The consequences of pandemic influenza for vulnerable populations will depend partly on the effectiveness of health risk communications. Strategic planning should fully consider how life circumstances, cultural values, and perspectives on risk influence behavior during a pandemic. We summarize recent scientific evidence on communication challenges and examine how sociocultural, economic, psychological, and health factors can jeopardize or facilitate public health interventions that require a cooperative public. If ignored, current communication gaps for vulnerable populations could result in unequal protection across society during an influenza pandemic. We offer insights on communication preparedness gleaned from scientific studies and the deliberations of public health experts at a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008.

Social science theories and empirical data on perceptions of environmental risk have focused almost exclusively on factors related to frequently occurring disagreements between the lay population and technical experts. Discussions of variability within the nonexpert population itself are uncommon, even though theories of risk and culture, as well as empirical evidence, suggest that significant differences in judgments may occur within a diverse population such as that in the United States. Perceptions of risk are influenced, in part, by characteristic ways in which situations of uncertainty are framed and interpreted. Because culturally based attitudes and values can influence general orientation toward risk and uncertainty, it is reasonable to expect that factors differentiating individuals on the basis of shared experiences, values, and beliefs relevant to risk evaluation will be associated with nonequivalent perceptions in many situations. One such variable, ethnicity, is examined for its association with variability in perceptions of environmental risk. The authors review available evidence indicating when ethnic differences in risk perceptions have been observed, and consider three hypotheses that could explain why ethnicity would be predictive of dissimilarities in judgments for many environmental risks. Possible explanations for an ethnicity effect include differences in prior experiences with or exposure to various hazards, dissimilar general beliefs about risk and uncertainty, and differences on various qualitative dimensions that influence nonexpert assessments of risk.

Risk communication is being characterized as one way of facilitating more effective, democratic and participatory risk management strategies. An emphasis on formal communication approaches as a means to improve decisions and decrease conflict will highlight the challenge of managing hazards within a culturally heterogeneous society. Communication and participatory strategies will be considered successful only if diverse communities can be engaged as partners in the policy process. Because responses to risks are embedded and evolve within broader social environments, achieving the promise of risk communication across a diverse society may not be possible absent an understanding of how sociocultural variables and past experiences shape the exchange of ideas or information in any particular situation. This paper considers the implications of ethnic and socioeconomic variability for the risk communication process, summarizing theoretical perspectives and empirical evidence on the link between sociocultural features and risk responses. Specifically, the factors that define the context of communication may influence: the initial framing of a risk issue, particularly, the adoption of an environmental justice vs. scientific/economic perspective; the perceived importance of various aspects of the decision problem; and prior beliefs about environmental hazards and agencies involved in risk management. Two examples of situations requiring communications about risk are presented and illustrate how these principles could operate in minority or lower‐income communities. A significant challenge for health and regulatory officials will be to engage in an interactive process of information and opinion exchanges that is reasonable and effective within vastly different socioeconomic and cultural contexts.

Some immigrants and refugees might be more vulnerable than other groups to pandemic influenza because of preexisting health and social disparities, migration history, and living conditions in the United States. Vulnerable populations and their service providers need information to overcome limited resources, inaccessible health services, limited English proficiency and foreign language barriers, cross-cultural misunderstanding, and inexperience applying recommended guidelines. To increase the utility of guidelines, we searched the literature, synthesized relevant findings, and examined their implications for vulnerable populations and stakeholders. Here we summarize advice from an expert panel of public health scientists and service program managers who attended a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008, in Atlanta, Georgia.

Although the expected affective consequences of future success and failure differentiated among individuals in the early and later stages of physical activity change, respectively; only the anticipated affective consequences of success predicted future behavior.

Decision making about environmental and public health risks has become a frequent source of social conflict in society, often resulting in major obstacles to effective risk management and disruptions in the policy process. Individuals vary not only in policy preferences and responses to environmental hazards, but also in underlying belief and value systems that influence several aspects of the environmental decision‐making process. In particular, variability in the framing of risk issues can exacerbate conflict, leading to differences in which perspectives are judged legitimate or valid, what solutions are seen as reasonable, and what type of information is seen as useful or relevant. In many controversies, groups have differed systematically in framing risk issues: as scientific or economic vs. fairness and equity questions, in terms of what at‐risk population is highlighted, and in focusing primarily on potential gain or loss as the result of a decision.

Constructing environmental and health policies appropriate across diverse communities is challenging. Group differences in the circumstances of exposure and in responses to environmental risk are common. Consequences of this variability may become more apparent given recent calls for more deregulation and an increased use of participatory strategies to manage environmental risks. Approaches requiring active public participation will be successful only if diverse groups can be engaged. Psychological studies of individual differences in risk behaviors can provide policymakers with insights about why responses vary in risk situations and how effective certain participatory strategies may be across a multicultural society. Responses of Mexican immigrant farmworkers to pesticide risk illustrate how the broader context of exposure can contribute to variability among communities in risk adaptation and affect the implementation of innovative policies.

We examined the experiences, perceptions, and values that are brought to bear when individuals from different ethnic and cultural backgrounds consider participating in health research. Fifty-three women from Latino, Asian American, Middle Eastern, or Non-Latino, White backgrounds participated in seven English or Spanish focus groups facilitated by trained investigators using a standard protocol. Investigators described the National Children’s Study (NCS) and then asked questions to elicit potential concerns, expectations, and informational needs. Group sessions were audio-recorded, transcribed verbatim, and analyzed using qualitative thematic methods. A major theme that emerged during focus groups was participant self-identification as a member of a cultural group or community when raising issues that would influence their decision to participate in research. A related theme was the belief by some that communities may differ in the ease of participation in the NCS. Identified themes related to the informed consent process included perceived risks, anticipated burden, perceived benefits, informational needs, and decision-making strategies. Although themes were shared across groups, there were cultural differences within themes. Findings indicated that individuals from diverse backgrounds may have different perspectives on and expectations for the research process. To effectively recruit representative samples, it will be important to address a range of issues relevant for informed consent and to consider the impact of participation on both individuals and communities.