This project examines how health departments (federal, state, and county) communicate with local residents during the investigation of suspect cancer clusters in their communities.

Every day in the United States, on average, three communities reach a sufficient state of alarm to call their state health department for assistance in the investigation of a suspected cancer cluster-an unusual and unexplained increase in the occurrence of cancer in space and time. State health departments investigate about a third of these complaints in one way or another, but find that very few cases (about 1%) feature suspect cancer rates, and almost none present a causal link to environmental carcinogens. Yet public concerns typically persist despite such reassurances. The subject of this project is the continuation and expansion of an established research project designed to examine the social and psychological circumstances surrounding citizen-initiated cancer cluster investigations, with an emphasis on two aspects: the effects of state health department communications, and the experiences of citizens and officials in public meetings held during these cases. This is a study of risk perception, risk communication, and public participation in risk analysis and decision making.

From the summer of 2004 to the fall of 2005, we conducted a mail survey, a news media content analysis, and participation observation in seven communities, selected in the course of conducting the 30-community survey, where state or federal agencies were holding public meetings as one means of risk communication. Following the public meeting, we mailed questionnaires to a random sample from the community, as well as to every attendee who signed in at the meeting. Across seven communities, we received 868 completed surveys, for a 25% average response rate. Of these, 165 were from meeting attendees, who alone had an average response rate of 73%.

Although we are unable to assess changes, our results do provide some information for public health agencies who conduct public meetings during local health investigations. Specifically, the analysis of survey data offered strong evidence that managing a fair public engagement process can contribute to positive civic outcomes even during periods of heightened community concern about area cancer rates. In addition, in response to our inquiry of why citizens chose to attend or not to attend community public meetings, the findings suggest that the majority of citizens who attended the public meetings could be categorized as the curious, the fearful, and the available while the majority of citizens who did not attend could be described as the uninformed, the indifferent, the occupied, and the disaffected. Finally, in our news media content analysis, the results found that news media partially framed the cluster issue as being about whether health authorities were doing enough for community members, whether in terms of enough research or enough mitigation. Further, when news content suggested a need to do more, the suggestion was not that authorities were incompetent but rather that they did not care enough to adequately attend to community needs. To date, we have provided the results back to agencies who participated in this research, as well as individuals who responded to the survey.

community empowerment in environmental management

• Craig Trumbo (University of Vermont)
• John Besley (University of South Carolina)