – 100 times lower than the CDC standard. With testing improvements, the non-detect level was later reduced to 2 ppb, 500 times lower than the CDC standard. So far so good. People could track not only when the level got below 1 ppm, but also how far below, all the way down to 2 ppb.
  • Here’s the problem. In a January 18 conference call, Dr. Letitia Tierney of the West Virginia Bureau for Public Health said that the odor threshold for MCHM is “100,000 times [lower than] the no observable adverse effect level,” a number WVAW used the next day in its “Our Next Stepslink is to a PDF file FAQ. 100,000 times lower than 1 ppm is 0.01 ppb. In other words, at least some people can smell MCHM in water all the way down to 0.01 ppb, not 2 ppb. Long after the techies were claiming “non-detect,” ordinary people could still detect the MCHM with their noses. (Elsewhere I’ve seen an odor threshold estimate for MCHM of 0.15 ppb – still more than an order of magnitude below 2 ppb.)

WVAW was fond of pointing out that odor isn’t a health issue, just an aesthetic one. It made that claim in its February 9 FAQ on “Answers to the top questions about your water,” link is to a PDF file for example. But when you notice that your tap water smells like licorice, that’s not just an aesthetic problem. It is also a signal that there’s something in your tap water that shouldn’t be there. And MCHM isn’t a chemical that’s known to be harmless but smelly. It’s a chemical that’s thought to be harmful at fairly low doses but is still smelly – and may or may not be harmful – at even lower doses.

An odor-based action level along the lines you suggest might have helped preserve credibility. It would have avoided the common complaint, “They tell me it’s safe but I can still smell it!” – or, worse yet, “They tell me it’s below detectable limits but I can still smell it!”

On April 23, by the way, the state Bureau for Public Health released a report on hospital emergency room visits link is to a PDF file associated with the Elk River spill. The report doesn’t mention odor. I would assume the emergency room records didn’t include any assessment of the strength-of-odor patients reported.

There are lots of other lessons to be learned from the way West Virginia’s drinking water contamination was communicated. I will cherry-pick a few, focusing on three key information sources: Freedom Industries, WVAW, and the CDC.

Note that the single most active information source during the crisis itself was none of these three. It was the West Virginia state government, especially the office of Governor Earl Ray Tomblin. Most observers give Tomblin fairly high marks for getting out the necessary information during the crisis phase of the spill. He held daily news conferences, for example – more than any other source. Perhaps wisely, Tomblin started receding into the background when the crisis phase gave way to the outrage phase – that is, when anxiety morphed into recriminations, with West Virginia’s long history of spotty environmental protection front-and-center.

Freedom Industries flunks PR 101

The worst communication performer by far was Freedom Industries, a small company with a somewhat checkered history. Freedom Industries was not the first to alert the state Department of Environmental Protection (DEP) to the spill. The DEP found out about it from local residents’ odor complaints, and had already sent inspectors to the site before the company called in the spill. Reports differ on whether it was Freedom Industries that notified WVAW or the DEP. Most local newspapers and broadcast news operations learned of the spill from neither Freedom Industries nor the DEP, but from Twitter and other social media.

Freedom Industries held one and only one news conference, late on the afternoon of January 10. The spill was discovered the morning of January 9; the ban on using water was instituted that afternoon. More than 24 hours after that, Freedom Industries President Gary Southern finally met with reporters in a parking lot adjacent to the facility, where he apologized not just for the spill itself but also for having taken “so long to come out and talk to you guys.”

The video of Southern’s ten-minute news conference is worth watching in its entirety. It was widely derided by journalists, activists, and others as arrogant. Much was made of Southern’s several efforts to walk away. “Look guys, it has been an extremely long day,” he said five minutes into the news conference. “I’m having trouble talking at the moment. I would appreciate it if we could wrap this thing up.” He tried to leave twice only to be called back by reporters to answer more questions; the third time he managed to escape.

Much was also made of the fact that Southern repeatedly “swigged” bottled water on camera while answering (or evading) questions about the spill that had contaminated his neighbors’ tap water.

But Southern’s news conference performance strikes me as less arrogant than shell-shocked. He faced the cameras like a deer caught in a car’s headlights … except when he drifted off-camera toward whoever was asking a question, needing to be reminded again and again to talk to the cameras, not to the reporter posing that particular question. And he was obviously losing his voice, coughing periodically until someone helpfully but unwisely brought him a bottle of water, which he understandably but unwisely hung onto and occasionally resorted to throughout the rest of the brief news conference. (Some news stories say Southern was suffering from pneumonia.)

Leaving aside the atmospherics, the main defect of Southern’s news conference was its brevity and vagueness. He didn’t stay for all the questions reporters wanted to ask, and even the questions he took were left largely unanswered. He vowed that “our intent is to be absolutely transparent – we’ll tell you what we know.” But he avoided explaining when the spill might have started; he avoided estimating how much MCHM might have spilled; he avoided addressing what the health implications might be. Perhaps most tellingly, he offered nothing approaching a timeline of the preceding day-and-a-half. His final response before fleeing was to promise that he would produce one. But as reporters loved pointing out in the days that followed, he never did.

Nor did he ever hold another news conference.

These aren’t so much risk communication failures as they are failures of basic public relations. Sometime after the spill, Freedom Industries hired the Charleston PR firm Charles Ryan & Associates (CRA). I don’t know whether CRA was onboard during Southern’s awful January 10 news conference, but I assume not; certainly he got no visible PR help. CRA did release a statement for the company on January 11. The morning of January 12, CRA managing partner Susan Lavenski announced that the agency had decided to stop representing Freedom Industries. No explanation was provided.

On January 17, eight days after the spill, Freedom Industries filed for bankruptcy, presumably at least in part to stave off the flood of lawsuits headed its way. It remained in business, though its Elk River facility was shut down.

On January 21, 12 days after the spill, Freedom Industries belatedly revealed that the ruptured tank had also contained a mixture of glycol ethers known as PPH – another chemical whose potential health effects are virtually unstudied.

The rudimentary Freedom Industries website, by the way, says nothing about either the spill or the bankruptcy.

West Virginia American Water isn’t empathic enough with anxious customers

Many of the lawsuits against Freedom Industries also name West Virginia American Water (WVAW) and its parent company, American Water Works, mostly for failing to close the Elk River intake as soon as it learned of the spill. WVAW officials explained that they initially thought their filters could cope with the contamination, in part because they weren’t told much about what the contaminants were. In addition, they said, shutting down the system would have meant no water for firefighting or toilet flushing, and would have made it tougher to resume operation once the crisis was past.

The prospect of litigation is, of course, not conducive to good risk communication. It’s hard to say empathic things when your lawyers are looking over your shoulder.

In the wake of the spill, questions have been raised about WVAW’s hazard management that are beyond my expertise:

  • Was it unwise to locate its intake downstream from the Freedom Industries facility?
  • Given its location, should it have known more about what was in the Freedom Industries tanks? Should it have had a better plan for a water emergency of this sort?
  • When notified of the spill, should it have shut the intake? Or should it at least have announced the do-not-use advisory immediately, instead of thinking/hoping its filtration system could handle the contamination?
  • Once its filters were contaminated with MCHM, why didn’t it start changing them out more promptly, so they wouldn’t become themselves a source of contamination?
  • Why did some of its relief tanker trucks give off a telltale licorice odor, suggesting they might have been filled with locally sourced (and MCHM-contaminated) water?

I haven’t seen too many similar questions about WVAW’s communications during the crisis. The main exception: There seems to be some agreement that the utility didn’t clearly explain to people how to flush out their home or business water systems, or why they needed to do so. But on the whole, the company did a creditable job of alerting its customers to the crisis, telling them how to cope with it (where to get bottled water, for example), and guiding them through the complicated phase-in process of lifting the ban.

I particularly like the way WVAW President Jeffrey McIntyre proclaimed his uncertainty, resisting the twin crisis communication temptations of overconfidence link is to a PDF file and over-reassurance. link is to a PDF file After issuing the do-not-use advisory late in the day on January 9, the company held its first news conference the morning of January 10. “I can’t tell you that the water is unsafe,” McIntyre said, “but I also can’t tell you that the water is safe.” Two days later, pressed to say when the ban would be lifted, he replied, “I don’t believe we’re several days from starting to lift, but I’m not saying today.” These are beautifully balanced acknowledgments of uncertainty about customers’ two principal questions.

Once the ban was lifted, on the other hand, WVAW changed its tune … or at least its tone.

Consider WVAW’s January 16 “Updated FAQs.” link is to a PDF file Here’s the key question and the entire answer:

How can West Virginia American Water be confident our water is safe at the level of 1 part per million (ppm) of MCHM, especially when questions have been raised about how this level was determined?

On January 10, 2014, the U.S. Department of Health and Human Services provided the West Virginia Department of Health and Human Resources (DHHR) with recommendations from CDC scientists who recommended an acceptable threshold of 1 ppm. Officials from DHHR’s Bureau for Public Health and the U.S. Environmental Protection Agency (EPA) reviewed the CDC’s recommendations and concurred with the 1 ppm level before we developed the protocols for lifting the water ban. On January 15, the CDC scientists reaffirmed 1 ppm as a “protective level to prevent adverse health effects.”

Although West Virginia American Water does not set water quality standards, our responsibility is to follow the rules and guidelines established by federal and state regulatory agencies, such as the CDC, EPA, West Virginia DHHR’s Bureau for Public Health and the West Virginia Department of Environmental Protection. This is a responsibility we take very seriously.

Despite the word “confident” in its phrasing of the question, WVAW isn’t quite saying that it considers the CDC standard solid and the water safe to drink. But it certainly isn’t saying that it’s okay if customers have their doubts. It seems to be saying that trusting the CDC standard, whether it’s solid or not, is “a responsibility we take very seriously” – implying that customers should take that responsibility seriously too, set aside their doubts, and be confident the water is safe.

One of the reasons many people questioned the 1 ppm standard is that even the CDC suggested that pregnant women might want to adhere to a lower standard. If pregnant women aren’t advised to drink the water, many were asking, why on earth should our kids drink it … or immunocompromised people … or, indeed, anybody? To WVAW’s credit, the January 16 FAQ includes this frequently asked question. But the answer is neither helpful nor empathic:

If the CDC is warning pregnant women not to drink the water, should I also have health concerns about using water for normal uses?

We understand that the CDC issued its recommendation for pregnant women “due to limited availability of data and out of an abundance of caution.” At the same time, CDC said “scientists continue to recommend 1 parts per million (ppm) as a protective level to prevent adverse health effects.”

If you have more questions about health risks, please contact the Poison Center at 1-800-222-1222.

Here’s an alternative answer to both questions that I’d have preferred:

CDC scientists have recommended an acceptable threshold of 1 part-per-million (ppm). They say 1 ppm is a “protective level to prevent adverse health effects.” Other federal and state agencies have reviewed the 1 ppm standard and say they concur. So West Virginia American Water is using that standard to determine when to lift the do-not-use advisory.

