The Role of Risk Perception in Flu Vaccine Behavior among African‐American and White Adults in the United States

Seasonal flu vaccination rates are low for U.S. adults, with significant disparities between African and white Americans. Risk perception is a significant predictor of vaccine behavior but the research on this construct has been flawed. This study addressed critical research questions to understand the differences between African and white Americans in the role of risk perception in flu vaccine behavior: (1) What is the dimensionality of risk perception and does it differ between the two races?  (2) Were risk perceptions of white and African‐American populations different and how were sociodemographic characteristics related to risk for each group? (3) What is the relation between risk perception and flu vaccine behaviors for African Americans and whites? The sample, drawn from GfK's Knowledge Panel, consisted of 838 whites and 819 African Americans. The survey instrument was developed from qualitative research. Measures of risk perception included cognitive and emotional measures of disease risk and risk of side effects from the vaccine. The online survey was conducted in March 2015. Results showed the importance of risk perception in the vaccine decision‐making process for both racial groups. As expected, those who got the vaccine reported higher disease risk than those who did not. Separate cognitive and emotional factors did not materialize in this study but strong evidence was found to support the importance of considering disease risk as well as risk of the vaccine. There were significant racial differences in the way risk perception predicted behavior.     

Risk Perception,Experience, and Objective Risk: A Cross‐National Study with European Emergency Survivors

Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross‐over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross‐over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed.     

The Effects of Urban Form on Ambient Air Pollution and Public Health Risk: A Case Study in Raleigh,North Carolina

Since motor vehicles are a major air pollution source, urban designs that decrease private automobile use could improve air quality and decrease air pollution health risks. Yet, the relationships among urban form, air quality, and health are complex and not fully understood. To explore these relationships, we model the effects of three alternative development scenarios on annual average fine particulate matter (PM_2.5) concentrations in ambient air and associated health risks from PM_2.5 exposure in North Carolina's Raleigh‐Durham‐Chapel Hill area. We integrate transportation demand, land‐use regression, and health risk assessment models to predict air quality and health impacts for three development scenarios: current conditions, compact development, and sprawling development. Compact development slightly decreases (?0.2%) point estimates of regional annual average PM_2.5 concentrations, while sprawling development slightly increases (+1%) concentrations. However, point estimates of health impacts are in opposite directions: compact development increases (+39%) and sprawling development decreases (?33%) PM_2.5‐attributable mortality. Furthermore, compactness increases local variation in PM_2.5 concentrations and increases the severity of local air pollution hotspots. Hence, this research suggests that while compact development may improve air quality from a regional perspective, it may also increase the concentration of PM_2.5 in local hotspots and increase population exposure to PM_2.5. Health effects may be magnified if compact neighborhoods and PM_2.5 hotspots are spatially co‐located. We conclude that compactness alone is an insufficient means of reducing the public health impacts of transportation emissions in automobile‐dependent regions. Rather, additional measures are needed to decrease automobile dependence and the health risks of transportation emissions.     

The Power of Perception: Health Risk Attributed to Air Pollution in an Urban Industrial Neighbourhood

This paper describes a multi-stakeholder process designed to assess the potential health risks associated with adverse air quality in an urban industrial neighborhood. The paper briefly describes the quantitative health risk assessment conducted by scientific experts, with input by a grassroots community group concerned about the impacts of adverse air quality on their health and quality of life. In this case, rather than accept the views of the scientific experts, the community used their powers of perception to advantage by successfully advocating for a professionally conducted community health survey. This survey was designed to document, systematically and rigorously, the health risk perceptions community members associated with exposure to adverse air quality in their neighborhood. This paper describes the institutional and community contexts within which the research is situated as well as the design, administration, analysis, and results of the community health survey administered to 402 households living in an urban industrial neighborhood in Hamilton, Ontario, Canada. These survey results served to legitimate the community's concerns about air quality and to help broaden operational definitions of health. In addition, the results of both health risk assessment exercises served to keep issues of air quality on the local political agenda. Implications of these findings for our understanding of the environmental justice process as well as the ability of communities to influence environmental health policy are discussed.     

