Chapter 58

### INTRODUCTION

One thousand and eighteen more Americans died in motor vehicle crashes October through December 2001 than in those 3 months the year before, according to researchers at the University of Michigan's Transportation Research Institute. As those researchers observed “… the increased fear of flying following September 11 may have resulted in a modal shift from flying to driving for some of the fearful.”1 One thousand and eighteen people dead, more than one-third the number of people killed in the attacks of September 11, in large part because they perceived flying to be more dangerous and driving less so, despite overwhelming evidence to the contrary.

In 1971, President Richard Nixon signed the National Cancer Act and declared “War on Cancer.” In 2004 the National Cancer Institute had a budget of $4.7 billion.2 In 2002, cancer killed 557,271 Americans. That same year, heart disease killed 696,9473. Yet the National Heart, Lung, and Blood Institute spent approximately$1.8 billion on cardiovascular diseases, including heart disease, in 2004.4 And there is no National Heart Disease Act, nor a national “War on Heart Disease”, despite the fact that heart disease kills roughly 25% more Americans each year than cancer, roughly 140,000 more deaths in 2002 alone.

Chronically elevated stress is known to weaken the immune system, contribute to cardiovascular and gastrointestinal damage, interfere with fertility, impair the formation of new bone cells, impede the creation of long-term memory, and contribute to a greater likelihood and severity of clinical depression.5

What do these three cases have in common? They demonstrate the threats to public health caused by gaps between risk perception, informed by the intuitive reasoning by which humans gauge the hazards they face, and risk realities based on science. The examples above demonstrate the vital role risk communication can play in advancing public health, by helping narrow those gaps.

### RISK COMMUNICATION DEFINED

Currently, there are multiple definitions of risk communication; however, most embody the basic idea that by providing people with more information, they will be able to make smarter choices about their health.

But that was not always true. The term “risk communication” arose largely as a result of environmental controversies in the 70s, when public concern was high about some relatively lower threats to human and environmental health. Scientists, regulators, and the regulated community described people as irrational, and their frustration gave rise to efforts to educate the public and defuse those controversies.

Early risk communication was viewed as a one-way process in which experts would explain the facts to the ill-informed lay public in ways that would help people behave more rationally, especially about such issues as air and water pollution, nuclear power, industrial chemicals, hazardous waste, and other environmental hazards. Thus, the goal of early risk communication was not always to enlighten people so they ...

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