But we understand that many customers are still worried about whether the water is safe to use, even though it meets the CDC’s 1 ppm standard. After all, even the CDC has advised pregnant women to avoid the water until the MCHM level is lower, just to be on the safe side. So why shouldn’t other people do the same thing if they wish?

We will keep testing the water throughout our distribution system, and we’ll keep posting the results on our website. You can watch the level in your area decline from the CDC standard of 1 ppm all the way down to the detection limit of the equipment, which is 2 parts-per-billion (ppb) – 500 times lower than the CDC standard. Wait until it’s low enough that you feel safe drinking it. Wait until it’s non-detect if you choose, below 2 ppb. We will continue providing bottled water to those who want it until the level of MCHM reaches non-detect levels throughout our system. It has already reached non-detect levels in many areas, but not yet all.

To be extra-cautious, you may want to consider waiting even longer than that – perhaps until neither you nor anyone you know can smell even a whiff of MCHM. For some people the odor detection limit for MCHM is 10 parts-per-trillion! That’s way below the 2 ppb detection limit of our equipment. We won’t consider our spill response job done until there is no remaining licorice odor anywhere in the system.

People who want to wait till then to drink the water are obviously being a lot more cautious than the CDC thinks is necessary. But you’re the one drinking the water. You’re the one giving it to your family. Wait until you feel it’s okay to drink.

WVAW would have been wise to validate many customers’ reluctance to start using the water again, even after it had told them they could. This is a classic risk communication seesaw: I’m likelier to decide the water is safe enough to drink now if you don’t sound like you think I’m an idiot if I’m still worried. Give me the information I need to decide to drink the water, but also give me “permission” to decide to wait a while longer if I prefer.

This is also a good example of the risk communication principle that in high-outrage situations transparency is not enough; empathy is just as important. Simply telling people their water is now below the CDC 1 ppm standard so it’s safe to drink lacks empathy for those who are still worried. It would have been much more empathic to say that some people are still worried, that that’s a natural way to feel, and that it’s fine to wait awhile longer until MCHM levels are lower before taking the plunge (or taking a sip).

In fairness, WVAW did occasionally come a bit closer to the empathic stance I’m recommending. A January 19 FAQ entitled “Our Next Steps,” link is to a PDF file for example, includes this brief passage:

We realize that, through no fault of our own, the public’s trust in the water has been shaken. Nothing is more important to our team than to rebuild that trust with our customers and the community.

It would have helped WVAW rebuild trust in the water if it had been less in a rush to rebuild trust in the water – less insistent, less “confident,” that the water was now safe to drink.

The CDC pretends a seat-of-the-pants standard constitutes sound science

The evening of January 9, just hours after the do-not-use water advisory was announced, West Virginia officials contacted the U.S. Centers for Disease Control and Prevention (CDC) and asked for a standard specifying how low MCHM levels in the water needed to get before the ban could be lifted. For obvious reasons, the pressure on the CDC to dream up a number was fierce. Sometime the next day it told state officials that 1 part-per-million should do the trick.

1 ppm was from a suspiciously even number – 1.3 ppm or 0.7 ppm might have sounded more like the result of an actual calculation. And initially the CDC wouldn’t say how it came up with its standard. A January 11 story in the Charleston Daily Mail noted that “There has been little explanation about how the CDC arrived at that number.”

On January 13, the Charleston Gazette ran a story by Ken Ward Jr. candidly headlined, “How do they know water’s safe at 1 ppm?” Ward’s story begins:

Tomblin administration officials continued on Monday to decline to provide detailed answers why they think 1 part per million of Crude MCHM is safe for West Virginians to drink.

Federal agencies also refused to explain how they calculated that figure in the absence of any real regulatory guidelines or published health standards for the material, also known as 4-methylcyclohexanemethanol.

A Ph.D. chemist who works with the Environmental Defense Fund wrote on his organization’s blog that West Virginia officials are trusting “shaky science” in their “rush to restore water service” to 300,000 residents in a nine-county region.

Richard Denison wrote that officials “made significant leaps in their calculation of a ‘safe’ exposure level – including assumptions that deviate from generally accepted practices.”

“As a result, these estimates fail to adequately account for either acute or chronic effects from ongoing exposure to water contaminated at the 1 ppm level,” Denison wrote. “At a bare minimum, the public deserves to know a lot more about the calculations behind officials’ insistence that a 1 ppm level in drinking water is safe.”

Among other things, this story demonstrates how activists fill the information vacuum when officials don’t explain themselves. Ward reported that “State officials have told the Gazette to ask the CDC for more information. But on Monday, the CDC referred questions to West Virginia American Water” – which consistently (and rightly) kept saying it had no expertise in water quality standards and was relying on federal and state officials. So Ward leaned on EDF’s Denison.

Why were officials reluctant to try to explain their scientific basis for 1 ppm? Because there wasn’t much of a scientific basis to explain.

A few days earlier, the head of the state’s Bureau for Public Health, Dr. Letitia Tierney, had briefly tried. As reported in Ward’s January 13 story, Tierney had said the 1 ppm standard was derived from an unpublished 1990 Eastman study that established an “LD50” of 825 milligrams per kilogram (mg/kg) for crude MCHM for rats. An LD50 is the dose that kills 50 percent of the population. According to the Eastman study, then, if you feed rats 825 mg of MCHM for every kg of body weight, half of them die. On the scale toxicologists use to classify poisons, this qualifies MCHM as only “slightly toxic.” More toxic poisons don’t need such a high dose to kill a rat.

Tierney said the CDC added two “uncertainty factors” to Eastman’s 825 mg/kg LD50 for rats. It reduced the number tenfold for the translation from rats to humans, and then tenfold again to account for the difference between killing half the population and killing especially sensitive individuals. That led to a guesstimate (my word – not the CDC’s or Tierney’s or Ward’s) that maybe 8.25 mg of MCHM per kg of body weight might be deadly to a sensitive human – such as a child with an immune-deficiency disease.

Well, then, assuming 8.25 mg/kg could kill such a child, how much MCHM would be safe for the child? To get from the dose that’s deadly half the time to the dose that’s safe all (or nearly all) the time, Ward said Tierney said, the CDC reduced the number again from 8.25 mg/kg to 1 mg/kg. Finally, the CDC factored in an estimate of how much a typical child weighs (10 kg) and how much water s/he drinks per day (1 liter = 1 kg), which yielded its standard of 1 ppm. Voila!

If this doesn’t sound like sound science to you, odds are it didn’t to readers of Ward’s article either, who had to decide whether to resume using the water once it got below the 1 ppm standard.

The calculation based on the LD50 for rats soon disappeared from the discussion. Eastman’s LD50 study is still mentioned on the CDC webpage that describes the basis for its 1 ppm standard, but the revised explanation is grounded in a different Eastman study link is to a PDF file, in which rats were fed various doses of pure (not crude) MCHM for 28 days, and then examined for kidney damage, liver damage, and a few other health problems. Instead of looking for an LD50, this study was aiming to establish a No Observed Adverse Effect Level (NOAEL) for rats – how much MCHM you can feed rats without making them sick … or at least sick in the particular ways you’re looking for.

The outcome was a NOAEL of 100 mg/kg per day. When Eastman scientists fed a handful of rats a daily dose of 100 mg of pure MCHM for every kg of body weight, after a month none of the rats were sick. The study didn’t continue feeding the rats MCHM to find out what that did to them over time; nor did it wait to see how the rats’ long-term health fared after a month on an MCHM diet; nor did it examine a full range of possible short-term health effects; nor did it look at a larger sample of rats to see if there might be a few especially sensitive ones that would suffer from 100 mg/kg. Still, this is the best study we’ve got. Some of the rats that ate 400 mg/kg of MCHM showed health effects after a month; those that ate 100 mg/kg or less didn’t.

The big problem for the CDC, obviously, was how to turn a NOAEL for rats into a NOAEL for children – without actually experimenting on any children. The CDC again assumed a hypothetical child who weighs 10 kg (22 pounds). If we assume the NOAEL for children is 100 mg/kg (the same as for rats), then a 10-kg child should be able to safely consume 1000 mg of HCHM per day. Assume the child consumes 1 liter of water a day. If 1000 mg of HCHM per day is safe, and the child is consuming 1 liter of water per day, then the water can safely contain 1000 mg of HCHM per liter. A liter of water weighs a kilogram. There are 1,000,000 mg of water in a kg = liter. So the NOAEL – if children are the same as rats – ought to be 1000 mg of HCHM per kg of water, which is 1000 ppm.

Now comes the non-mathematical part. The CDC reduced this 1000 ppm figure by three factors of ten:

  • One uncertainty factor to address “differences between animals and humans.”
  • One uncertainty factor to address “differences accounting for sensitive humans.”
  • One uncertainty factor to address “weaknesses in the toxicological database.”

Three tenfold uncertainty factors converted a hypothetical NOAEL of 1000 ppm into a proposed standard of 1 ppm.

This feels like something of an improvement over Tierney’s explanation. At least it starts with the highest dose that doesn’t make any rats sick, not the lowest dose that kills half of them.

Most experts would agree that the way the CDC says it got to 1 ppm is a fairly conventional procedure. If the CDC had taken many months to produce a standard instead of less than a day, it still would have ended up applying arbitrary uncertainty factors to scanty animal data. Everybody wishes there were a better basis for human exposure standards to hazardous chemicals. But human evidence is hard to come by; it’s unethical to feed humans chemicals until they get sick, so all scientists can do is look for humans who got sick and try to figure out what their exposures were. Even animal evidence is prohibitively expensive to collect, especially if you consider all the exposure pathways and health impacts and potentially synergistic combinations of chemicals you might want to study.

The toughest uncertainty is how much to fiddle with animal data when trying to derive a human standard. Some experts would say that using three tenfold reductions to get from a rat NOAEL to a hypothetical safe human dose yields too conservative an answer – that it’s overwhelmingly likely that we can safely drink water with a lot more than 1 part-per-million of MCHM.

Other experts would say that the CDC should have used four or five or even six tenfold reductions instead. Here are three more possibilities:

  • Another uncertainty factor to address differences between pure MCHM (which is what the Eastman study studied) and what was actually in the Freedom Industries tank, a mix of raw MCHM (which contains several other chemicals) and PPH (a different mix of entirely different chemicals).
  • Another uncertainty factor to address all the health outcomes the Eastman study never looked at, including long-term outcomes it couldn’t possibly have looked at. (In fairness, Eastman also ran an Ames test on MCHM, and it was negative, which means the chemical probably isn’t much of a carcinogen or mutagen.)
  • Another uncertainty factor to address the grounds for mistrusting any research conducted and reported by the manufacturer of the chemical studied – with no peer-reviewed publication and no oversight by neutral observers or (better yet) by critics.

