Crisis and Emergency Risk Communication
as an Integrative Model
BARBARA REYNOLDS
Office of Communication, Centers for Disease Control and Prevention,
Atlanta, Georgia
MATTHEW W. SEEGER
Department of Communication, Wayn e State University,
Detroit, Michigan, USA
This article describes a model of communication known as crisis and emergency risk
communication (CERC). The model is outlined as a merger of many traditional
notions of health and risk communication with work in crisis and disaster communi-
cation. The specific kinds of communication activities that should be called for at
various stages of disaster or crisis development are outlined. Although crises are
by definition uncertain, equivocal, and often chaotic situations, the CERC model
is presented as a tool health communicators can use to help manage these complex
events.
The anthrax attack of September 2001 was arguably one of the most public and dis-
ruptive public health emergencies of recent history. Although much larger and wide-
spread health risks exist, such as the avian flu, the emergence of sudden acute
respiratory syndrome (SARS), the upswing in skin cancer, and the recent West Nile
virus outbreaks, anthrax was new in terms of the perceived threat and the intentional
nature of the attack. Moreover, because anthrax was connected in terms of time and
perception to the 9=11 World Trade Center disasters, it created heightened public
concern and widespread public outrage. The event placed significant pressure on
the public he alth community to communicate effectively within a context of imm edi-
acy, threat, and high uncertainty.
Health professionals, including those in the health communication domain,
often frame their messages regarding the possibility of serious public health harm
as risk communication (Covello, 1992; Freimuth, Linnan, & Pot ter, 2000; Heath,
1994; Sandman, 2002; Witte, Meyer, & Martel, 2000). In organizational settings,
including corporate contexts and disaster management, however, these perspectives
more often have been framed as crisis communication (Barton, 2001; Coombs, 1995;
Seeger, Sellnow, & Ulmer, 1998, 2001). In addition, the public health community
has engaged in issue management regarding health promotion and has sought to
An earlier version of this article was presented at the National Communication Associ-
ation Convention, November 2002.
Address correspondence to Matthew W. Seeger, Department of Communication, Wayne
State University, 585 Manooqian Hall, Detroit, MI 48201, USA. E-mail: Matthew.Seeger
@Wayne.edu
Journal of Health Communication, 10:43–55, 2005
Copyright # Taylor & Francis Inc.
ISSN: 1081-0730 print/1087-0415 online
DOI: 10.1080/10810730590904571
43
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influence public policy regarding health issues. The anthrax episode, however,
required new forms of public health communication. In this discussion, we identify
the distinguishing features of these forms of public health communication. We pro-
pose a comprehensive approach to emergency public health events that incorporates
both risk communication and crisis communication into a hybrid form known as
CERC.
Communication During Crises and Disasters
In general, the management of natural disasters and public health emergencies has
always included a significant communication component in the form of warnings,
risk messages, evacuation notifications, messages regarding self-efficacy, infor -
mation regarding symptoms and medical treatment, among many others. Different
kinds of crises, however, manifest different forms of threat and different communi-
cation exigencies (Pauchant & Mitroff, 1992; Seeger, Sellnow & Ulmer, 2003). Some
kinds of natural disasters, such as hurricanes, for example, may prompt recommen-
dations that residents stockpile water and food or that that they evacuate. Hazard-
ous chemical spills often result in recommendations that residents close windows,
shut off all outside ventilation, and shelter in place. Tornado warnings usually
include recommendations that residen ts seek shelter imm ediately. Floods usually
are accompanied by recommendations that residents drink bottled water or boil
water to avoid waterborne pathogens (Sellnow, Seeger, & Ulmer, 2002).
Public health emergencies, in contrast, generally concern the outbreak of parti-
cular diseases or the identification of specific risks from environmental or life-style
factors. Foodborne pathogens, such as ground beef contaminated with e.col i
157:H7, for example, create a risk to the general public health. In such cases, public
health agencies will track the sources of the disease, undertake actions to stop the
contamination, issue warnings and recalls, and provide the public with information
about symptoms, treatments, an d ways to avoid exposure (Fischhoff & Downs,
2001; Ulmer & Sellnow, 2000). During the outbreak of West Nile virus, public health
agencies have disseminated information about the nature and frequency of the dis-
ease and the level of risk and have offered guidelines for how to avoid mosquito
bites. Typically, these activities rely on the mass media and general public education
campaigns to spread the word.
The specter of bioterrorism raised by the 9=11 attacks and the anthrax outbreak,
however, raised the possibility of intentional widespread harm to the public health.
Some scenarios involving agents such as botulism, plague, anthrax, smallpox, VX,
mustard and sarin gas, as well as radiological materials could cause widespread harm
to the public health Centers for Disease Control and Prevention ([CDC], 2002;
National Council on Radiation Protection & Measurement, 2001). Moreover,
emerging diseases such as SARS or avian flu HN51, although less malevolent in their
origins, create similarly frightening scenarios of widespread harm to the public
health. The technical assessment of hazard, then, suggests a high level of risk.