Lightning Rods,Earthquakes, and Regional Identities: Towards a Multi‐Scale Framework of Assessing Fracking Risk Perception

Hydraulic fracturing has provided a persistent, polarizing, and highly politicized source of controversy internationally and in numerous national contexts for just under a decade. This research uses hydraulic fracturing (i.e., fracking) operations in New Zealand as a vignette through which to understand the underlying causes of controversy and the appropriateness of attempts to address them. A multi‐method approach using interviews (n = 25), diagrammatic analysis, and newsprint media was applied to evidence two major findings. First, previous attempts to explain fracking controversy based on social constructivist theory lack a multi‐scalar approach to the assessment of factors that influence risk perceptions. It is found that risk perception surrounding fracking in New Zealand reflects intra‐scalar interactions between factors originating at the international, national, regional, and local scale. Second, there is a concerning absence of critique pertaining to the concept of “social license to operate” (SLO), which has been advocated both internationally and nationally as an appropriate form of stakeholder engagement. This article contributes to the SLO outcomes literature by establishing a need to consider multi‐scalar influences on risk perception when explaining diverse SLO outcomes in communities where fracking operations are prospective or already taking place.     

Context,Cultural Bias,and Health Risk Perception: The “Everyday” Nature of Pesticide Policy Preferences in London,Calgary, and Halifax

Risk perception and the cultural theory of risk have often been contrasted in relation to risk‐related policy making; however, the local context in which risks are experienced, an important component of everyday decision making, remains understudied. What is unclear is the extent to which localized community beliefs and behaviors depend on larger belief systems about risk (i.e., worldviews). This article reports on a study designed to understand the relative importance of health risk perceptions (threat of harm); risk‐related worldviews (cultural biases); and the experiences of local context (situated risk) for predicting risk‐related policy preferences regarding cosmetic pesticides. Responses to a random telephone questionnaire are used to compare residents’ risk perceptions, cultural biases, and pesticide bylaw preferences in Calgary (Alberta), Halifax (Nova Scotia), and London (Ontario), Canada. Logistic regression shows that the most important determinants of pesticide bylaw preference are risk perception, lack of benefit, and pesticide “abstinence.” Though perception of health risk is the best single predictor of differences in bylaw preferences, social factors such as gender and situated risk factors like conflict over chemical pesticides, are also important. Though cultural biases are not important predictors of pesticide bylaw preference, as in other studies, they are significant predictors of health risk perception. Pesticide bylaw preference is therefore more than just a health risk perception or worldview issue; it is also about how health risk becomes situated—contextually—in the experiences of residents’ everyday lives.     

Risk Perception and Information Processing: The Development and Validation of a Questionnaire to Assess Self‐Reported Information Processing

The role of information processing in understanding people's responses to risk information has recently received substantial attention. One limitation of this research concerns the unavailability of a validated questionnaire of information processing. This article presents two studies in which we describe the development and validation of the Information‐Processing Questionnaire to meet that need. Study 1 describes the development and initial validation of the questionnaire. Participants were randomized to either a systematic processing or a heuristic processing condition after which they completed a manipulation check and the initial 15‐item questionnaire and again two weeks later. The questionnaire was subjected to factor reliability and validity analyses on both measurement times for purposes of cross‐validation of the results. A two‐factor solution was observed representing a systematic processing and a heuristic processing subscale. The resulting scale showed good reliability and validity, with the systematic condition scoring significantly higher on the systematic subscale and the heuristic processing condition significantly higher on the heuristic subscale. Study 2 sought to further validate the questionnaire in a field study. Results of the second study corresponded with those of Study 1 and provided further evidence of the validity of the Information‐Processing Questionnaire. The availability of this information‐processing scale will be a valuable asset for future research and may provide researchers with new research opportunities.     

“These Power Lines Make Me Ill”: A Typology of Residents’ Health Responses to a New High‐Voltage Power Line

Little attention has been devoted to the potential diversity in residents’ health responses when exposed to an uncertain environmental health risk. The present study explores whether subgroups of residents respond differently to a new high‐voltage power line (HVPL) being put into operation. We used a quasi‐experimental prospective field study design with two pretests during the construction of a new HVPL, and two posttests after it was put into operation. Residents living nearby (0–300 m, n = 229) filled out questionnaires about their health and their perception of the environment. We applied latent class growth models to investigate heterogeneity in the belief that health complaints were caused by a power line. Classes were compared on a wide range of variables relating to negative‐oriented personality traits, perceived physical and mental health, and perceptions of the environment. We identified five distinct classes of residents, of which the largest (49%) could be described as emotionally stable and healthy with weak responses to the introduction of a new power line. A considerable minority (9%) responded more strongly to the new line being activated. Residents in this class had heard more about the health effects of power lines beforehand, were more aware of the activation of the new line, and reported a decrease in perceived health afterwards. Based on our findings we can conclude that there is a considerable heterogeneity in health responses to a new HVPL. Health risk perceptions appear to play an important role in this typology, which has implications for risk management.     