Still other experts might agree with the CDC that three tenfold reductions are just right.

What no expert could say with a straight face is that choosing three tenfold reductions instead of two or four is a scientific, data-based decision. The CDC’s 1 ppm is a seat-of-the-pants guesstimate, not hard science. How conservative to be in the absence of good data isn’t a scientific question at all. It’s a values question, a very familiar one: How safe is safe enough?

I don’t fault the CDC for making a guesstimate; it had no choice. And I don’t fault the CDC for the guesstimate it picked; that’s simply a matter of opinion. I fault the CDC for trying to make its guesstimate sound more scientific than it really was.

Not that the CDC hid its process or was in any way deceitful about it. All the relevant information is on the CDC website and was provided to the media. Anyone who was paying close attention could quickly figure out that there wasn’t a lot of science behind the 1 ppm number. But the CDC avoided saying so; it allowed those who wanted to think the number was “sound science” to hang onto their illusions.

In fact, the CDC avoided interviews and public meetings altogether during the crucial early days, until criticism from journalists and area residents forced it to become more accessible. The Gazette’s Ken Ward Jr. told the Reporters Committee for Freedom of the Press that he had trouble getting responses from federal officials from the very start. At a news conference on January 10, the CDC’s 1 ppm standard was announced not by the CDC, but by James Hoyer of the West Virginia Army National Guard. “We wanted to know where that 1 part per million number came from,” Ward said. He was referred to someone in the governor’s office (not the CDC) to answer his question. “And I waited, and I waited and I waited and I waited, and she finally called me and said no I’m not going to explain this to you, you’ll just have to trust me.”

On January 20, two national groups, the Society for Environmental Journalists and the Society of Professional Journalists, sent a complaint letter link is to a PDF file to both the CDC and the U.S. Environmental Protection Agency, asserting that since the spill “many news reporters have had real difficulty getting access to – and meaningful responses from – responsible federal officials.” The letter emphasized the CDC’s repeated refusals to explain the basis for its 1 ppm advisory level. The CDC’s January 22 response conceded that “there was valid uncertainty in determining how to return the community back to normal and we should have communicated this uncertainty better.” That concession was one of the episode’s better risk communication moments.

The way the 1 ppm standard played out undermined its credibility badly. Plenty of journalists, commentators, and ordinary citizens put two and two together to figure out how arbitrary the 1 ppm number really was. Many of them ended up thinking the CDC and state officials were trying to put something over on them. Essentially, the CDC gave them the information they needed to understand how weak the science was, but by not telling them how weak the science was, fully and frankly (and in person, not via surrogates), it left them feeling more suspicious than they would otherwise have felt.

The real question wasn’t whether 1 ppm was a “hard” number. The real question was whether it was a conservative soft number or a not-so-conservative soft number – that is, whether the CDC should have responded to the weakness of the science with an even lower (more cautious) standard. The CDC and state authorities didn’t address this question at all until after critics had staked out the position that the 1 ppm standard wasn’t conservative enough.

Then, belatedly, they stopped expecting people to take the standard’s scientific validity for granted, and started defending its conservativeness instead. On January 16, for example, Ward published a follow-up story in the Charleston Gazette based on a media conference call with the CDC’s Dr. Vikas Kapil. Ward reported that “Kapil said that at every step, scientists used the most conservative estimates.” He quoted Kapil’s defense of using tenfold “uncertainty factors”: “Some people apply smaller factors, sometimes three, sometimes four, depending on what it is you’re talking about, but we applied the highest, so we feel pretty comfortable that the 1-part-per-million number is a number that would not be associated with any adverse effects for humans, based on this methodology.”

But Ward went on to quote Dr. Richard Denison of the Environmental Defense fund:

Denison, though, said that what the CDC refers to as “safety factors” – and tells the public add conservatism to the agency’s risk assessment – actually are more like “reality factors,” which simply help translate animal studies of a limited range of health effects to the real world.

“They do not impose this super safety standard,” Denison said. “That’s a standard claim of industry.”

If the CDC wanted to include additional levels of safety to be conservative toward protecting public health, Denison said, the agency would have divided the 0.1-milligram per kilogram number by 10 again, or by 100, to add more protections.

Denison said residents should remember the uncertainties involved, and make their own decisions about using the water.

The CDC further undermined its own credibility with a January 15 letter link is to a PDF file to the West Virginia Department of Health and Human Resources from CDC Director Thomas Frieden, in which Frieden said:

Since making the initial calculations, scientists have obtained additional animal studies about MCHM. These are currently being reviewed. At this time, the scientists continue to recommend 1 ppm as a protective level to prevent adverse health effects. However, due to the limited availability of data, and out of an abundance of caution, you may wish to consider an alternative drinking water source for pregnant women until the chemical is at non-detectable levels in the water distribution system.

Because of the vulnerability of fetuses, it’s quite common to protect pregnant women more cautiously than other people; pregnant women are often advised to avoid alcohol and even coffee, for example. Nonetheless, the pregnant women afterthought in Frieden’s letter left the distinct impression that the CDC had its own doubts about whether 1 ppm was conservative enough, doubts that might have been fueled by the “additional animal studies” Frieden mentioned. Kapil and others insisted that there was no new scary information and that this additional even-more-conservative recommendation for pregnant women didn’t mean the original recommendation for everybody else wasn’t conservative enough. But some damage was done.

A controversy over whether CDC was avoiding the word “safe” added more fuel to the fire. One of the key CDC spokespeople in West Virginia was Dr. Tonja Popovic. Journalists and residents noticed that Popovic steadfastly avoided saying the water was “safe” – and called her on it. As reported later by WOWK-TV:

Officials dodged the word for weeks following the leak, reluctant to call the water safe. Dr. Tonja Popovic with the CDC used a different word when she visited Charleston Feb. 5.

“We’re not really talking about whether the water is safe, we’re talking about whether the water is appropriate for use,” Popovic said.

She later explained why some scientists avoid the word.

“We really just don’t use the term safe,” she said. “Because that does not well describe what we can do with the information we have.”

It’s a tussle in terminology that means nothing to those living in Charleston.

13 News interviewed 10 people at random Monday. One person said he thinks it’s okay to drink the water. Nine people said they do not think the water is safe.

“Nobody could convince me it’s safe,” said Ramona Morris, of Charleston.

I sympathize with Dr. Popovic here. She was trying to get across that nothing is ever entirely “safe” – that is, zero risk. (See my 2005 column, “Risk Words You Can’t Use.”) Rather than telling people something is safe or not safe, therefore, it’s both better science and better risk communication to tell them how safe (and how unsafe) it is. But we don’t really know how safe/unsafe MCHM is. The CDC didn’t actually decide that water with 1 ppm of MCHM is safe to drink. Rather, it decided that the water wasn’t unsafe enough to justify advising people not to drink it – a decision made by applying seat-of-the-pants “uncertainty factors” to the small amount of scientific data it had.

This would have been hard to explain under the best of circumstances (though it would have been worth trying). It was especially hard to explain after having ducked reporters’ interview requests, after having been less than forthright about the inadequacies of the data, after having failed to acknowledge the debate over whether its uncertainty factors were conservative enough, and after having belatedly decided to advise pregnant women not to drink the water until the MCHM was undetectable. In light of those signals, the CDC’s avoidance of the word “safe” came across as yet another signal that it secretly doubted the water was safe to drink.

Barbara Reynolds – a risk communication professional at CDC – ultimately threw in the terminological towel and said the water was safe to drink. From the WOWK website:

Barbara J. Reynolds, Crisis Communication Specialist for the CDC, used the word “safe” when describing the water still being tested in West Virginia, a change in the CDC’s wording in previous statements. In the past, the CDC used the word “appropriate.”

Reynolds said during an interview, “The question came up on whether they would use the word ‘safe.’

“It became confusing, unfortunately, from a scientific toxicologist perspective that word has a very precise meaning but we have to recognize that you and I and others that are not scientists [and] use the word safe in more of a generic way.”

“We were making more trouble for people than good by not using the word in the generic way,” Reynolds said. “It's not from a scientific perspective but just in a lay perspective … saying the water is safe to drink, to bathe in and clean, is really what we were saying on the fifth of February we just didn't use the word.”

The most visible critic of CDC’s science – and its explanations of its science – was Richard Denison of the Environmental Defense Fund. Just the titles of Denison’s blog posts tell the story. Here are the main ones:

So what would I have liked the CDC to say? From the outset, I think, it should have aggressively made the following points:

  1. We have very little scientific evidence about the risk associated with MCHM in drinking water, especially crude MCHM mixed with PPH, which is what actually leaked from the Freedom Industries tank.
  2. It will surprise many people – maybe even shock people – to know that this inadequacy of data is more the rule than the exception. There are thousands of chemicals about which very little is known except for a few animal studies of debatable applicability to human risk. MCHM is one of many. We usually know something about the size of the risk when small numbers of rodents are exposed to large quantities of one substance at a time over a short period of time. We know much less about the size of the risk when large numbers of human beings are exposed to small quantities of lots of substances at once over a long period of time. Much of what we say about human chemical risks is shockingly tentative.
  3. For obvious reasons, it’s almost impossible to do really good scientific experiments on how chemicals affect people. If a chemical is very common or very dangerous, we find out when people who were exposed get sick. If it’s less common and less dangerous, the human evidence is typically hard to interpret, so we wind up extrapolating from animal studies instead.
  4. The only level of MCHM in water that we know is completely safe is no MCHM at all. This is a chemical that doesn’t belong in people’s drinking water, period.
  5. But now that it is in the water in West Virginia, the question we have been asked is when should the do-not-use advisory be lifted. It’s not “when do we tell people the water safe to drink.” It’s when do we stop telling people the water is unsafe to drink.
  6. The key study examined how much MCHM rats could consume without showing signs of sickness.
  7. Instead of setting a standard based directly on that study, we set a standard 1000 times lower. That’s meant to cover the differences between rats and humans, the fact that some humans are more sensitive than others, and the general weakness of our database. That’s how we came up with 1 part-per-million.
  8. That choice – a safety standard for humans that’s 1000 times lower than the level of MCHM that made some rats sick in one industry study – is obviously debatable. Some experts think it’s unreasonably conservative and a higher standard would be good enough. Other experts think it’s not conservative enough and we should use a lower standard that would protect people more.
  9. Because fetuses are so much more vulnerable than even children, we decided to advise pregnant women to wait to drink the water until the level of MCHM is no longer detectable. That’s about 10 parts-per-billion [it later went down to 2 ppb] – 100 [500] times less MCHM than our 1 part-per-million standard for lifting the water-use ban.
  10. People who want to apply our advice for pregnant women to themselves and their families – that is, who want to avoid the water until it gets way below 1 part-per-million, all the way down to 10 [2] parts-per-billion – should feel free to do so.
  11. The people who developed the 1 part-per-million standard have told us that they personally would feel comfortable drinking water with that amount of MCHM in it, and would comfortably give it to their families. But they have also told us that they wouldn’t have any criticism of a friend who wanted to wait for a bigger margin of safety. We hope it won’t be too long before the levels are non-detect throughout the system. [On February 20, WVAW announced that its entire system was below 10 ppb. On March 3 it announced that the whole system was below 2 ppb; that’s when WVAW stopped distributing bottled water and the CDC said even pregnant women should go ahead and use tap water.]
  12. We wish we had really good science on MCHM (and on thousands of other chemicals). We wish we could tell people how much MCHM in the water is “safe” – period, with no gobbledygook; no ifs, ands, or buts. We don’t have that kind of good science. We hope we’re using good judgment about the uncertain science we do have. But people who want to substitute their own judgment should feel free to do so, with our apology for not having more certain science to rely on.

