I love my job. I love that we can have an exercise about anthrax, a decision-making drill about what we’d do, and it can spur a chance to talk about how we (as in you and me) do risk communication. This is not an easy post to write, though, because I’m not exactly going to be complimentary.
Our discussion was about how sometimes we don’t tell the whole story. Consider our flu shot messaging. There was a big brouhaha earlier this year when CIDRAP said that our flu shots weren’t very good. Lots of public health folks were worried saying anything negative about the shot would discourage folks from getting their flu shot. But CIDRAP was right, and the work they did was just a meta-analysis, so the data already existed. We knew flu shots weren’t that great, but we never told the public, and then we, only begrudgingly, accepted Dr. Osterholm’s results.
The discussion today was around giving medicines to political leaders and hospital workers during an anthrax scenario. I argued that we should be transparent in this effort; not only should we give them the medicine, we should tell the public that we did. I felt that our electing to give that medicine to those targeted groups before giving them to the public was justified and defensible, and the public would understand if we told them about it and why.
We’re not very good at telling the truth. We try, sometimes, to sugarcoat the truth, I think. We imagine ourselves as parents, shielding the public–our children–from the bogeyman. From learning too much and being scared. We continue to do this even after anecdotes and best practices and stories detail how well the public handles the truth, the bloody, awful truth.
We fail our charges in this way.
Which bring me to my link. I’m a HUGE fan of Dr. Peter Sandman. His Risk = Hazard + Outrage idea is sublime in its simplicity and depth. He’s one of the forefathers of risk communication and is still one of the most giving. His website is a veritable treasure trove of knowledge, free for the taking. A few years ago, Dr. Sandman spoke at a NPHIC conference, giving their distinguished Berreth Lecture. The Lectures I’ve heard usually focus on a personal history or new way forward. Dr. Sandman’s Lecture, though, implored us as communicators to be more truthful. Even if our rationale for hiding something or not telling the whole truth might be logical or purposeful, we need to trust our publics.
It’s a very long read, but it’s an exquisite piece, and one I’ve been saving for far too long. Please enjoy the 2009 NPHIC Berreth Lecture, as presented by Dr. Peter Sandman.
UPDATE: I’ve spoken with a good friend at CIDRAP (Dr. Nicholas Kelley) about their work on the flu shot report, and he pointed me to the 2013 Special Edition of the South Dakota State Medical Association’s South Dakota Medicine journal, “The Story of Immunization.” I wanted to call special attention to the Afterword by Drs. Kelley and Osterholm (PDF) that gets directly at the heart of the matter:
We must not become pro-science activists who use the same approaches as the anti-science activists to sell our programs. If we do, we will lose the public’s trust and our credibility.