Inspire Hope, Not Fear: Communicating Effectively About Climate Change and Health

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VIEWPOINT
Inspire Hope, Not Fear: Communicating Effectively About
Climate Change and Health
Wendy Ring, MD, MPH
Bayside, CA
HEALTH CARE PROFESSIONALS HAVE A
VITALROLETOPLAY
Why Now, Why Us? When I first learned about cli-
mate change 15 years ago, I was the medical director
of a rural community health center in northern Cal-
ifornia. I was too busy to do anything more than
click on climate change action alerts, but I assumed
activists and experts would take care of the problem
and we still had plenty of time. When our rivers
started to dry up and wildfires filled the sky with
smoke, I did more clicking, increased my donations
to environmental groups, and waited for a leader to
issue instructions. By the time dust storms raised
valley fever rates 8-fold
1
and Aedes aegypti mosqui-
toesdthe most effective vectors for dengue, yellow
fever, and chikungunyadfound a new home in
California,
2
I realized we were running out of time
and that leadership had to come from people like
you and me.
The window of opportunity to prevent cata-
strophic climate change is closing. The year 2015
will mark either a historic global accord aimed at
dramatically lowering greenhouse gas emissions or
our last, lost opportunity to preserve a livable planet
for future generations. Our current emissions path,
including the proffered international commitments
to date, will cause average global temperature to
rise more than 2C above preindustrial tempera-
tures, possibly as soon as mid-century.
3
Health professionals have untapped power to
influence what happens at this critical juncture:
We are trusted messengers.
4
We have experience
translating scientific information into plain language
for individuals and communities. We have a grow-
ing base of evidence documenting the negative
health consequences of climate change and the pos-
itive health (and therefore economic) benefits of
mitigation.
5
And, in a health landscape dominated
by chronic disease, we have experience from our
daily clinical practice in motivating behavior change.
This is a call to action. With international nego-
tiations showing little cause for us to be optimistic
about closing the gap between political expedience
and necessity, it is time we as health care professio-
nals step forward to put these powerful assets to use.
Leading From Below. I was never a comfortable or
confident speaker, but in 2012 my husband and I
set off across the country by bicycle on a speaking
tour about climate change and health. Since that
time I have given hundreds of talks to groups ranging
from small-town Rotary Clubs to grand rounds at
major medical centers. My initial nervousness
resolved as I discovered that my high standard for
polished presentations was self-imposed. Audiences
value sincerity and reliable information delivered in
terms they can understand. I found that people want
to hear what health professionals have to say about
climate change and our colleagues want to know how
they can help. The most important thing we can do is
stand up and tell them because political pressure
applied by active citizens is the only force that can
divert us from our crash course with disaster.
In my travels as an itinerant climate preacher, I
met many colleagues and students who also wanted
to take action but felt isolated and unsure of what to
do. Together we formed Climate 911, a national
network to mobilize and support health professio-
nals calling for climate action. Our activities include
workshops on best practices in climate/health com-
munication, lobbying, op-ed writing, and monthly
collective action in support of a healthy climate
The author declares she has no conflict of interest.
From Family Medicine, Physicians for Social Responsibility, “Climate 911,”Bayside, CA. Address correspondence to W.R . (wring123@gmail.com).
Annals of Global Health
ª2015 The Author. Published by Elsevier Inc.
on behalf of Icahn School of Medicine at Mount Sinai
VOL. 81, NO. 3, 2015
ISSN 2214-9996
http://dx.doi.org/10.1016/j.aogh.2015.06.006

solution such as clean energy, active transportation,
and sustainable agriculture. Please join us by signing
up at www.climate911.org.
The following information is a distillation of best
practices in communicating about climate and
health gleaned from personal experience and the
growing body of published literature on climate
communication.
RETHINKING OUR COMMUNICATION
STRATEGY
Fear Doesn’t Work. The first attempts by public
health professionals and environmentalists to edu-
cate about climate and health were inspired by cli-
mate communication research demonstrating the
benefit of framing climate change as a health issue.