Summary

There are plenty of other risk communication lessons that could be harvested from West Virginia’s Elk River spill, but these five will do for now:

number 1
Poor crisis communication when the water was most contaminated made the outrage management much tougher after nearly all the contamination was gone.
number 2
An odor-based standard for when people could resume using the water could have helped add credibility to the quantitative (but arbitrary) standard that was used.
number 3
Freedom Industries never gave itself a chance to do any risk communication; in its only news conference it flunked PR 101.
number 4
Although its overall communication effort wasn’t bad, West Virginia American Water showed insufficient empathy for its customers’ reluctance to trust that the water was safe. That probably backfired, making it harder for people to start drinking the water again.
number 5
The U.S. Centers for Disease Control and Prevention failed to acknowledge until too late that its 1 part-per-million standard was a debatable guesstimate, not a scientific calculation, while sending misleading signals that suggested it might not trust its own standard.

What to say when a chemical that’s outlawed in some countries is legal in yours

name:Peter
This guestbook entry
is categorized as:

      link to Outrage Management index

field:Government risk assessor/communicator/manager
date:April 7, 2014
location:Australia

comment:

The Australian government regulator that has regulatory responsibility for consumer product safety is the Australian Competition and Consumer Commission (ACCC). I notice they currently have a live issue with hazardous aromatic amines (eg benzidine, 3,3’-dimethoxybenzidine) being found, through their own survey, in a small number of dyed articles, e.g. children’s jeans and pillowcases.

Unlike the European Union, Australia does not presently have specific regulations for these chemicals in consumer goods, although consumer goods are expected to be “safe” generally and there are strict liability provisions for consumers who suffer loss from defective goods.

Not surprisingly, there has been a lot of rather unbalanced media re cancer – kids – jeans etc. See these links, for example:

How would you approach putting this small risk in a more balanced context? Your site has some really helpful risk comparison tables but I didn’t see anything that deals with this particular issue.

peter responds:

I will respond to your comment about carcinogenic dyes in kids’ clothes in a minute.

First, regarding the risk comparison tables you referenced at the end of your comment: Beware!

The tables are in Appendix B of a booklet entitled “Risk Communication, Risk Statistics, and Risk Comparisons: A Manual for Plant Managers,” which I wrote with Vincent Covello and Paul Slovic in 1988 for the Chemical Manufacturers Association (now called the American Chemistry Council). The main thrust of the booklet itself is to warn that risk comparisons often backfire, and to propose a hierarchy of kinds of risk comparisons from most to least acceptable. We added Appendix B with actual risk comparison data somewhat reluctantly, fearing that it might facilitate exactly the sorts of misuse the rest of the booklet inveighed against.

So we tacked on this red-boxed warning at the bottom of every table:

Warning!

Use of data in this table for risk comparison purposes can damage your credibility (see text).

“See text” wasn’t a link, of course. In that pre-Internet era there was no such thing. On the other hand, there wasn’t nearly as much risk that Appendix B would take on a life of its own, independent of the advice in the rest of the booklet, especially Part III. That’s what it has done. When I Googled “risk comparisons” this morning, Appendix B was the very first entry. In my website statistics, Appendix B has tallied 10 hits a day so far this month, more than any other section of the booklet. And you found the tables in Appendix B “really helpful.”

For a quick summary of why these tables are dangerous, see my seminar handout on “How to Do Risk Comparisons.” link is to a PDF file

One final warning: The tables were compiled in 1988 from sources even older than that – so the numbers are really, really out-of-date.

Now that I’ve got that off my chest, I’ll turn to your comment.

I looked at the three links you provided, and didn’t find them very inflammatory. The news stories struck me as pretty matter-of-fact (almost surprisingly so), reporting that so-called “azo dyes” had been found in four pairs of kids’ jeans and one pillowcase (out of 199 items tested by the ACCC), that prolonged exposure to some azo dyes is considered a possible cancer risk, and that the retailers involved had initiated voluntary recalls. Even the user comments are few in number and mostly quite mild in tone. Judging from these three links, Australian media seem to have covered the story without much hype. And Australian parents don’t seem to be freaking out at this probably-small-but-certainly-unnecessary risk to their children – or even expressing much disapproval of the ACCC for not having outlawed azo dyes as some other countries have done.

I’m not convinced that the ACCC needs to do any follow-up risk communication about this event.

Generically, this is an example of what I consider the single most fundamental truth of risk communication: the supremacy of outrage over hazard in determining people’s hazard perception. Most people most of the time shrug off most risks. We have enough on our worry agendas already. Only when a new risk arouses outrage – that is, gets us upset – do we add it to the list.

It follows that if you don’t want people to take a risk more seriously than it deserves, you need to avoid getting them upset. And if some people are already upset, you need to figure out how best to calm them down.

It certainly won’t help to insist that parents who routinely take the huge risk of driving their children around town have no business getting upset about a little dye in the kids’ jeans. In hazard terms, which is how experts think, car accidents are a more serious risk than clothing dyes. But in outrage terms, which is how the public thinks, a pair of jeans that might give your child cancer is scarier than a trip to the store to buy (or return) the jeans.

See my “Introduction to Risk Communication and Orientation to this Website” for an overview of the “outrage → hazard perception” principle and links to articles and videos that explain it in more detail.

Some aspects of the azo dye controversy are intrinsically outrage-arousing – most notably the fact that we’re talking about cancer and children. There’s not much the ACCC can do about that except to acknowledge it empathically. Every time the ACCC points out that the risk is small, it should also point out that any cancer risk to children, even a small one, is naturally upsetting to many parents.

Another outrage component relevant to azo dyes is uncertainty (knowability). I don’t have to be a toxicologist or review the evidence on azo dyes to be near-certain that there isn’t convincing data nailing the size of the azo dye risk: “A child who wears a pair of these jeans for X hours increases his or her cancer risk by Y percent.” When we say a cancer risk is small, we usually mean there’s not convincing evidence that it’s big, so we think it’s probably small. The uncertainty of the azo dye risk exacerbates some people’s outrage. (Others react the opposite way: “I won’t worry until they tell me they’re sure.”) Again, the only risk communication “solution” to uncertainty is empathic acknowledgment. Pretending to be more certain than the data justify is tempting, but sooner or later it backfires, undermining agency credibility.

Two other relevant outrage components are the memorability of past similar cases and the untrustworthiness of the source of the potential hazard. According to the news stories you cited, most or all of the azo-dyed clothing the ACCC found was imported from China. China has been responsible for memorable instances of poisoned consumer products in the past, such as melamine in powdered milk and pet food. And China has sometimes been willing to cover up such instances for unconscionable lengths of time, arousing justified mistrust.

Still, parents are used to the fact that their kids face all sorts of risks. They avoid the ones they can, and try not to worry too much about the ones they can’t avoid. I suspect a key issue here is people’s sense that azo dyes ought to be one of the avoidable risks.

Similarly, many people want genetically modified (GM) food ingredients to be an avoidable risk. In 2011, public worry and pressure – in my terms, public outrage – finally led Food Standards Australia New Zealand (a bi-national government agency) to issue labeling rules for GM foods. The rules are explicit that “GM labelling is not about safety. It is about helping consumers make an informed choice about the food they buy.” In other words, the purpose of labeling GM foods is to make a risk the agency considers tiny avoidable for consumers who wish to avoid it.

If the ACCC were to publish a list of products with azo dyes, that would enable worried parents to avoid the risk. But of course producing such a list would require a lot more work than spot-checking 199 items.

And it would still leave parents with the burden of protecting their children. Why not just outlaw azo dyes, as other countries have done? This is the aspect of your comment I find most interesting: If you’re a government regulator, what should you say about a chemical that’s outlawed in some countries but legal in yours?

Typically, regulatory agencies give the false impression that risk is dichotomous at zero. They don’t actually claim that this is so – since they know perfectly well it isn’t. But they endlessly imply it. If something within their purview is risky, they imply, they will outlaw it. If they haven’t outlawed it, it must be safe.

When pressured to do so, agencies are usually willing to concede four categories of exceptions to this oversimplification:

number 1
They’ll concede under pressure that some permitted risks are non-zero – but they’re so small they’re literally “negligible” – that is, appropriate to neglect. Then they’ll belatedly explain that “safe” doesn’t mean the risk is zero; it means the risk is acceptably low. They’ll try to avoid addressing the question of “acceptable to whom?”
number 2
They’ll concede under pressure that risk magnitude is hard to measure – that there’s always a band of uncertainty around any risk estimate, and for some kinds of risks (chemical carcinogens, for example) the band is wide. So the meaning of “safe” morphs from zero-risk to low-risk to probably low-risk (or even to not provably high-risk). They’ll try to avoid addressing how conservative (precautionary) it makes sense to be in the face of high uncertainty about a probably low risk.
number 3
They’ll concede under pressure that some risks are worth taking because they are inextricably linked to benefits. So the meaning of “safe” morphs yet again to something like “probably safer than other feasible ways of achieving the same benefits.” They’ll try to avoid addressing whether everyone agrees the benefits are worth achieving, or how expensive an alternative needs to be before it is deemed not to be feasible.
number 4
They’ll concede under pressure that they’re sometimes wrong. Years or even decades may go by before they realize that something they thought was safe isn’t. More years or even decades may go by before they manage to get the newly recognized risk regulated. They’ll try to avoid addressing whether these delays are ever politically motivated.

One of the exceptions that regulatory agencies are extremely reluctant to concede is that different countries reach different conclusions about the same risks.

I believe it helps to think of risk regulation in terms of three buckets: an “obviously needs to be regulated” bucket, an “obviously okay to leave unregulated” bucket, and a “tough call” bucket.

If a chemical carcinogen (for example) belongs in the first bucket, every well-run country – at least every well-run affluent, developed country – will regulate or outlaw it. If it belongs in the second bucket, those same countries will leave it unregulated. They’ll all make the same decisions about those two buckets. And those decisions will be easy to defend and hard to challenge. They’re largely science-based decisions.

