Tainted Tomato Cases Reach 552 read the headline of a June 20, 2008, MSNBC News Services story. The Associated Press reported on Aug. 29, 2007, Spinach Recalled Over Salmonella Fears. This was preceded on May 10, 2006, by another MSNBC News Services story with the headline, Toxic Pet Food Kills Dozens of Dogs.
Though some of these stories were later shown inaccurate, these and other high-profile, food-safety crises vividly demonstrate how difficult it is to provide clear and consistent information to affected individuals, the professionals who come to their aid and the public at large. The risk communications surrounding these events were often inaccurate, inconsistent, inadequate or late. Communication missteps hampered community, state and national responses to the threats; in some cases, they resulted in widespread public confusion.
The headlines above speak to the challenges and perils of communicating to a public and media who often demand immediate answers, scientific certainty and reassurances. Organizations that routinely monitor food-safety communications -- such as Booz Allen Hamilton's Food Safety Workgroup -- note that in the case of the bagged-spinach recall, federal public health authorities were faced with a communications dilemma. Although a single manufacturer was the target, that one source had packaged spinach under multiple brands, which led to confusion about and resistance to the recall. The result: Many consumers believed that no spinach was safe, and more broadly, many avoided buying or eating not only spinach, but also a wide variety of green leafy produce.
In the case of the pet-food recall, initially federal authorities didn't correctly identify the problem's scope, and that impacted the credibility of their later communication to the public and media. In fact, some authorities primarily reposted the manufacturers' press releases, while consumers complained loudly that they lacked correct or sufficient information about which products or manufacturers used the toxic ingredient. The steady stream of images and sound bites in the media, as well as an online outcry from pet owners who lost their beloved pets, only intensified the crisis.
These unintended consequences of food recalls and warnings illuminate the need for advanced planning, clear strategies, enhanced coordination and risk tools to effectively communicate with the public before, during and after food-safety defense crises. Research and experience show that the key to successful risk communication is for emergency management and public health systems to respond to public perceptions and to establish, maintain and increase their own credibility and therefore the public's trust. The public must believe that government and commercial entities are working together, doing everything they can and staying on top of the situation. But most importantly, the public wants to see evidence that these entities have viable plans for early detection, rapid assessment, timely communications and that they issue clear, accurate guidance on what the public should or shouldn't do -- e.g., "Do not eat food product X, which might include specific identification guidance, or find a substitute."
Salmonella is a group of bacteria that causes food poisoning. Every year, 40,000 salmonella cases are reported in the United States, according to the Centers for Disease Control and Prevention.
In her 2004 New York Times article, Jennifer Wilkins suggested the United States is particularly vulnerable to both unintentional food safety and intentional food-defense crises, and pointed to several factors that contribute to this vulnerability. For one, the United States is importing increasing amounts of food. Also in 2004, James Zirin noted in The Washington Times that while half of the food consumed in this country is imported, the U.S. Department of Health and Human Services estimates that less than 10 percent of it is ever inspected. Moreover,
contamination by food-borne diseases or a terrorist act doesn't have to occur within the United States to have a devastating affect on its food supply.
These factors may have been top-of-mind for then departing Secretary of Health and Human Services Tommy Thompson when he publicly acknowledged the vulnerability of the U.S. food supply. In an Associated Press report, Thompson said, "For the life of me, I cannot understand why the terrorists have not attacked our food supply because it is so easy to do." Thompson was quoted similarly in 2001, two months after the World Trade Center attacks. At that time, and according to a story by Frederick Golden in Time, Thompson told Congress, "I am more fearful about this [organized attack on food and crops in North America] than anything else."
Whether the causes are intentional or unintentional, communicating about food-safety defense crises falls within the risk-communications parameters.
Numerous terms are used in the subject area of risk, which can be confusing. The President's Commission on Risk Assessment and Risk Management final report refers to risk assessment as the process of organizing and evaluating information about the nature, strength of evidence and likelihood of adverse health or ecological effects from one or a combination of threats. Risk management is the process of analyzing, selecting, implementing and evaluating actions to reduce risk. In this article, the term risk communication means the interactive exchange of information and opinion among individuals, groups and institutions about food-safety defense risk.
Risk communication is a science-based approach for communicating effectively in emotionally charged, high-stress or controversial situations. Also worth noting is the substantive growth in the risk-communications body of knowledge over the last 20 years. Still, risk communication continues to be a powerful, albeit neglected, tool for policymakers and emergency management professionals.