6
The central message deployed in response to this
finding, which remains the dominant narrative, is a
depressing litany of all the ways that climate change
can make us sick. The intended purpose of these
scare talks was to prove to nonbelievers that climate
change is real and serious. This strategy was based
on 3 erroneous assumptions: (1) people need to be
convinced that climate change is real and serious;
(2) fear motivates action; and (3) we all have to
agree on the problem before we can agree on
solutions.
As some of us suspected from our experience in
clinical practice, fear tactics do not promote acti-
vism, but instead provoke denial, passivity, and
fatalism. My early climate presentations in this
vein were quite successful at generating concern
but produced little in the way of action.
We Have a Silent Majority. In our politically polar-
ized society, opinion about climate change is deter-
mined more by group allegiance than scientific
fact.
7
Fortunately, agreement is not a prerequisite
for action. Communication aimed at reversing cli-
mate denial is at best a waste of time and at worst can
alienate and silence potential allies. If we skip over the
climate catechism and its ideological battleground
and look directly at public support for climate policy,
there is a surprising amount of agreement. Even in the
United States, where public opinion lags behind other
nations, polls repeatedly indicate that a majority of
Americans in both major political parties and in red
and blue districts believe our government should do
more about climate change and support a broad
spectrum of policies to lower greenhouse gas emis-
sions.
8-10
When questions about belief in the human
causation of climate change are added to polls,
majority support goes away.
11
If lack of public support for climate policy is not
the problem, then the sticking point must be else-
where. Further examination of US polling data con-
firms a theme I heard repeatedly in conversations
across the country: People don’t believe they can
get government to act and therefore do not bother
to demand it. We suffer from an endemic lack of
political efficacy. This widespread belief that voters
have no power partly arises from the common mis-
conception among supporters of climate policy that
they are in the minority, but it is also due to the very
real observation that large campaign contributions
from the fossil fuel industry subvert democracy
and induce politicians to act against the wishes
and interests of their constituents.
Given that time is limited, we should stop trying
to scare people out of denial, stop trying to convince
deniers that climate change is real, and focus our
efforts on empowering the rest of us to stand up
and demand climate solutions.
THEELEMENTSOFEFFECTIVE
COMMUNICATION ABOUT CLIMATE
CHANGE
Identify the Target and Focus. Effective messaging
about climate change is communication that results
in action. Governments have proven they will not
act without strong and sustained pressure from their
citizenry. Polls indicate that as much as one third of
Americans are willing to use their votes and/or join
a political campaign to make elected officials to act
on climate change,
11
but this is not happening.
What we need to tap into this potential energy are
the voices and leadership of respected members of
our communities. This dictates a change in our
communication strategy from top down (ie, experts
testify before politicians who ignore the facts and
serve the interests of their industrial benefactors) to
bottom up (ie, we all educate and mobilize the
people around us to exert pressure on politicians and
to replace those who persist in climate inaction). We
should choose who we talk to, what we say to them,
and how we say it with this specific goal in mind.
Establish a Connection. Get personal. Although our
titles and education give us some credibility, what
listeners need to make the move from angst to
action is to connect with us as human beings. Lis-
tening to “experts”can reinforce passivity. For an
audience to begin seeing themselves as actors, they
have to see themselves in us. The depersonalized,
passive voice of the scientific lecture will not serve
this purpose. We must set it aside and let people
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see beyond our credentials to who we are, how we
feel, and why we care. Introduce yourself, name
the common ground you have with your audience,
and share a brief story about a personal experience
or a deeply held moral value that prompted you to
stand up for climate action.
Know your audience. It is equally important to
acknowledge to listeners that you know who they
are by tailoring your presentation to their commun-
ity, locale, values, and concerns. Be sure to select
images of people who mirror the age and ethnic
mix of your audience. When discussing the health
impacts of climate change, fossil fuels, and climate
solutions, bring them as close to home as possible.
Information at county, state, and regional levels bro-
ken down by demographic group can often be found
online with a little searching. These are the things
people will go home and talk about, so conducting
the research to tailor your presentation is well worth
the effort.