But with regard to the third bucket, the messy “tough call” bucket, the science doesn’t permit clear inferences. So agencies are much more responsive to other influences: activist pressure, industry lobbying, public outrage, etc. Since these other influences are more localized, the decisions are much less consistent from agency to agency – or from country to country. The third bucket is less science-based and more values-based and politics-based than the other two buckets. That’s not evil. When science doesn’t lead you to a clear action decision, it’s appropriate that other factors hold sway.

Of course agencies (and countries) do vary in how conservative they are, in how strictly they regulate these “tough call” third-bucket risks. But even between agencies/countries of roughly comparable conservativeness there will be lots of inconsistencies: One agency/country decides X is too dangerous to permit but Y is okay; another decides Y is excessively dangerous but X is okay. The inconsistency results from differences in local conditions – including how much economic and political pressure is applied in each agency/country with regard to X and Y.

So the E.U. regulates azo dyes more strictly than Australia. This isn’t necessarily a shocker; odds are there are other “tough call” third-bucket chemicals that Australia regulates more strictly than the E.U. But if the ACCC isn’t willing to admit the existence of the third bucket, then the inconsistency is bound to look bad.

I think there is a strong risk communication rationale for coming out of the closet about the third bucket, instead of pretending that third-bucket decisions, too, are rigorously science-based.

Going after pregnant women who drink: It’s not just straightforward precaution advocacy

name:Anonymous
This guestbook entry
is categorized as:

      link to Precaution Advocacy index

field:Unspecified
date:March 29, 2014
location:Australia

comment:

In Australia the Northern Territory Government has announced an inquiry into the consequences from Fetal Alcohol Spectrum Disorder (FASD).

Minister for Children and Families John Elferink had suggested earlier that measures to “protect the unborn child” may include prosecution of mothers who consume alcohol whilst pregnant.

I’m wondering about the reasons for Mr. Elferink’s outrage. I think he may be concerned, largely, with the drain on resources required to “manage” children with FASD who have troublesome behaviors. Therefore, I suggest that any concerns expressed by the wider community should be explored with ongoing dialogue.

It’s not difficult to come up with scenarios. Imagine at one extreme that FASD mostly results in children who are totally incapacitated and reliant on fulltime care to sustain life. Imagine at a different extreme that FASD nearly always results in one effect only: irreversible sterility of the adults with the condition. I would guess that community attitudes toward those two scenarios would be widely different.

What do you think? Would it be valid to include in the discussion the “management” issues involving other circumscribed communities, such as those affected by thalassemia and Tay-Sachs Disease?

peter responds:

Fetal alcohol spectrum disorder (FASD) is the currently preferred label for a range of undesirable things that can happen to fetuses if the mother abuses alcohol. It includes fetal alcohol syndrome along with a number of other conditions of varying severity.

On one level FASD is a straightforward medical horror story: children condemned to lifetime disabilities, sometimes severe, because their mothers drank during pregnancy. It’s a 100% preventable disorder – just keep pregnant women from drinking alcohol. Why wouldn’t a decent society do everything it reasonably could to prevent FASD?

Your comment suggests some aspects of the FASD issue – and FASD risk communication – that make it a lot more complex than that.

number 1
There’s a lot of societal confusion about the ways we think a pregnant woman should be autonomous and the ways we think she should be subject to external control in the interests of her baby-to-be. Many people find it quite reasonable, for example, to allow women to get abortions if they so choose but forbid them to drink alcohol while pregnant; many others think it’s crazy to judge that killing the fetus is somehow more acceptable than endangering its health. What legal limits should be imposed on a pregnant woman’s right to abuse her own body? In Australia’s Northern Territory, Minister Elferink’s proposal to prosecute pregnant women for alcohol consumption was highly controversial.
number 2
Even those who think a woman should be legally entitled to behave in ways that endanger her fetus usually think that behavior should be discouraged. But how emphatically discouraged remains a controversy. A doctor's advice to lay off the booze while pregnant? Sure. Glares of disapproval from strangers across the room at a cocktail party? Maybe not. There is disagreement over how well shame works as a motivator anyway. And even if it does work, how unkind is it okay to be in the interests of pushing somebody else to stop endangering her baby-to-be?
number 3
As you rightly point out, society’s interest in FASD is motivated by more than compassion for the child’s possible future suffering. The disabilities that FASD causes can require very expensive care. Inevitably, taxpayers end up paying a significant share of the cost. Some would say this fact gives us more right to intervene; we’re not just interfering in the future of somebody else’s child; we’re protecting our own financial stake in that child becoming a self-supporting adult. Others would say self-interest gives us less right to intervene; our pretense of compassion for the child masks our real motive, which is merely to save money. (Of course many people feel both: compassion for a future disabled child and concern about the social costs of caring for that child.)
number 4
This is all further complicated by our mixed feelings about alcohol dependency itself. Medicine has redefined alcoholism as a disease, no different in principle from, say, epilepsy. Ordering an alcohol-dependent woman to stop drinking is thus as foolish and unfeeling as ordering an epileptic to stop having fits. (A severe epileptic seizure during pregnancy can damage the baby too, but we rarely prosecute or even criticize pregnant epileptics.) Of course many people simply don’t agree that alcoholism is a disease. Many others agree on the surface, but underneath we may continue to believe that a woman of character would simply quit drinking, alcoholism or not, rather than endanger her baby-to-be. Some alcoholics do quit, after all; and some recovering alcoholics object vehemently to the claim that before they quit they were sick (rather than weak or self-indulgent or some other explanation). If alcohol consumption is a decision that a woman freely makes, does that mean we must respect the decision (even if we consider it a bad decision), or may we coercively countermand it? If alcohol consumption isn’t a decision at all but merely a symptom of disease, does that mean we must tolerate the symptom, or may we coercively countermand it?
number 5
As if all that weren’t complicated enough, in the Northern Territory of Australia the mothers whose babies are diagnosed with FASD are disproportionately likely to be aboriginals – a group toward whom many white Australians have exceedingly ambivalent feelings. Your comment (anonymous though it was) didn’t mention this fact explicitly. But it was probably in your mind when you hypothesized that perhaps people wouldn’t mind so much if FASD led to sterility instead of expensive behavioral problems, and again when you compared FASD to Tay-Sachs and thalassemia, both diseases that concentrate in people of less low-status ethnicities. Of course the comparison isn’t fair. Tay-Sachs and thalassemia are genetic diseases, period. Alcohol abuse undoubtedly has a genetic component, but it also has a social component. Pregnant aboriginal women are likelier than pregnant white women to drink alcohol for reasons that have less to do with their genes than their culture – including the unfinished history of oppression at the hands of non-aboriginal Australians. Does the oppressed status of aboriginals disqualify members of oppressor races from policing their prenatal health practices? Or does it give us a special obligation to take action to protect the health of aboriginal babies-to-be? Is it possible to distinguish (and disentangle) concern about the health of an aboriginal fetus from guilt-contaminated contempt for the fetus’s drunken aboriginal mother?
number 6
Then there’s the slippery slope problem – or maybe I should call it the mission creep problem. If it’s okay to do something about pregnant women who drink alcohol, what about pregnant women who drink coffee? Who smoke? Who don’t wear their seat belts? Who like to ski? Who like to sky-dive? Who go to concerts where recreational drugs are in the air? Who work in chemical factories where non-recreational toxins are in the air? Who live in polluted cities? Who eat too much fat and not enough protein? Who eat genetically modified foods? And so on, ad infinitum. Do we really know better than a pregnant woman does how best to nurture her fetus? And assuming we do, and have some science to back up our claim, does that entitle us to make her do it our way? Or is there something special about alcohol that distinguishes it from the rest of the fetal care litany?
number 7
Finally, take note of the science itself. There is strong evidence that FASD risk increases when pregnant women drink heavily and routinely. There is also strong evidence that FASD risk increases when pregnant women drink seldom but give in to an occasional alcohol binge. But there is little-to-no evidence that FASD risk increases when pregnant women never binge but drink lightly (one drink a day or less) while pregnant. Light drinking while pregnant hasn’t been proved safe either, since it’s impossible to prove a negative. But the absence of evidence that it’s dangerous suggests that the risk, if it exists, must be small. It’s certainly not crazy for pregnant women to avoid alcohol entirely, just to be on the safe side. Nor is it crazy for pregnant women to permit themselves an occasional drink; science establishes only that pregnant women shouldn’t drink heavily or binge, not that they shouldn’t drink at all. And of course science is no help whatever in determining what if anything the rest of us should do about a pregnant woman who knows all that but drinks heavily or binges anyway – especially if it’s a pregnant stranger from a race our society has a long history of oppressing.

What does any of this have to do with risk communication?

On its surface, trying to convince a pregnant woman to avoid alcohol is straightforward precaution advocacy. The superficial problem, in other words, is the insufficiency of the woman’s outrage about the hazard of alcohol to her unborn child. There are lots of precaution advocacy strategies available to help Minister Elferink and his colleagues develop risk communication campaigns aimed at reaching pregnant woman who keep on drinking. (There’s a research literature on this topic already, some of it from Australia. One of the major steps seems to be to get obstetricians to discuss drinking – and not just heavy drinking – early and often when they talk with patients.)

But underneath this deceptively simple precaution advocacy challenge lies a maelstrom of outrage: responsible parents’ outrage at parents who don’t take proper care of their children; taxpayers’ outrage at people whose children end up needing a lot of government assistance; sober people’s outrage at alcohol abusers; white outrage at perceived or real aboriginal shiftlessness; aboriginal outrage at all-too-real white oppression; maybe even men’s outrage at women and women’s outrage at men.

Three pillars of effective risk communication in high-outrage environments are empathy, candor, and dilemma sharing. If Mr. Elferink hopes to communicate effectively about the risk of fetal alcohol spectrum disorder, especially if he wants to do so with the aboriginal community and with pregnant women of any race who drink, he will need to find empathic ways to be candid about the issues listed above and the dilemmas they present.

It won’t help to pretend that he is embarked on a straightforward quest to improve medical outcomes for babies by teaching their mothers to avoid alcohol.

A riot after police kill a citizen: What’s the hazard, what’s the outrage?

name:Nika
field:Journalism student
date:March 13, 2014
location:China

comment:

I am learning your theory of Risk = Hazard + Outrage, and I am confused about how to identify the two factors, especially the hazard. If one person is killed by a government official, which raises public outrage and may lead to public unrest, is this called “high hazard” or “low hazard”?

peter responds:

The hazard and outrage concepts are sometimes difficult to apply. They are slippery. But see if the following helps.

Case One

A government official kills a citizen. First let’s assume the killing was completely justified and no danger to anyone else. Assume the citizen was trying to commit a serious crime (to kill someone else, for example), and the official was a police officer who rightly saw there was no way to prevent the crime except to kill the criminal. It’s over now, and no one else is at any risk.

