ABSTRACT
Health organizations face complex challenges in the 21st century, with the development of technology alongside the complexity of the world of epidemics. This chapter examines various strategies for risk communication used by health authorities to communicate epidemics and vaccinations in order to shape vaccine policies. Professional literature on risk management and risk communication emphasizes the importance of creating trust between the authorities and the public (Cvetkovich and Lofstedt, 1999; Earle and Cvetkovich, 1995; Lofstedt, 2005). Studies have found that when individuals who comprise the general public feel they have no control over a situation, trust in organizations is a key determinant in the public’s reception of the risk management approach (Cvetkovich and Winter, 2002). The social trust approach asserts that shared values between individuals
and organizations to develop policy and make decisions is a key predictor of their trust in these organizations and in their risk management practices. Studies have found that individuals’ level of openness rises when they believe that organizations and institutions hold similar salient values (Siegrist et al., 2000). Furthermore, it has been found that there is a correlation between the level
of trust and/or credibility people attribute to an organization and its communicator, and the extent to which they are willing to receive the organization’s recommendations (McComas and Trumbo, 2001; Poortinga and Pidgeon, 2005; Siegrist et al., 2005). The more risk managers are perceived by the public as credible and confidence-inspiring, the more open and attentive the public will be to accept the health organizations’ directives. Trust is created by considering the needs and values of different publics, as
well as the level of credibility of the organization. It would be expected that the authorities would adopt strategies that establish the credibility of the discourse. However, as Foucault (1980) argued, discourse is controlled by mechanisms that determine its limits: what one is allowed or is not allowed to discuss, where and how one should talk and to whom. Foucault emphasized that the mechanisms of power in society create a reality of truth and falsehoods within the scientific discourse – i.e., what is considered truth in the discourse, and what is defined as false. In the context of the discourse on epidemics, the desire to shape the
truth, inasmuch as its power stems from mechanisms of control, refers to the use of force on those who hesitate or refuse to cooperate with guidelines. The strategies exemplified in this chapter expose Foucault’s claims, and
raise the question of the ability of health organizations to create trust based on the credibility of the scientific discourse. This chapter will demonstrate how the strategy of truth and falsehood is transformed into myths, how scientific discourse is reduced to certainty, and how an epidemic turns into a “problem” that begs a solution. It will also demonstrate how the discourse preserves control mechanisms using statistical methodologies.