Acknowledge Emotions. Contemplation of climate
change provokes strong negative emotions such as
fear, sadness, anger, and anxiety in almost everyone.
Eco-psychologists caution that emphasizing the
dangers of climate change and warning of a future
dystopia activates psychological defenses as a way to
escape emotional discomfort.
12,13
If people are in
denial, more facts only fortify their resistance. Nor is
it helpful to swing the pendulum too far in the other
direction and paint a rosy picture of a low-carbon
future. Ignoring the losses we inevitably face on a
changing planet leaves us unable to work through
our guilt and grief and keeps us trapped in denial.
14
Attention to feelings is important because
research indicates that strong negative emotions
correlate with low levels of support for climate pol-
icy, whereas positive emotions like interest and hope
are associated with increased support of climate
action.
6,15
Joanna Macy, eco-philosopher and Bud-
dhist scholar, believes we must first acknowledge
and accept our painful emotions around climate
change before we can have hope and think clearly
about solutions.
16
Therefore, we cannot be in denial
about being in denial. We have to help people move
through this stage by acknowledging the negative
feelings we all have about climate change, thanking
listeners for being willing to make themselves
uncomfortable, and reassuring them that there are
solutions and actions they can take.
Be Aware of Cognitive Processing and Biases. Balance
emotional and intellectual content. The fields of cog-
nitive psychology and neurobiology provide useful
insights into how people process information, which
can inform our climate communication. Experiential
processing, centered in the amygdala, is emotional,
visual, rapid, intuitive, automatic, and based on past
experiences. Analytic processing, located in the ante-
rior cingulate cortex, is intellectual, abstract, rational,
and deliberative. Survival responses occur in response
to experiential processing cognition, which may
explain why scientific appeals to reason fail to galva-
nize public action.
17
To generate passionate and
thoughtful advocacy, we need to address the heart as
well as the head.
Focus on the here and now. We are also prone to
perceptual distortions that predispose us to irra-
tional responses to climate change. We accept the
status quo as our moral baseline and view any sacri-
fice or loss in the service of improvement as an
unjust theft of something to which we are entitled.
We abhor the loss more than we appreciate gain.
We discount the importance of events that are dis-
tant in space or time and lend more importance to
small effects with high probability than to large
impacts with more uncertainty.
18,19
Things that
may happen at the end of the century are mean-
ingless to the average person. Harms and benefits
are only compelling if they happen here and now.
Tell stories. We are not cognitively wired to
respond appropriately to slow-onset threats like
climate change that require current and sustained
sacrifice to avoid future risk.
18
We are superbly
wired for stories. Functional magnetic resonance
imaging studies performed while participants read
or listen to stories show activation of sensorimotor
regions corresponding to the actions and experi-
ences of story characters and increased connectivity
that lasts for days afterward.
20
We are so naturally
receptive to this form of communication that the
cortical activity of a story listener mirrors that of the
teller.
21
Stories about people and places where cli-
mate solutions are working provide vision, inspira-
tion, and a sense of positive momentum toward a
sustainable future.
Emphasize Solutions and Benefits. Be positive. If
dire predictions don’t motivate action, the solution
is not to make them scarier. Repeated exposure to
stressful stimuli creates psychic numbing and we
learn to sleep through the alarm.
18
Vision, sol-
utions, and a sense of momentum are positive
motivators for change.
22
Although some mention of
the health harms is necessary to build a sense of
urgency, our main emphasis must be on solutions
and their benefits.
Our message must be one of hope. “Successful
climate solutions are happening all around us.
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They come with a bonus of improved health and
well-being. We need only generate the political
will to rapidly scale up these successes to state,
national, and international levels to prevent cata-
strophic global warming. If we act now, we can
transition to 100% clean energy by 2050. We can
get 80% of the way with existing commercially avail-
able technology.
23-25
We can afford to do this
because the decreased health spending and eco-
nomic losses averted by preventing premature mor-
tality are equal to or exceed the cost of switching to
clean energy.
26,27
The hold of Big Oil on govern-
ment can be broken by an active, engaged citizenry.
