Strategic Communication at the Intersection of Health, the Environment, and Inequality: The Case of Public Messaging from the Environmental Defense Fund

Chris Skurka, Ph.D.,The Pennsylvania State University
Cassandra Troy, Ph.D., University of Illinois Urbana-Champaign
Helen Joo, Environmental Defense Fund
Rainer Romero-Canyas, Environmental Defense Fund

Table of Contents

Abstract

In the U.S., air pollution has the most adverse health impacts on Black communities. As a result, environmental advocacy groups like the Environmental Defense Fund (EDF) have turned their attention to strategic messaging that conveys how Black communities—Black children in particular—are at relatively greater risk than other communities for air pollution’s effects. To test the effectiveness of this messaging strategy, we adopt a “public interest relations” approach, conducting an experiment in which participants were exposed to an EDF-produced video about racial health disparities or control videos about air quality that did not mention health consequences. Greater perceptions of risk to oneself and to Black children were associated with greater support for clean air policies and greater intentions to partake in health activism. Exposure to the EDF video primed the importance of perceived risk to Black children in predicting policy support and activism intentions, offering some empirical support for the effectiveness of EDF’s messaging approach. At the same time, the EDF video also neutralized the importance of perceived personal risk in predicting policy support, which suggests advocacy messaging about racial health disparities may also have unintended consequences. Practically, these findings suggest that disparity messaging can be a valuable strategy for mobilizing action on behalf of particularly vulnerable groups, although it may not be suitable for increasing the importance of personal risk beliefs among broader audiences.

Acknowledgement

This project was supported by a Page Legacy Scholar Grant from the Arthur W. Page Center for Integrity in Public Communication at the Donald P. Bellisario College of Communications at The Pennsylvania State University. Any opinions, findings and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of Penn State.

Strategic Communication at the Intersection of Health, the Environment, and Inequality: The Case of Public Messaging from the Environmental Defense Fund

Air pollution contributes to over 6 million premature deaths related to heart disease, stroke, lung cancer, and COPD globally each year (Health Effects Institute, 2020). Transportation emissions are responsible for much of this pollution (U.S. Environmental Protection Agency, 2015), yet air pollution does not impact all groups equally. Children are especially vulnerable to pollution impacts (U.S. Environmental Protection Agency, 2023). Moreover, in the U.S., compared to white individuals, Black individuals have greater exposure to particulate pollution, largely due to years of residential segregation, which puts them at greater risk for premature death (American Lung Association, 2023; Jbaily et al., 2022). Black children in particular suffer disproportionately from asthma and asthma-related deaths (U.S. Environmental Protection Agency, 2023).

In light of these concerning facts, the Environmental Defense Fund (EDF) has turned its attention to public communication strategies that raise awareness of the harms of air pollution and promote clean air solutions among their publics. EDF is a non-profit organization dedicated to rigorous environmental science and environmental advocacy, and their team has created public-facing websites which share their data with the general public and with community organizations. EDF has begun exploring how to best communicate with their stakeholders about how air pollution unevenly affects children’s health, explicitly embracing racial disparity framing (and occasionally a social justice lens) to shed light on the issue.

Researchers have studied the influence of strategic messages about health inequalities (e.g., Bigman, 2014; Nicholson et al., 2008; Skurka, 2017), but there is a gap in the literature in terms of studies that evaluate strategic messages explicitly linking health inequalities to environmental hazards, such as air pollution, and the potential for such messaging to foster support for clean air solutions. This research-in-brief helps fill this gap and provides an empirical test of such messaging. This work has practical implications as it can help EDF, other nonprofits, and health- and environment-focused advocacy campaigns more broadly to better communicate about the disproportionate health impacts minorities face from environmental risks. In doing so, we adopt a “public interest relations” approach, which centers the public good over the interests of any one organization, including EDF (Brunner & Smallwood, 2019; Fessmann, 2017).