These risks are also new to the general public and, therefore, include low famili-
arity, are seen as unnatural and exotic, and create high levels of uncertainty. In most
cases, they involve organisms that cannot be seen and diseases and symptoms that
have not before been evident in the general population. This general lack of famili-
arity is likely to enhance the perceived risk by the general public (Sandman, 2002). In
the case of an intentional bioterrorism attack, the percei ved outage surrounding the
44 B. Reynolds and M. W. Seeger
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event also will be high, further enhancing the perceived risk. Bioterrorism is also
likely to create very high level s of uncertainty. Moreover, these emerg ent threats
require more cooperation between various governmental agencies, such as various
law enforcement groups; elected officials at local, state, and national levels; and
the emergen cy management and Homeland Security infrastructure. In some cases,
threats may become politicized, adding complexity. As with other forms of risk com-
munication, these emergent threats create challenges for the medic al and public
health community to communicate in accurate, credible, timely, and reassuring
ways.
Risk and Crisis Communication
Risk communication is a mature area of research and practice that informs many
public health campaigns. Heath (1994) suggests, ‘‘Risk communication deals with
risk elements, whether they are appropriately tolerable, and risk consequences’’
(p. 257). Covello (1992) defines risk communication as ‘‘the exchange of information
among interested parties about the nature, magnitude, significance, or control of a
risk’’ (p. 359). The National Research Council (1989) describes risk communication
as ‘‘an interactive process of exchange of information and opinion among indivi-
duals, groups, and institutions’’ (p. 2). Risk communication, then, is closely associa-
ted with threat sensing and assessment. In practice, risk communication most often
involves the producti on of public messages regarding health risks and environmental
hazards. Witte and colleagu es (2000) observe that risk communication is most clo-
sely grounded in research on fear appeals as a persuasive device. These messages seek
to induce behavioral change by presenting a threat and describing a behavior or
behavioral change that may alleviate the threat. Efficacy is the effectiveness or feasi-
bility of the behavioral change in alleviating the threat while self-efficacy refers to the
belief that the recommendation can be carried out (Egbert & Parrott, 2001; Witte
et al., 2000, p. 20). Risk communication is also grounded in an assump tion that
the public has a generalized right to know about hazards an d risks. The availability
of information allows the public to make informed choices regarding risk. In this
way risk communication facilitates decisio n making and risk sharing.
Sandman’s (1993, 2002) model of risk as a function of hazard (defined as tech-
nical assessment of risk) and outrage (defined as a cultural view of risk) has framed
many of the efforts to communicate about various public health risks. Moreover, his
detailing of the factors associated with outrage has provided a helpful framework for
assessing the public’s response to various risk factors. Other basic principles of effec-
tive communication also have informed the practice of risk communication. Audi-
ences tend to sim plify messages. Credibility is important to the belie vability and
effectiveness of messages. Risk messages should include some self-efficacy action
that can be taken to reduce the risk (Egbert & Parrott, 2001). Messag es are more
effective when they are strategically matched to aud ience needs, values, background,
culture, and experience (Murray-Johnson, Witte, Liu, & Hubbel, 2001). Risk mes-
sages should be clear and simple, appeal to reason and emotion, and offer solutions
to problems (Friemuth et al., 2000). Much of risk communication as practiced in
public health incorporates these features in public messages, usually carried in the
mainstream media, as general persuasive campaigns. They seek to inform the public
and change behavior in ways that protect and improve the public health and safety.
Crisis and Emergency Risk Communication 45
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Communication, usually in the form of publ ic relations (PR), is also a tra-
ditional activity following a crisis. (see Coombs, 1995; Seeger et al., 1998.) Orga niza-
tional crises, such as a plant explosion, employee violence, toxic spill, or
transportation accident usually generate widespread public and media interest and
often criticism. This crisis communication role of PR derives from the need for
skilled communicators to strategically defend and explain the organization’s position
in the face of crisis-induced criticism, threat, and uncertainty. During crises, PR
practitioners typically face a hostile and inquisitive press and provide accounts of
what went wrong, why, and what is being done in response. Thus, historically, crisis
communication served as spokesperson, buffer, and disseminator of information
(Seeger et al., 1998). This perspective most often involved two defensive strategies:
‘‘deny that a crisis exists, refuse to answer media questions, and resist involvement
by appropriate government agencies’’ or ‘‘releasing partial, often inaccurate and
delayed information while concealing unfavorable facts’’ (Wilcox, Ault, & Agee,
1986, p. 310). This form of post-crisis PRs contributed to a cynical view of organiza-
tions and PR. In general, it served to reduce organizational credibility and often sig-
nificantly enhanced the harm (see Guth, 1995; Small, 1991; Seeger & Bolz, 1996). As
the role of PRs has expanded and as crises have become more common, so too has
the notion of crisis communication. One fundamental change involves a cardinal
tenet among PRs practitioners that an honest, candid, prompt, accurate, and com-
plete response to a crisis is always called for (Small, 1991).