Please join us.”
Emphasize health benefits. The health benefits of
climate solutions are substantial because fossil-fuel
dependence really does make us sick. Our own
health professions are victims of status quo bias in
their near-exclusive focus on technological cures for
diseases of environmental origin. There is solid
evidence that air pollution, physical inactivity, and
consumption of sweetened beverages and processed
foodsdwhich are themselves products of our fossil-
fueleintensive systems of energy, transportation,
and agriculturedcontribute significantly to car-
diovascular disease, chronic lung disease, obesity,
diabetes, and cancer
28-30
The effects are not small.
Massachusetts Institute of Technology researchers
estimate that in 2005, air pollution from fossil fuel
killed 200,000 Americans.
31
Unlike climate change,
these environmental effects of fossil fuel are rapidly
reversible and result in prompt improvements in
population health. The benefits of action are here,
now, and relevant to almost everyone in our society.
Explain the Difference Between Policy and Individ-
ual Action. It is essential to make it clear that the
solutions we advocate are policies rather than
changes in individual behavior. Global emissions
reductions sufficient to stabilize the climate can
only be accomplished by government action and
international cooperation, but this is not what
most people think of when they think about climate
action. In the face of corporate dominance of the
political process, many people feel the only power
they have is to vote with their dollars by greening
their personal lifestyles.
Those who subscribe to this view of environmen-
tal action by consumer choice may feel guilty if their
options are constrained by income or circumstance
or become defensive if they think they are being
told what to do. Acknowledge the difficulty of
swimming upstream against the main current of
society and ask for support of policies that make
healthy choices easy and available to everyone.
Although it may seem counterintuitive, those who
factor environmental concerns into their purchasing
are not more likely to become climate activists.
Token or single environmental actions relieve moral
tension and absolve the actor, in his or her mind, of
the responsibility to engage politically as a citizen.
17
Educate to Empower. Because our goal is to build
political efficacy, the way we deliver information is
as important as the content. Successful education
starts from where people are and builds on their
life experience, using analogies, anecdotes, and
common sense to construct a bridge between the
known and the new. Use accessible language that
is clear and straightforward. Avoid jargon and the
use of big words if small ones will do. Use numbers
sparingly, round off, and translate units of measure
to those in common use. Describe solutions in terms
of what matters most to your audiencedthat is,
“stop air pollution”instead of “lower greenhouse
gas emissions.”Describe events in terms of their
effect on people rather than the planet. For example,
say “flood”instead of “heavy rain.”
32
Employ interactive learning such as group partici-
pation in scenarios and problem solving, and use ques-
tions and comments as springboards for discussion.
Encouraging members of your audience to talk and
respecting what they say increases confidence, under-
lines the richness of community assets, and provides
opportunities to practice talking about climate issues.
CONCLUSION
Keeping silent on climate change is not an option for
health professionals because climate change is a major
health justice issue. Climate change magnifies the
burdens of poverty, injustice, and unfavorable social
determinants of health, increasing vulnerability to
climate-related disease and disasters. It also offers an
unprecedented opportunity to improve public health
and promote equality by targeting investment in effi-
cient housing, public and active transportation, walk-
able neighborhoods, distributed clean energy, and
local food production to neighborhoods whose resi-
dents have the greatest needs. As professionals whose
mission is to promote health, this is clearly our
business.
Most health professionals personally want cli-
mate action but hesitate to speak out publicly
because they do not consider themselves experts.
A frontline health worker’s knowledge about climate
change may not be as detailed as a researcher in
academia, but we are all experts in our own
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communities. Grounded in science and providing
care for society’s most vulnerable members, we are
best placed to understand and explain the local
harms of inaction and the “here and now”benefits
of tapering off fossil fuels. Everyone wants good
health for themselves and their loved ones, and
this common aspiration can be a powerful incentive
to demand that our governments do more to lower
greenhouse gas emissions. As trusted messengers,
skilled communicators, and local experts, health
professionals have a critical role to play in building
public pressure for climate solutions.
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