But let’s assume the dead citizen’s neighbors don't realize that, and don’t want to realize it. They liked their neighbor who was killed, they don’t like the police, and so they find it easy to believe – mistakenly – that the police officer had no valid reason to kill their friend. They mistakenly fear the police will attack and kill them too for no valid reason. So they stage a protest that turns into a riot.

The citizens were in a high-outrage low-hazard situation. They were angry and frightened and therefore felt endangered, even though in fact they were not endangered.

Case Two

Now let’s assume the killing was completely unjustified. The police department is in an undeclared war with the people of this town, and will use any flimsy excuse they can find to kill local citizens. The citizen who was killed was doing nothing wrong. The police officer hunted him down like an animal. He and his fellow police officers do that often. Everyone in town is at risk from these out-of-control officials.

The dead citizen’s neighbors realize that, and decide to do something about it. So they stage a protest that turns into a riot.

These citizens were in a high-outrage high-hazard situation. They rightly felt endangered, which made them all the more angry and frightened.

Analysis

In both cases, the outcome is a riot. The riot is a high-hazard situation for everyone. It is a hazard to the police, to citizens of the community, and of course to the social order. In that sense, one person’s or group’s outrage is sometimes a hazard to others.

But just as important as the need to quell the riot is the need to address the underlying situation. And there the two cases have very different implications.

In Case One, addressing the underlying situation means working to reduce the townspeople’s outrage, which is not justified by the facts. Outrage management approaches will help.

But in Case Two, addressing the underlying situation means working to validate the townspeople’s outrage and help them find more effective ways to reform the out-of-control police department. Crisis communication approaches will help, not outrage management.

We could dig deeper still if we wanted. In Case One, maybe the criminal’s crime was itself provoked by outrage that we could have found a way to manage better, thus preventing the crime. In Case Two, maybe the police department’s misbehavior is a product of outrage that could have been managed and still needs to be managed, thus diminishing police officials’ hostility toward the townspeople and their motive to misbehave.

I hope this helps!

Explaining a voluntary, very partial evacuation of an angry town with a coal mine fire

name:Trevor Kerr
This guestbook entry
is categorized as:

      link to Crisis Communication index

field:Medical microbiologist (retired)
date:March 2, 2014
location:Australia

comment:

An editorial in today’s newspaper refers to a fire in an open-cut brown coal mine in the Latrobe Valley, Victoria (Australia), near the town of Morwell, that’s been burning for three weeks. You might also want to look at this news story.

Yesterday, the State’s Premier, his Minister for Emergency Services, and the fire services chief stood next to the State’s Chief Health Officer as she announced new guidance for those people exposed to the smoke and ash. Essentially, the advice is that people in higher risk categories should assess their own situations with a view to voluntarily removing themselves.

Some of the reactions from residents are along the lines of “What’s changed, to warrant this advice, when we’ve been in this for three weeks?”

The official responses have been based on knowledge about harm from limited exposures to pollutants and estimates of the time it will take to control the fires. There are several “wicked” parameters bearing on this situation, but on just those two I’ll try a couple of comments.

  1. On quantification of hazard from the smoke, it seems to me the Government ought to be making as many analyses of the fallen dust and the air quality as it can manage, and submitting samples to at least three levels of testing, one of them being entirely independent and with eminent international standing.
  2. On the estimate of duration of hazard, the “ten days” is nonsense. Why not nine, or eleven? Maybe they should have stuck with the “weeks, possibly months” line. The fire services are facing steep challenges and unknown hazards in their work of control. Their experience is almost totally on wildfires in bush and grasslands, where the endpoint for difficult situations is to let a fire “burn out.” That is, clearly, not an option in this case.

There are complex factors in the background history of that part of the Latrobe Valley, and the Hazelwood power generator is right at the heart of the global warming debate. There’s also a recent history of exposure to asbestos.

As for communication of risk, that’s made more difficult due to the depressed socioeconomic status of the immediate region. The people can’t be expected to be as aware of complex hazards, nor be able to keep up with changes in advice. I just hope no one in authority takes a jab at local residents who are smokers.

Finally, my impression from the TV images is that the key people in the recent news item do not seem to be all that empathetic, probably due to natural demeanor and/or stage fright. The politicians are facing a general election later this year, and seem to be permanently wired up to the political spin apparatus. The best communicator is the fire chief, Craig Lapsley. I guess it will fall to him to explain why the fire is taking longer to extinguish.

I should declare that some of my relatives live in the Valley, as far as I know not in the affected area. I am not associated in any way with the personnel or the organizations mentioned.

peter responds:

With some hesitation, I’m classifying the Morwell coal mine fire in my mind as an example of crisis communication rather than outrage management. Officials don’t consider the situation enough of a crisis to justify evacuating the town, at least not yet. And until recently they didn’t consider it enough of a crisis to justify advising even especially vulnerable residents with asthma and similar conditions to get out of town for a while on their own.

But obviously everybody in town is going through a hellish experience, and everybody is rightly worrying how long it will last and how bad it will get. So most of the risk communication lessons of Morwell draw on crisis communication principles. link is to a PDF file

I’ve only read a little of the coverage, including the two clips you recommended. Here are four tentative reactions.

number 1

The empathy deficit

I think you’re absolutely right that Victoria officials need to be more empathic to the people of Morwell. It’s always important in situations like this to tell people stories about themselves – in this case, to talk knowledgeably and vividly about how awful it has been to live in Morwell these past weeks. Even (maybe especially) if the situation doesn’t justify ordering a mass evacuation, it justifies a more emotional, less matter-of-fact acknowledgment of what the situation feels like to the people who are stuck in it.

The editorial in The Age is reasonably empathic. Even though it doesn’t tell stories about the tough time various individuals are having in Morwell, it does include some appropriate descriptions of what they’re going through. The headline, “A hazy response as Morwell suffers,” is certainly empathic. And the lede is wonderful

Seventy years ago, after disastrous bushfires ignited the open-cut coal mine near Yallourn in Gippsland, royal commissioner Leonard Stretton described how the town’s residents lived mostly “in a fine rain of abrasive coal particles.” Yallourn no longer exists. It was dismantled in later decades by the town’s owners, the former State Electricity Commission, and sacrificed to the vast industrial exercise of mining brown coal to provide electricity for the state.

Residents of the nearby town of Morwell, however, know all too well what this “fine rain of abrasive coal particles” is like. For the past three weeks they have lived in it and breathed it constantly….

Dr. Rosemary Lester comes across in the news story you recommended as comparatively cold. I’m sure this is unfair. She is being admirably straightforward in her substantive responses to people’s concerns and criticisms – for example, conceding that not much is known about the health effects of living near a coal fire for weeks or months. And she hasn’t fallen prey to the temptation that besets so many technical experts to hide her uncertainty and concern behind a curtain of impenetrable jargon. Odds are she’s been working long hours trying to figure out what’s best for the people of Morwell. Odds are she is more upset on their behalf than she considers it professional to show. So she focuses instead on what she knows and what she recommends.

But unexpressed empathy doesn’t help much. People need to feel that the officials they’re relying on know and care what they’re going through. It doesn’t work to fake empathy. But it’s foolish to hide empathy; officials need to learn to let it show.

number 2

Worst case scenarios versus over-reassurance

I agree with you that a ten-day estimate for getting the fire under control sounds optimistic (though I’m not sure I’d go along with “ridiculous”) – not to mention actually putting it out; “under control” just means it’s contained. And any optimistic estimate risks setting people up to suspect that authorities are trying to calm them rather than level with them. That suspicion can be paradoxically alarming; when officials over-reassure, the public worries all the more.

I’m not convinced that’s what’s happening here, however. The editorial says officials are saying “at least ten days.” That doesn’t sound to me like an effort at false reassurance. It sounds like a warning not to expect miracles – which is good as far as it goes.

But “how soon might you get the fire under control” probably isn’t the top question in the minds of Morwell residents. In a crisis, we typically have two top questions: “What do you think will probably happen, what’s the likeliest outcome?” and “What are you worried about, what’s the worst outcome that’s not vanishingly unlikely?” These are our two top questions when we’re talking to a doctor about a not-yet-diagnosed illness or talking to a plumber about a mysterious leak. Saying it will take at least ten days to get the fire under control answers a different and less crucial question, “What’s the best outcome that’s not vanishingly unlikely?”

Moreover, there’s always a risk that people will do what you have done: interpret the “best case scenario” as a likeliest case prediction … especially if no likeliest case prediction is offered. Then if ten days pass and the fire still isn’t under control, officials will lose a lot of credibility. And even before then, people may feel over-reassured, which as I have said is anything but reassuring.

What would a full answer look like? I don’t know the facts and I’m not a fire expert, but something like this:

It’s probably going to take several more weeks before we get this fire under control. It might be months, even. Worse still: As many of you have learned, sometimes coal fires are never brought under control, and take years to burn themselves out. That’s the worst case, obviously. The best case: It’ll be at least another ten days. That’s what we’re hoping for, ten days. But we’re not counting on it.

To the extent that they can, officials should handicap these widely varying estimates. For example, do they think the awful worst case of never getting the fire under control is a one-in-a-thousand shot, or one-in-a-hundred, or one-in-ten, or what? If they’re unwilling to guesstimate with numbers, they can use words instead; is it “highly unlikely” or “something we’re actively worrying may actually come to pass”? (See “Estimating uncertain probabilities quantitatively.”)

If there has been a breakthrough that alters these three scenarios in a good direction, officials should say so. They should be sure to explain what the breakthrough is, not just start sounding more optimistic. Ditto if there’s a setback that alters the three scenarios in a bad direction. People want to know what’s being done to control the fire almost as much as they want to know the prognosis for finally getting it controlled.

Bear in mind that “it’s not as bad as we feared” is a far better mid-crisis message than “it’s worse than we thought.” Given that it’s impossible to predict at the outset how bad a crisis will turn out, officials should make sure their early messaging is sufficiently pessimistic that they’re very unlikely to have to go down the “worse than we thought” road later.

The two most important lessons here: First, don’t over-reassure, and avoid saying things that may sound like you’re trying to over-reassure. And second, focus mostly on two scenarios, the likeliest scenario and the worst scenario that is likely enough to be worth worrying about.

number 3

Acknowledging uncertainty and sharing dilemmas

We know long-term exposure to the products of coal combustion is a serious health hazard. That’s one of the main reasons coal-fired power plants are strictly regulated. And we know short-term exposure causes acute symptoms like eye irritation and bad asthma days. What we don’t know is whether there’s a significant long-term health impact of short- to mid-term exposure. Are people who have lived near an out-of-control coal fire for several weeks or months more likely than others to end up years later with lung cancer or COPD or other serious illnesses? A little more likely? A lot more likely? That we don’t know.

It seems to me that Dr. Lester is being pretty candid about this uncertainty. But I haven’t investigated thoroughly enough to know if it took her too long to get there. Is she finally “admitting” the uncertainty under pressure or has she been proclaiming the uncertainty (as she should have done) from day one? And maybe she needs to say more aggressively what everyone already knows: Living with an ongoing coal fire in your back yard certainly isn’t good for you, and it's almost certainly at least a little bad for you, especially if you’re already coping with respiratory problems. We just don’t know how bad.