Crisis communication, then, involves the sending and receiving of messages ‘‘to
prevent or lessen the negative outcomes of a crisis and thereby protect the organiza-
tion, stakeholders, and=or industry from damage’’ (Coombs, 1999, p. 4). As such, it
is part of the larger crisis management function (Seeger et al., 1998). Fearn-Banks
(2002) sugg ests that ‘‘Crisis communication is verbal, visual, and = or written interac-
tion between the organization and its stakeholders (often through the media) prior
to, during and after a negative occurrence’’ (p. 480). These communication processes
are designed to reduce and contain harm, provide specific information to stake-
holders, initiate and enhance recovery, manage image and perceptions of blame
and responsibility, repair legitimacy, generate support and assistance, explain and
justify actions, apologize, and promote healing, learning, and change (Seeger et al.,
2003). Crisis communication seeks to explain the specific event, identify likely con-
sequences and outcomes, and provide specific harm-reducing information to affected
communities in an honest, candid, prompt, accurate, and complete manner.
One of the principal distinctions between crisis communication and risk com-
munication concerns their origins. Crisis communication typically is associated with
PRs and is grounded in efforts to strategically manage and frame public perceptions
of an event so that harm is reduced for both the organization and stakeholders. Pub-
lic Relations has sought to ‘‘develop communication models and frameworks that
inform practice and which help limit and alleviate the damage to both the organiza-
tion and other crisis stakeholders such as the community, victims, and their families’’
(Seeger et al., 1998, p. 66). Crisis communication also has begun to draw more heav-
ily on the need to communicate during public emergencies, earthquakes, floods,
hurricanes, and so on (Auf Der Heide, 1989; Sellnow, Seeger, & Ulmer, 2002). This
may involve disseminating information about evacuations, about harm mitigation
resources and procedures, and about possibilities of additional harm (see Mileti &
Sorensen, 1990; Sorensen, 2000). Emergency public information, most often associa-
ted with natural disasters, is designed to ‘‘protect health, safety, and the environment
46 B. Reynolds and M. W. Seeger
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by keeping the public informed’’ and ‘‘to restore public confidence in the organiza-
tion’s ability to manage an incident’’ (Mileti & Sorensen, 1990, p. 4).
Risk communication, in contrast, most often is associated with the identification
of risks to the public he alth and efforts to persuade the public to adopt more healthy,
less risky behaviors (Freimuth et al., 2000). Thus, public campaigns regarding the
hazards of cigarette smoking are the archetype for risk communicati on. Similar cam-
paigns regarding HIV=AIDS and safe sex, drunk driving, binge drinking, vaccines,
drug abuse, infectious diseases, exercise, and various kinds of disease and health
screenings have sought to disseminate information about risk and persuade the pub-
lic to modify their behaviors accordingly (see Murray-Johnson et al., 2001; Rogers &
Deckner, 1975; Smart & Fejer, 1974; Witte, 1992). Risk communication also involves
the disse mination of information about env ironmental hazards such as those asso-
ciated with chemical and toxic contaminates, carcinogens, pathogens, and related
environmental hazards (Powell & Leiss, 1997). Lundgren (1994) also describes com-
munication about chronic, endemic diseases with long induction times as care com-
munication. This form of ongoing communication encourages long-term behavioral
and environmental changes. The underlying assumptions of these various perspec-
tives is that informing the public may allow them to make choices to avoid or reduce
exposures, manage a condition or a risk, or both. Thus, federal and state environ-
mental protection agencies provide fish consumption advisories detailing the level
of contamination in various species. In addition, more specific and detailed warnings
may be found in a variety of pamphlets and brochures disseminated by heath provi-
ders, social service agencies, and in schools. Finally, risk communication also is asso-
ciated with natural disasters, principally in the form of preevent warnings, such as
evacuation advisories, and in posteve nt recommendations about avoiding additional
harm, such as boiling drinking water in the case of a flood.
One focus of risk communication might be loosely described as seeking to create
a rational understanding of risk. As Ropeik and Gray (2002) have recently sug -
gested, often popular understandings of risk in the general public do not match
the scientific facts. Risk communication often seeks to identify persuasive strategies
so that the public can be convinced of a particular view regarding some risk. Among
the common strategies are the use of technical experts or others who have high credi-
bility as well as the skill in translating scientific information to messages appropriate
for lay audiences. Thus, failure to accept this technical view of risk is framed as inef-
fective communication, poor trust, low credibility, or a case of misunderstanding. In
addition, much of risk commun ication is grounded in the use of fear appeals in per-
suasive messages (Witte et al., 2000). These risk communication messages introduce
a threat, such as the possibility of a health harm given a set of conditions. A change
in the conditions, such as the modification of some lifestyle behavior, is then pro-
posed as a way to alleviate the threat . This problem–solution message structure is
well established as a basic form of persuasion (Witte et al., 2000).
Risk and crisis communication have much in common and intersect at a variety
of points. In fact, some suggest that crisis communication is a more limited form of
risk communication (Lundgren, 1994). Both forms of communication involv e the
production of public messages designed to create specific responses by the public.
In both cases, the messages largely are mediated through mass communication chan-
nels, although they also have public communication and group communication
dimensions. Risk communication and crisis communication each rely on credibility
as a fundamental persuasive attribute, although they manifest in differen t ways.
Crisis and Emergency Risk Communication 47
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