Loss of Agro-Biodiversity, Uncertainty, and Perceived Control: A Comparative Risk Perception Study in Austria and China

The biogeographical centers of origin of important food crops-called Vavilov centers-are considered to be crucial sources of genetic diversity for present and future crop-breeding programs and thus for human food safety worldwide. Global environmental change and more intensified modes of crop production may cause genetic erosion (loss of traditional crop varieties and loss of crop wild relatives), especially in Vavilov centers. The present study focused on how the risk of genetic erosion (or loss of agro-biodiversity) is perceived in comparison to 16 other risk topics by experts and lay people in Austria and China. The most striking result was that genetic erosion was perceived to be an exceptionally unknown and uncertain risk topic, given that only genetically modified organisms (GMOs) were perceived as being even more uncertain. As a consequence of the high uncertainty, the idea of applying the precautionary principle to further prevent genetic erosion is discussed. An unprecedented finding-one that differs from Austrian participants-is that the Chinese have a higher perceived control over all risk topics. The increased perception of controllability in China is discussed in light of the theory of reflexive modernization. This theory strives to explain the increased critical attitude in Western countries such as Austria toward scientific innovations and toward the idea that everything can be calculated and mastered at will. By revealing different notions of risk perception, this research also provides additional scientific input to risk communication efforts for public education.     

GIS‐Based Integration of Social Vulnerability and Level 3 Probabilistic Risk Assessment to Advance Emergency Preparedness,Planning, and Response for Severe Nuclear Power Plant Accidents

In the nuclear power industry, Level 3 probabilistic risk assessment (PRA) is used to estimate damage to public health and the environment if a severe accident leads to large radiological release. Current Level 3 PRA does not have an explicit inclusion of social factors and, therefore, it is not possible to perform importance ranking of social factors for risk‐informing emergency preparedness, planning, and response (EPPR). This article offers a methodology for adapting the concept of social vulnerability, commonly used in natural hazard research, in the context of a severe nuclear power plant accident. The methodology has four steps: (1) calculating a hazard‐independent social vulnerability index for the local population; (2) developing a location‐specific representation of the maximum radiological hazard estimated from current Level 3 PRA, in a geographic information system (GIS) environment; (3) developing a GIS‐based socio‐technical risk map by combining the social vulnerability index and the location‐specific radiological hazard; and (4) conducting a risk importance measure analysis to rank the criticality of social factors based on their contribution to the socio‐technical risk. The methodology is applied using results from the 2012 Surry Power Station state‐of‐the‐art reactor consequence analysis. A radiological hazard model is generated from MELCOR accident consequence code system, translated into a GIS environment, and combined with the Center for Disease Control social vulnerability index (SVI). This research creates an opportunity to explicitly consider and rank the criticality of location‐specific SVI themes based on their influence on risk, providing input for EPPR.     

A Bayesian Approach to Integrated Ecological and Human Health Risk Assessment for the South River,Virginia Mercury‐Contaminated Site

We conducted a regional‐scale integrated ecological and human health risk assessment by applying the relative risk model with Bayesian networks (BN‐RRM) to a case study of the South River, Virginia mercury‐contaminated site. Risk to four ecological services of the South River (human health, water quality, recreation, and the recreational fishery) was evaluated using a multiple stressor–multiple endpoint approach. These four ecological services were selected as endpoints based on stakeholder feedback and prioritized management goals for the river. The BN‐RRM approach allowed for the calculation of relative risk to 14 biotic, human health, recreation, and water quality endpoints from chemical and ecological stressors in five risk regions of the South River. Results indicated that water quality and the recreational fishery were the ecological services at highest risk in the South River. Human health risk for users of the South River was low relative to the risk to other endpoints. Risk to recreation in the South River was moderate with little spatial variability among the five risk regions. Sensitivity and uncertainty analysis identified stressors and other parameters that influence risk for each endpoint in each risk region. This research demonstrates a probabilistic approach to integrated ecological and human health risk assessment that considers the effects of chemical and ecological stressors across the landscape.     

