title: Risk-communication capability for public health emergencies varies by community diversity.
abstract: BACKGROUND
  Public health emergencies heighten several challenges in risk-communication: providing trustworthy sources of information, reaching marginalized populations, and minimizing fear and public confusion. In emergencies, however, information may not diffuse equally among all social groups, and gaps in knowledge may increase. Such knowledge gaps vary by social structure and the size, socioeconomic status, and diversity of the population. This study explores the relationship between risk-communication capabilities, as perceived by public officials participating in emergency tabletop exercises, and community size and diversity.
  
  
  RESULTS
  For each of the three communication functions tested, risk-communication capabilities are perceived to be greater in communities with fewer then 10% of the population speaking a language other than English at home, decreasing as the percentage grows to 20% (ANOVA P </= 0.02). With respect to community size, however, we found an N-shaped relationship between perceived risk communication capabilities and population size. Capabilities are perceived highest in the largest communities and lowest in the smallest, but lower in communities with 20,000-49,999 inhabitants compared to those with 2,500-19,999.
  
  
  CONCLUSIONS
  The results of this study suggest the need to factor population diversity into risk communication plans and the need for improved state or regional risk-communication capabilities, especially for communities with limited local capacity.
authors: Center for Public Health Preparedness, Division of Public Health Practice, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. esavoia@hsph.harvard.edu
authors: Elena
authors: E
authors: Savoia
authors: Michael A
authors: MA
authors: Stoto
authors: Paul D
authors: PD
authors: Biddinger
authors: Paul
authors: P
authors: Campbell
authors: Kasisomayajula
authors: K
authors: Viswanath
authors: Howard
authors: H
authors: Koh