The uncertainty about health effects of the Morwell coal fire isn’t remediable; it’s just something that must be acknowledged, early and often. But there shouldn’t be too much uncertainty about how much of what pollutants the residents of Morwell are breathing. Of course officials can’t always do as much monitoring as neighbors want them to do, but something is wrong if they’re not doing enough to say confidently what’s in the air. Even if their health conclusions are necessarily sketchy, their air quality assessments shouldn’t be.

The Victoria Environmental Protection Authority posts hourly air quality data from throughout the state, including three locations in the Latrobe Valley. If people near the fire are demanding additional information on other pollutants or other locations, so they can make their own health judgments and action decisions, I’d certainly advise the relevant agencies to try hard to meet that demand.

Your comment expresses some doubts about whether air quality information is being provided in ways that Morwell residents find trustworthy. You advocate making sure independent experts with “eminent international standing” have a hand in determining exposures. I don’t know whether the trustworthiness of these data is actively being questioned, but I agree with you that if it is, some accountability mechanism is needed. I generally prefer oversight by skeptics, critics, and opponents to bringing in expert neutrals, since my experience is that expert neutrals (however eminent) lose their presumption of neutrality as soon as they express an opinion on something controversial. But either is better than no accountability mechanism at all.

Your comment also expresses doubts about whether the “depressed socioeconomic status” of some people in and around Morwell could get in the way of their ability to understand what they’re being told. I wouldn’t worry so much about that. While there’s no doubt that richer, better educated people are usually more skilled at interpreting technical information than their working-class neighbors, the biggest determinant of comprehension isn’t wealth, class, or even education. It’s the motivation to pay attention. (See “Motivating Attention: Why People Learn about Risk … or Anything Else.) Most Morwell residents are undoubtedly highly motivated to understand what’s happening to their town, and maybe to their health. They’re paying plenty of attention. Their outrage (see #4) may get in the way of their comprehension; it won’t keep them from learning a lot, but it can certainly distort what they learn, especially if the outrage is directed at the people who are doing the teaching. But I wouldn’t worry much about the victims of a fire being too uneducated to understand what they’re told is happening.

One important aspect of crisis communication that’s missing from the coverage I’ve read is a candid acknowledgment of the dilemma officials face regarding what to do about the people of Morwell while efforts continue to put out the fire.

Apparently the situation isn't bad enough – yet, anyway – to justify forcing everyone to leave, or even aggressively urging everyone to leave. And it isn't bad enough – yet – to justify government programs to take care of those who want to leave but don’t have the financial resources or don’t have a suitable place to go. But it has been three weeks and counting, and while nobody knows the long-term health effects of a few months living with a coal fire, officials do know that the people likeliest to suffer those health effects are those with particular preexisting health problems. So they’re left giving advice that many people understandably find profoundly unsatisfactory.

I think they should say so – something like this:

We understand the tough questions that are raised when we recommend that certain vulnerable populations leave town voluntarily till the smoke clears. If some people should get out of town for the sake of their health, why not everyone? If we didn’t advise anyone to leave two weeks ago, why are we recommending that now? What about people who want to leave but can’t because they have commitments in town, or because they can’t afford it, or because they have no appropriate place to go? If the government thinks people should leave, why isn’t it doing more to help them leave?

There would be tough questions whatever we did. What would critics say if we weren’t even advising those with health problems to leave? What would they say if we ordered everyone to evacuate? Given what we know (people with prior health problems face the greatest health risk from the fire) and what we don’t know (how long the fire will last, and what the long-term health consequences are of a fire that lasts that long), we think the middle course makes the most sense. But no course feels really right, does it?

number 4

Addressing the outrage

A lot of people in Morwell are angry. As I have already mentioned, their anger, like any variety of outrage, can get in the way of their comprehension. And it can get in the way of their taking the right precautions.

Generically, I draw a distinction between outrage management and crisis communication. In outrage management, outrage is high but hazard is low; people are unduly upset; the task is to find ways to calm them down, to reduce their outrage. In crisis communication, on the other hand, hazard and outrage are both high; people’s justified outrage helps motivate needed precautions; the task is to guide them through their outrage, not to talk them out of it.

The situation in Morwell is a crisis. So outrage management isn’t the main task. The main task is to help people cope, not to calm them down.

But outrage management isn’t entirely irrelevant in a crisis. Outrage at the situation (at the fire, in other words) is justified, and it’s useful because it motivates precaution-taking. But outrage at the people and organizations trying to manage the situation (at the government, for example) is a different story. It may or may not be justified. Justified or not, citizen outrage at government crisis managers motivates a lot of oppositionality. If I’m angry at officials, I will naturally mistrust what they tell me. If they want me to evacuate, I might look for reasons why I should stay in town instead, or why they should give me more help to get out, or why they should have told me to get out weeks ago. If they don’t want me to evacuate, I might look for reasons why I should leave. If they tell me the situation is getting better, I’ll think they’re covering up. If they tell me it’s getting worse, I’ll think it’s their fault.

It’s always possible, even likely, for outrage at a bad situation to morph into outrage at the officials who are trying – so far unsuccessfully – to manage it. That’s especially likely if outrage at officialdom is already pretty high, which wouldn’t be surprising in a depressed coal-mining town. Add in the fact that officials managing the Morwell situation haven’t always been as empathic as they might have been, and the stage is set for outrage pyrotechnics. I’m told those pyrotechnics have been much in evidence with regard to the Morwell fire in some radio call-in shows in Victoria, and presumably elsewhere as well.

So officials need to think not only about the principles of crisis communication link is to a PDF file , but about key outrage management strategies link is to a PDF file as well: staking out the middle, acknowledging prior misbehavior, acknowledging current problems, giving critics credit for improvements, sharing control, being accountable, etc.

name:Maryanne Martin
field:Senior facilitator and coach, Fire Up Coaching
date:March 2, 2014
location:Australia

Maryanne Martin has launched a Fire Up program on Coaching for Community Engagement. She and I had exchanged emails about the Morwell situation before I received Trevor Kerr’s Guestbook comment. So I sent her my draft response for any comments she might want to add. This is her reply.

Given that it’s a crisis situation, are people being given enough actions to help them “bear their pain”? There’s really only one action on the table – to leave town – and as you point out if there’s resentment or mistrust of the authorities then people may not be very receptive to the one action offered to them. A menu of options would be better.

I think that it’s likely the government’s response to date has been heavily influenced by the corporate communications branches in the office of the Premier and the offices of the various fire authorities that have been responsible for handling the response. The people in these communications roles are very good with messaging for the browser audience. But they lack knowledge of what I’d call “engagement,” which deals more with attentive and passionate audiences.

Because the response is being led by these people, it’s likely they are wanting to make the situation seem not as bad as it is, or could become, partly in an effort to reassure and importantly to make the government seem competent and on top of things. But as you point out if the situation gets worse and they have downplayed the risks, then they are not going to look very competent in the longer term.

I think another action I’d recommend if the Premier were to ask my view (highly unlikely!) is to actually send people with strong engagement knowledge and skills to Morwell and provide some kind of face-to-face forum(s) – not a town hall meeting, though! – that would allow people to express their frustrations so they get a sense of being heard, as well as a sense that someone actually cares, and that the authorities have the courage to come face-to-face with the people of Morwell. Of course, this would need to follow outrage management guidelines: listen, listen, listen, admit mistakes, acknowledge the inadequate effort to respond to people’s angst, and most importantly don’t try to talk people out of whatever view they have on the issue no matter how bizarre it might be.

However, the challenge for any group of engagement specialists in doing this is walking the line between listening/empathy and knowing when to be firm about what the engagement “promise” is. Sometimes when you are face-to-face and listening well, showing care, etc., people think that you are agreeing to take more action than it is possible to take. So at some point in the listening, acknowledging etc., you’re required to not overpromise on things that you can’t deliver. It is a fine line, because as soon as you say, for instance, that you can’t change policy (which is the truth), you run the risk of undoing all the listening etc. that’s gone before.

Gain-of-function research: Should researchers who say misleading things about their results be trusted on safety?

name: Debora MacKenzie
This guestbook entry
is categorized as:

      link to Pandemic and Other Infectious Diseases index

field:Medical writer, New Scientist
date:February 14, 2014
location:Belgium

comment:

I am writing something on the risks of gain-of-function research with flu. As you know, I reported the ferret-transmissible H5N1 work, and efforts by the Rotterdam group to change their message from “fear this virus” to “this virus is safe” when it appeared they might not be allowed to publish. In the past I have concluded that, yes the research is risky, but the greater risk is not finding out the pandemic potential of the widespread, wild virus, thus doing nothing to prepare for the possibility that it might evolve the ability to cause a pandemic.

I wondered how your thinking about that whole incident has matured in the time since. As you may know, the Rotterdam group and with them all European researchers are now threatened with having to get permission from export control officers who understand next to nothing about virology before they can publish anything. I still think this work is worth doing on the basis of risk evaluation alone, and that could be a regrettable disincentive. But the work must absolutely not be done without sufficient safety controls, and the defensiveness and distaste for openness the conflict created in some of the researchers is also worrying.

You and Jody are the risk experts. I’d be grateful for anything you may have time to tell me about this.

peter responds:

My wife and colleague Jody Lanard coauthored this response.

As risk communication experts, we are not qualified to have to a professional opinion on the comparative risks and benefits of gain-of-function (GOF) research like that done by Ron Fouchier at the Erasmus Medical Center in Rotterdam.

We do have a professional opinion that both sides in risk controversies typically make one-sided arguments on behalf of their positions. So it is not surprising that proponents of GOF research tend to overstate the probability that it will have major benefits (i.e. help prevent or mitigate a pandemic) and to understate the probability that it will do serious harm (i.e. help launch a pandemic). In exact parallel, we think opponents of GOF research tend to overstate the probability of serious harm and to understate the probability of major benefits.

Obviously, the rhetorical imbalance of both sides does not answer the question of whether GOF research is more valuable than dangerous or vice-versa.

We also feel qualified to have a professional opinion about the way Ron Fouchier communicated with the public and the scientific community about his research. And we believe that opinion is relevant to the questions you ask.

Dr. Fouchier’s early descriptions of his results were very alarming – in his presentations, in his media interviews, and on the Erasmus Medical Center website (and perhaps in the paper he initially submitted, which of course we have not been permitted to see). His later descriptions of the same research, after a controversy arose over whether the research should be continued and whether it should be published, were much more reassuring. For our detailed documentation of these discrepancies, see “Science versus Spin: How Ron Fouchier and Other Scientists Miscommunicated about the Bioengineered Bird Flu Controversy.”