Risk Perception and Disaster Preparedness in Immigrants and Canadian‐Born Adults: Analysis of a National Survey on Similarities and Differences

Research has documented that immigrants tend to experience more negative consequences from natural disasters compared to native‐born individuals, although research on how immigrants perceive and respond to natural disaster risks is sparse. We investigated how risk perception and disaster preparedness for natural disasters in immigrants compared to Canadian‐born individuals as justifications for culturally‐adapted risk communication and management. To this end, we analyzed the ratings on natural disaster risk perception beliefs and preparedness behaviors from a nationally representative survey (N = 1,089). Factor analyses revealed three underlying psychological dimensions of risk perception: external responsibility for disaster management, self‐preparedness responsibility, and illusiveness of preparedness. Although immigrants and Canadian‐born individuals shared the three‐factor structure, there were differences in the salience of five risk perception beliefs. Despite these differences, immigrants and Canadian‐born individuals were similar in the level of risk perception dimensions and disaster preparedness. Regression analyses revealed self‐preparedness responsibility and external responsibility for disaster management positively predicted disaster preparedness whereas illusiveness of preparedness negatively predicted disaster preparedness in both groups. Our results showed that immigrants’ risk perception and disaster preparedness were comparable to their Canadian‐born counterparts. That is, immigrant status did not necessarily yield differences in risk perception and disaster preparedness. These social groups may benefit from a risk communication and management strategy that addresses these risk perception dimensions to increase disaster preparedness. Given the diversity of the immigrant population, the model remains to be tested by further population segmentation.     

Cigarette Smoking and Multiple Health Risk Behaviors: A Latent Class Regression Model to Identify a Profile of Young Adolescents

Cigarette smoking is often established during adolescence when other health‐related risk behaviors tend to occur. The aim of the study was to further investigate the hypothesis that risky health behaviors tend to cluster together and to identify distinctive profiles of young adolescents based on their smoking habits. To explore the idea that smoking behavior can predict membership in a specific risk profile of adolescents, with heavy smokers being more likely to exhibit other risk behaviors, we reanalyzed the data from the 2014 Health Behaviour in School‐Aged Children Italian survey of about 60,000 first‐ and third‐grade junior high school (JHS) and second‐grade high school (HS) students. A Bayesian approach was adopted for selecting the manifest variables associated with smoking; a latent class regression model was employed to identify smoking behaviors among adolescents. Finally, a health‐related risk pattern associated with different types of smoking behaviors was found. Heavy smokers engaged in higher alcohol use and abuse and experienced school failure more often than their peers. Frequent smokers reported below‐average academic achievement and self‐rated their health as fair/poor more frequently than nonsmokers. Lifetime cannabis use and early sexual intercourse were more frequent among heavy smokers. Our findings provide elements for constructing a profile of frequent adolescent smokers and for identifying behavioral risk patterns during the transition from JHS to HS. This may provide an additional opportunity to devise interventions that could be more effective to improve smoking cessation among occasional smokers and to adequately address other risk behaviors among frequent smokers.     

A Social‐Cognitive Model of Pandemic Influenza H1N1 Risk Perception and Recommended Behaviors in Italy

The outbreak of the pandemic influenza H1N1 2009 (swine flu) between March and April 2009 challenged the health services around the world. Indeed, misconceptions and worries have led the public to refuse to comply with precautionary measures. Moreover, there have been limited efforts to develop models incorporating cognitive, social‐contextual, and affective factors as predictors of compliance with recommended behaviors. The aim of this study was to apply a social‐cognitive model of risk perception and individual response to pandemic influenza H1N1 in a representative sample of Italian population. A sample of 1,010 Italians of at least 18 years of age took part in a telephone survey. The survey included measures of perceived preparedness of institutions, family members and friends’ levels of worry, exposure to media campaigns (social‐contextual factors), perceived coping efficacy, likelihood of infection, perceived seriousness, personal impact, and severity of illness (cognitive evaluations), affective response and compliance with recommended behaviors. Results demonstrated that affective response fully mediated the relationship between cognitive evaluations and social‐contextual factors (with the exception of exposure to media campaigns) and compliance with recommended behaviors. Perceived coping efficacy and preparedness of institutions were not related to compliance with recommended behaviors.     

