Getting information out to people can be a messy business. It gets worse when the information is coming from individuals working in a variety of disciplines in a time-constricted crisis mode. It just so happened that when the H1N1 (Round 1) broke earlier this spring, that I was working on a multi-institutional public health project. I had met a range of experts and was learning of the hard work of capturing raw research and reaching out to the public in an understandable way to change awarenesses, and ultimately behavior.

I’d run across a stat that said that 48% of Americans read at 8th grade level or below, so the writing has to be straightforward and simple. The “call to action” has to be specific and clear.

H1N1

Then the H1N1 virus hit and spread rapidly around the world. It was unpredictable and apparently highly contagious. It had an as-yet unclear lethality. Its behaviors weren’t fully mapped. In a world with high mobility, this was starting to look quite concerning. With an emerging sense of revelation of the shape of this health threat, it looked to be a concerning event.

That was all on my mind as I watched the so-called swine flu outbreak hit the public airwaves. I saw professional public health officials speak with credibility and care. I saw accurate information released with methodological and strategic care. It looked like the various global, national, tribal, state, and local agencies were all playing their parts. It looked like the bench-top research was moving along as it should—and the information was coherently released. It looked like various countries were reporting what they were seeing in a cooperative manner. I thought, Wow, all good!

Boy, was that assessment a little premature. As the weeks passed, I had students who posted vivid conspiracy theories on why the government had any interest in this flu; one student suggested that the government had bought into the pharmaceutical companies and wanted a financial windfall. Then, on a van ride from the airport, one of the people sitting in the back said that the concerns of the WHO were overblown and that the threat sure hadn’t materialized. (The typical understanding is that it’s the second wave of a flu season what may come back with a vengeance, based on past pandemics.)

I ran into plenty of individuals who would not wash their hands for basic hygiene.

A lot of conversations went along the lines of how many tens of thousands of Americans die annually from the common flu.

Going with the Evidence

That was a helpful lesson—about not assuming efficacy until the evidence rolled in…and knowing that messages are all polysemic and many-meaninged. People will receive information in different ways, and they will emerge with different understandings. And making that leap into a particular behavior mode would also depend on various complex factors.