Consider for example this direct quote from Dr. Fouchier in a November 28, 2011 Erasmus Medical Center Press Release: “In the laboratory, it was possible to change H5N1 into an aerosol transmissible virus that can easily be rapidly spread through the air.” Then consider this direct quote from his February 29, 2012 presentation to the American Society for Microbiology: “These [lab-mutated] viruses do not kill ferrets if they are sneezed upon…. If anything, our data suggest that this virus spreads poorly.”

Rather than owning up to the way he changed his story, Dr. Fouchier has consistently blamed discrepancies like these on “inaccuracy” on the part of journalists (including you).

We take no position on which (if any) of Dr. Fouchier’s descriptions of his own research were the correct ones: whether he hyped his early descriptions or downplayed his later descriptions or both.

Either way, we think Dr. Fouchier’s wildly inconsistent public communications about his research justify considerable skepticism about his candor. And we find ourselves wondering whether scientists who explain their results in apparently careless, highly discrepant ways – and then blame others for the subsequent confusion and alarm – should be trusted to be sufficiently scrupulous about other aspects of their research, including safety protocols.

We note as well that most of the GOF research community has been unwilling to hold Dr. Fouchier publicly accountable for the discrepancies in his communications about his research. His colleagues seem to have united in defense of his public reputation, acquiescing in the papering over of the discrepancies for which he was responsible.

Are some GOF scientists more deeply committed to their “Guild” solidarity than to candor in public communications? If so, is it outlandish to wonder whether they might similarly paper over violations of safety protocols, and try to deal with such problems out of the public eye? These questions are not meant to be rhetorical or snarky. We mean the questions literally; we are not trying to imply that we know the answers. We do consider these questions worth asking as part of the ongoing debate over whether GOF research should continue and, if it does, with what sort of oversight.


For my earlier writing about the controversy over Dr. Fouchier’s H5N1 biotechnology research (gain-of-function research), see the following:

Why you should never give up on working with fanatics

name:Lauren
This guestbook entry
is categorized as:

      link to Outrage Management index

field:State government
date:January 9, 2014
location:Australia

comment:

I’m currently working with an outrage management issue and would to ask you what you would do.

The majority of people in a local community I am working with would like us to do a fuel reduction burn to reduce the fuel hazards surrounding their township.

There are a small group of “fanatics” that are quite passionate about stopping the burning in this space. It is clear that they are not interested in talking out their “issues” with the burn, which we have offered on numerous occasions. (They seem to have a larger agenda which isn’t really about the burn in question but looks more like a policy issue without admitting to it.) All they seem to want to do is to have us write letters in response to their anger – which only seems to increase the outrage on both sides.

I remember when I heard you speak after the 2009 Black Saturday bushfires, you were talking about some fanatics who will always say black when you say white. I believe we are in this space.

How do you work with these sorts of groups? Is there a point when you say, “Right, we are doing everything reasonable to try and work with you on this issue. If you would like to join in please do so. If not, we have to end further communications”?

I’m trying to find the balance between what is right and what the majority of the community would like, and also find a way to lift staff morale.

peter responds:

A few months ago I wrote a long Guestbook entry about prescribed burns (or “fuel reduction burns”), addressing both the problem of how to arouse sufficient outrage (concern) about wildfire/bushfire risks and how to ameliorate excessive outrage about prescribed burns. I won’t go back over that ground here.

You’re raising a different question – two questions, really: How can you work with fanatics who seem determined to polarize the controversy rather than seeking any sort of path forward? And when if ever is it okay to give up on working with them? Both questions, obviously, apply to nearly every controversy, not just controversies over fire management.

Here’s the answer to both questions in a nutshell: You should keep trying to find common ground with fanatics, essentially forever – long after you are convinced that your efforts to do so will prove fruitless. That’s the best way (the only way, really) to help everyone else see the fanatics as fanatics, and thus to minimize their ability to derail your project or policy. It’s also the best way to make sure your project or policy actually improves by taking onboard the fanatics’ concerns … even though their intransigence may make you feel like stonewalling them instead.

The term “fanatic” sometimes misleads my clients into thinking that fanatics are nothing but troublemakers. My clients are often inclined to think that anyway, but my use of the term “fanatic” may give them the impression that I think so too. To the contrary, fanatics play an essential role in the ecosystem of a controversy:

  • Sometimes compromise really isn’t the right path forward; sometimes a project or policy really needs to be defeated and “fanatic” opposition is the only moral option. Pause for a second and ask yourself if there’s anything you would fight against (or for) uncompromisingly. I’ll bet there is. On that issue, you’re a fanatic too, and proud of it.
  • Sometimes the best way for opponents to achieve a compromise they can live with is to insist for a while that they will never compromise. Polarization as a tactic can win them more supporters, build their supporters’ fervor, garner publicity, and in countless other ways help push the compromise to come in the direction they favor. The tactic may backfire: Tactical fanatics or their supporters may turn into real fanatics who can’t stomach any compromise at all. But it’s not rare for erstwhile fanatics to cut a deal in the end.
  • Even if fanatics mean it when they say they’ll never compromise, they may still cut a deal in the end … if you manage the controversy in such a way that cutting a deal is their only alternative to being marginalized entirely. I’ll get back to this in a minute.
  • Finally, fanatics who remain true to their fanaticism and never cut a deal may nonetheless contribute to the deal that eventually gets cut without them. Corporate and government officials work more responsively with their moderate critics when there are extreme critics lurking (or demonstrating) outside the meeting room. Critics who think compromise is the right path forward thus owe a debt of gratitude to critics who don’t.

So however you decide to respond to your fanatic opponents – and however frustrated you may be by their fanaticism – try not to forget their legitimacy. A world in which no one ever took uncompromising principled positions would not be a better world.

Most successful movements in history have had both a radical wing and a moderate wing. The moderates ended up with holidays, schools, and streets named after them. But it’s the extremists who gave the moderates much of their power and kept them from settling for too little.

Local activist causes, too, have radical and moderate wings. Usually a group’s most committed volunteers are its radicals, while those who contribute mostly money rather than time tend to be more moderate. The radicals, of course, want the group to stay pure; the moderates want it to accomplish something, to bring home half a loaf. Aware of these competing demands, the group’s leaders zig and zag as needed: One month they need a half-a-loaf semi-victory for their contributors; the next month they’ll need a gesture of purity for their volunteers. If they follow the moderates too much, they risk being/looking coopted. If they follow the radicals too much, they risk being/looking marginalized.

In my 2003 column on “Stakeholders,” I distinguish fanatics from three other groups as follows:

“Fanatics” You know their telephone numbers by heart, and they know yours. They want input into everything you decide. Your issue is their main preoccupation in life, second only to job and family (and sometimes not that).
“Attentives” They monitor the media coverage of your issue carefully. Sometimes they go to a meeting, answer a survey, check out a web site, subscribe to a newsletter, contribute to a campaign. Your issue isn’t distorting their lives the way it is for the fanatics, but it’s in their Top 20.
“Browsers” They check you out in the media from time to time, but they don’t want to be bothered providing input. Your issue is on their “worry list,” but nowhere near the top.
“Inatttentives” They don’t know and they don’t want to know.

In a typical controversy, corporate or government officials interact with the fanatics while the attentives watch; the browsers follow the dialogue casually in the media, and the inattentives don’t know it’s happening.

For the officials, there are two possible paths to success: Satisfy the fanatics or bore the attentives. If you can reach an accommodation with the fanatics that satisfies them, obviously the controversy is over. Sometimes you can do that.

But fanatics are hard to satisfy. The likelier path to success is to keep trying unsuccessfully to satisfy the fanatics … while the attentives watch. You’re making concession after concession, taking onboard as much of what the fanatics are telling you as you can. The fanatics hardly seem to notice; instead of compromising in return, they keep coming up with demands that are more and more extreme and more and more peripheral. But the attentives notice. Even though your concessions don’t satisfy the fanatics, they satisfy the attentives, and the attentives start to wonder whether the fanatics are simply unsatisfiable. As the attentives lose interest in the controversy, the fanatics face a difficult choice: Cut a deal or fight on alone, without a constituency of supportive attentives. Your goal is to force the fanatics to that choice point.

The best path to success for the fanatics, on the other hand, is to make sure you don’t keep trying to satisfy them. The last thing they want is for you to make concessions that might look good to the attentives. So they look for ways to con you into not making concessions at all. They try to come up with demands that will look sensible to the attentives but that you will find unacceptable – better yet, offensive. If they can get you to cut off communications, then they can interpret your refusal to deal with them however they wish. You were afraid they’d win. Or you were arrogant in your power. You were coldly calculating or unbearably hotheaded. Fanatics demand to be let in, in ways calculated to maximize the odds that you’ll exclude them instead. They’d far rather complain about being excluded than have to deal. (This isn’t a onetime thing. If you let them in, they’ll look for an excuse to walk in a way they can blame on you.)

What’s going on here is a competition between you and the fanatics over who will look reasonable to the attentives. If the fanatics look reasonable and you look intransigent, the controversy grows. If you look reasonable and the fanatics look intransigent, the controversy ebbs.

So it’s theater. The fanatics are trying to show the attentives how unacceptable your position is, how compromise with you would be immoral; and simultaneously also show the attentives how intransigent you are, how unwilling to compromise. You’re trying to show the attentives how much you respect the fanatics’ concerns, how badly you want to find a path forward both sides can live with, how frustrated you are that they don’t seem willing to compromise, how committed you are to keep trying anyway. The media are watching the play as well, and so are the browsers via the media. But unless the controversy turns into an election issue, the media and the browsers are secondary. The core audience is the attentives.

As you point out in your comment, there’s a morale issue here. Engaging with fanatics is never fun. It’s certainly not fun to keep on listening, offering compromises, and making concessions to fanatics who are doing everything in their power to give offense and get you to stop. And it doesn’t help that so much of this work takes place at rancorous public meetings that run late into the night, with community relations staffers expected to keep their tempers and stay positive, then go home and try to sleep so they can do their day jobs the next morning – often without even comp time, much less hazardous duty pay.

I don’t have a good solution to the morale issue. It helps if your community relations people understand the dynamic that’s at work – understand that it’s theater and they have a role to play. It helps even more if they know that top management understands the dynamic, and understands that their role is difficult and unpleasant and too often thankless. And see what HR has to say about comp time and hazardous duty pay.

When can you stop trying to work with the fanatics? When there are no more attentives, perhaps – when you have already taken onboard much of what the fanatics were demanding, when nobody sees much value in their remaining demands, when they’re totally discredited. Odds are that will never happen. Even if it does, I would still hesitate to stop; stopping might bring the fanatics back to life. Long after the attentives (and the media) have lost interest, smart companies and government agencies continue engaging with the fanatics, just in case anyone is still watching.

Copyright © 2014 by Peter M. Sandman

Contact Information:   Peter M. Sandman

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Email:  peter@psandman.com
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