Health Risk Characterization of Chlorpyrifos Using Epidemiological Dose‐Response Data and Probabilistic Techniques: A Case Study with Rice Farmers in Vietnam

Various methods for risk characterization have been developed using probabilistic approaches. Data on Vietnamese farmers are available for the comparison of outcomes for risk characterization using different probabilistic methods. This article addresses the health risk characterization of chlorpyrifos using epidemiological dose‐response data and probabilistic techniques obtained from a case study with rice farmers in Vietnam. Urine samples were collected from farmers and analyzed for trichloropyridinol (TCP), which was converted into absorbed daily dose of chlorpyrifos. Adverse health response doses due to chlorpyrifos exposure were collected from epidemiological studies to develop dose‐adverse health response relationships. The health risk of chlorpyrifos was quantified using hazard quotient (HQ), Monte Carlo simulation (MCS), and overall risk probability (ORP) methods. With baseline (prior to pesticide spraying) and lifetime exposure levels (over a lifetime of pesticide spraying events), the HQ ranged from 0.06 to 7.1. The MCS method indicated less than 0.05% of the population would be affected while the ORP method indicated that less than 1.5% of the population would be adversely affected. With postapplication exposure levels, the HQ ranged from 1 to 32.5. The risk calculated by the MCS method was that 29% of the population would be affected, and the risk calculated by ORP method was 33%. The MCS and ORP methods have advantages in risk characterization due to use of the full distribution of data exposure as well as dose response, whereas HQ methods only used the exposure data distribution. These evaluations indicated that single‐event spraying is likely to have adverse effects on Vietnamese rice farmers.     

Dengue Disease Risk Mental Models in the City of Dhaka,Bangladesh: Juxtapositions and Gaps Between the Public and Experts

Worldwide, more than 50 million cases of dengue fever are reported every year in at least 124 countries, and it is estimated that approximately 2.5 billion people are at risk for dengue infection. In Bangladesh, the recurrence of dengue has become a growing public health threat. Notably, knowledge and perceptions of dengue disease risk, particularly among the public, are not well understood. Recognizing the importance of assessing risk perception, we adopted a comparative approach to examine a generic methodology to assess diverse sets of beliefs related to dengue disease risk. Our study mapped existing knowledge structures regarding the risk associated with dengue virus, its vector (Aedes mosquitoes), water container use, and human activities in the city of Dhaka, Bangladesh. “Public mental models” were developed from interviews and focus group discussions with diverse community groups; “expert mental models” were formulated based on open‐ended discussions with experts in the pertinent fields. A comparative assessment of the public's and experts’ knowledge and perception of dengue disease risk has revealed significant gaps in the perception of: (a) disease risk indicators and measurements; (b) disease severity; (c) control of disease spread; and (d) the institutions responsible for intervention. This assessment further identifies misconceptions in public perception regarding: (a) causes of dengue disease; (b) dengue disease symptoms; (c) dengue disease severity; (d) dengue vector ecology; and (e) dengue disease transmission. Based on these results, recommendations are put forward for improving communication of dengue risk and practicing local community engagement and knowledge enhancement in Bangladesh.     

A Systems Approach to the Policy‐Level Risk Assessment of Exotic Animal Diseases: Network Model and Application to Classical Swine Fever

Exotic animal diseases (EADs) are characterized by their capacity to spread global distances, causing impacts on animal health and welfare with significant economic consequences. We offer a critique of current import risk analysis approaches employed in the EAD field, focusing on their capacity to assess complex systems at a policy level. To address the shortcomings identified, we propose a novel method providing a systematic analysis of the likelihood of a disease incursion, developed by reference to the multibarrier system employed for the United Kingdom. We apply the network model to a policy‐level risk assessment of classical swine fever (CSF), a notifiable animal disease caused by the CSF virus. In doing so, we document and discuss a sequence of analyses that describe system vulnerabilities and reveal the critical control points (CCPs) for intervention, reducing the likelihood of U.K. pig herds being exposed to the CSF virus.