Although salmonella is primarily transmitted through meat products, there has been an influx of vegetable-related cases in the last year.
A thorough understanding of the principles in risk-communication research and practice can inform and guide communication decision-makers in managing message content, messenger characteristics and channel effectiveness. The three key concepts are: perceptions of risk; mental noise; and anticipation, preparation and practice.
In his research, leading risk-communication expert Peter Sandman has identified at least 20 risk-perception or fear factors that can affect how people in a high-concern state of mind view the magnitude of a food-safety defense risk, and therefore its acceptability. For example, risks are generally more worrisome, feared and less acceptable if they are perceived to be:
o under the control of others, especially if they aren't trusted;
o unfair or inequitable;
o man-made as opposed to natural in origin;
o unfamiliar or exotic;
o uncertain; and
o a threat to children.
Further, risk-perception theory counters the conventional notion that facts speak for themselves. People commonly accept high risks, yet at the same time, they fear or become outraged over less-likely risks. For example, once a risk becomes familiar or is no longer new, it's often less of a concern. In their perceptions research, noted risk-communication experts David Ropeik and Paul Slovic, show that at the time bovine spongiform encephalopathy (BSE), commonly known as mad cow disease, first appeared in Germany, a public opinion survey found that more than four in five Germans (85 percent) thought it was a serious threat to public health. The same poll was conducted concurrently in the United Kingdom, where BSE had been around for years and had killed numerous animals and more than 100 people. The UK poll found that only four in 10 British citizens (40 percent)
considered mad cow disease a serious threat.
More recently in 2003, Steve Raabe of The Denver Post and Matthew Walter of the Arkansas Democrat-Gazette, reported on how the U.S. Department of Agriculture (USDA) announced a presumptive diagnosis of BSE in an adult Holstein cow located in Washington state. Officials traced the animal's origin to Canada using an ear tag identification number. The immediate fallout was dramatic: Fearful consumers in the United States and Canada stopped buying beef, and exports from both countries were stalled for months. Sales in related industries similarly declined. Tyson Foods Inc., the largest beef producer in the United States, estimated that BSE cut its beef segment operating income by $61 million in 2003.
The USDA's response in this case was fast and dramatic, and it averted a much larger and more devastating crisis. First, the USDA was proactive in communications by announcing the cow's presumptive diagnosis before labs in England had verified the BSE. Second, despite a relatively low risk level to other livestock and human health, the agency publicly announced proposals to cut the risk even further, including more testing, additional monitoring and tighter controls for imported cattle. Sources said these proactive communications in 2003 helped avoid a UK-style outbreak and more damaging impacts. According to the UK's Department for Environment, Food and Rural Affairs, BSE affected 180,625 British cattle and a virtual worldwide ban on British beef cost farmers billions of dollars.
When individuals are severely stressed and/or otherwise highly concerned about a risk, such as food-safety defense, their ability to process information is typically reduced by up to 80 percent. These concerns -- or mental noise - serve to distract individuals (consumers) and diminish their ability to effectively hear, understand and remember messages. Constructing and delivering information to a stressed population during a food-safety defense crisis is therefore radically different from normal communication. Noted social scientist Dr. Elaine Vaughan, points to a number of possible negative consequences when risk-communication techniques and approaches aren't appropriately applied, including:
o The audience is confused by the message.
o Strong reassurances are issued prematurely.
o Fears are raised without a simultaneous increase in self-efficacy or confidence in risk-reduction steps.
o Contradictory messages are sent.
o Public perceptions are ignored and concerns are not addressed.
o The public refuses to follow recommendations.
o The public's confidence declines in the assessment of risk by experts.
o There's unnecessary social and economic disruption.
Planning is essential for successful risk communication about food-safety defense. Numerous communications experts -- such as Sheldon Krimsky, Alonzo Plough, Caron Chess and R.C. Brownson -- advocate for risk-communication planning that employs specific techniques and approaches rather than generic program goals; be based on a working knowledge of the audiences; provide a framework for addressing audience concerns; and most of all, be flexible and allow for the unexpected. In addition, emergency management professionals must have a clear understanding of the purpose of the communication, the audience and the fundamental message before engaging in risk communication.
Emergency management professionals first must know the purpose of the risk communication. The initial impetus behind communicating food-safety defense risks is usually reactive (risk communication activities in response to a public health and safety concern can be either reactive or proactive, depending on the situation). If a risk communication is to take place, is the goal to inform or persuade audiences? Each situation is unique, but with few exceptions, risk communication is used to assist individuals, communities and society at large to prevent, reduce or mitigate their risk.
For risk communication to be effective, knowledge about the intended audience is also essential. The same risk may have to be communicated to multiple audiences, including scientists, the general
public, mass media, administrators, health-care professionals, private organizations, administrators or elected officials, and therefore must be tailored to the needs of each. It may also be necessary to use different channels to reach these various audiences. Moreover, the complexity and uncertainty of the scientific issues can mean that literacy and numeracy of audiences are especially important considerations if they are to understand and act on the messages.
The third element of risk communication is creating the message and preparing the messenger. Based on the science, purpose, audience and situation, emergency management professionals must decide on the main message to communicate. In risk communication, it could be that there's little reason for concern, a great need for concern or that the potential risk is unknown. Planning is essential in developing and using consistent messages. It's important to recognize, however, that the risk-communication message may have to change over time because of the situation's uncertainty and the possibility that new information will be uncovered.
Much of the success of effective risk communication about food-safety defense is predicated on the amount of work and detailed thinking that goes into planning and preparation before the crisis occurs. The more questions that can be asked and answered during this stage, the better the outcome will be. This is especially true regarding high-visibility issues, such as food-safety defense. Planning questions can be framed as elements to make a food-safety defense risk communication plan easy to use, flexible and easily adaptable for evolving situations. The following are some sample questions developed by Booz Allen Hamilton's Food Safety Workgroup:
What do we want our risk communication to accomplish?
o Increase collaboration with industry/growers to create a "cascading" communication affect with suppliers (grocery, wholesalers, food service) to increase message consistency and accuracy.
o Proactively engage print, broadcast and electronic media by providing stories and amplifying messages through effective partnerships.
o Harness and integrate the power of online media such as blogs, webcasts and other electronic media into one risk-communication plan.
o Train representatives in the delivery of key messages.
o Increase communication and information flow with manufacturers, distributors and retailers about sourcing, containing and limiting distribution of the product (food).
o Communicate at the point of sale to get the prevention and mitigation message to consumers at time of purchase decision.
What's an optimal combination of strategies?
o Establish a public-facing Web site as a portal for accessing information, messages, materials, etc.
o Assess which communication channels are most viable based on geography, type of product, type of consumer and so forth.
o Gather and use historic data from previous recall efforts. When was it done well? Are there examples of when, how and why the public and food-supply chain reacted favorably or unfavorably (following guidance) to a recall?
How can we assess progress and impact?
o Conduct formative research and benchmark against best practice in risk communication.
o Communicate lessons learned by monitoring media response; evaluating effectiveness of messenger, message and means; assessing risk-communication gaps and strengths; and making real-time adjustments when needed.
o Monitor blogs and other electronic media: Which has the highest traffic and the most chatter (both positive and negative)?
o Analyze media placement and coverage and its implications for the overall risk-communication strategy.
What's the real or perceived benefit if we execute our plan?
o Improve communication to strengthen reputation/credibility with consumers, industry, retailers, Congress, partners and other key stakeholder groups.
o Establish communications presence in the market as the go-to source for information, updates and ongoing guidance.
o Use short- and long-term metrics to show impacts on building ownership of the process with the target partner groups and progress on the food-protection plan.
Communicating food-safety defense risk is a complex endeavor with multiple perspectives, approaches and components. There's no single, standard food-safety defense situation or plan. The affected individuals may live in geographic proximity or be scattered throughout the country. The type of exposure and its extent and potential risks, possible actions that can be taken and so forth are highly variable, and each situation is unique. The best practices outlined in this article present a flexible, multicomponent approach for addressing the public's concerns, establishing trust and producing an informed public that's involved, interested, thoughtful, solution oriented and collaborative.
These unintended consequences of a food crisis illuminate the need for advanced planning, clear strategies, enhanced coordination and risk tools to effectively communicate with the public before, during and after food-safety defense crises. Research and experience show that the key to successful risk communication is for emergency management and public health systems to respond to public perceptions and to establish, maintain and increase their own credibility and therefore the public's trust. This can be accomplished with advanced risk and crisis communication planning, clearly developed strategies and the development and implementation of communication tools and tactics to effectively reach the public before, during and after a food safety or food defense crisis.