To start, why would we expect that learning about exposure risks could lead to broader support for clean air initiatives? Many theories of health behavior change identify the importance of risk perceptions in driving protective behaviors, including the health belief model (Rosenstock, 1974), protection motivation theory (Rogers, 1983), and the risk perception attitude framework (Rimal & Real, 2003). These frameworks posit that the more one perceives themself (or a sympathetic other) at risk for harm, the more inclined they should be to take actions that mitigate the harm. When communicating racial disparities regarding air pollution, messages about Black Americans’ greater exposure should elicit more interest in mitigating harm in the form of support for policies and behaviors that reduce air pollution. It is critical to empirically establish this link in this context, as this will verify whether strategic communication professionals should indeed target beliefs about air pollution risks in order to bring about changes in key downstream behaviors (Hornik & Woolf, 1999). We hypothesize that perceptions of personal risk (H1a), risk to Black children (H1b), and risk to white children (H1c) will be positively associated with policy support. Additionally, perceptions of personal risk (H2a), risk to Black children (H2b), and risk to white children (H2c) will be positively associated with intentions to engage in health activism.

How then might EDF’s messaging about air pollution’s unequal effects on Black and white children impact key stakeholders? Writing about the role of theory in communication campaigns, Fishbein and colleagues (Fishbein & Cappella, 2006; Fishbein & Yzer, 2003) proposed two mechanisms by which campaign messages bring about changes in attitudes or behavior. First, messages indirectly impact attitudes or behavior by changing average values of relevant beliefs. If beliefs predict attitudes or behavior, then message appeals can indirectly impact persuasion by changing average levels of those beliefs (Fishbein & Ajzen, 2010). A second mechanism, predicated on media priming (Roskos-Ewoldsen et al., 2013) and associative network models of memory (Bower, 1981), is concerned with the size of the association between beliefs and persuasion. Because a person’s cognitive network includes nodes for belief-related cognitions (e.g., perceived risk) and nodes for attitudes or intentions (e.g., policy support), exposure to the message should co-activate those nodes (Keating, 2023). When the nodes are co-activated, the relationship between those nodes (beliefs and attitudes/intentions) should become stronger, even if average belief levels are unchanged by message exposure. This is the type of campaign effect mechanism we focus on here. Specifically, we expect an EDF message emphasizing racial disparities in air pollution’s impacts will strengthen the link between perceived risk to Black children and policy support (H3a) and activism intentions (H3b).

Methods

Participants were N = 450 U.S. adults recruited through CloudResearch’s Prime Panels. Please refer to Table 1 for sample demographics. We recruited equal portions of Black and non-Black participants given the salience of race to our hypotheses. The data presented here are part of a larger study in which participants were randomly assigned to a choice exposure arm (in which participants were allowed to choose a video to watch) or a forced exposure arm (in which participants were randomly assigned to watch one of the videos). This paper is focused on the effects of different message frames, so we focus only on the forced exposure data.

Participants were randomly assigned to watch one of three videos. The first video was the treatment video of interest: a 75-second video produced and disseminated by EDF. The video discusses how some children (Black children) are at greater risk for childhood asthma than others (white children) and that vehicle pollution is the root cause of this issue (see Table 2 for video description). The other two conditions were control videos identified online in which participants watched videos about air quality that we identified online (“Everyday Tasks That Are Sources of Air Pollution” or “Air Quality Monitors Are Working Around the Clock”). We selected these videos because they were about the same general topic as the EDF video (air quality) but did not discuss the consequences of air quality for human health. We edited them to be of similar length as the EDF video. Given similar patterns between the two control groups, we collapsed them into a single control group for analysis.

After viewing their assigned video, participants completed various self-report measures. We measured risk perception for three groups: personal risk to oneself, risk to Black children, and risk to white children. Risk perception includes both judgments of risk severity and risk susceptibility (Witte, 1992; Yang et al., 2014), so we assessed both dimensions for each group. Participants also reported their support for various clean air policies and their intentions to engage in several health activism behaviors. Table 3 provides all survey items and descriptive statistics.

Results

We tested our hypotheses with hierarchical regression models, one for each dependent variable. The first block included demographics and the three risk perception measures, which allowed us to test H1 and H2. The second block included a dummy-coded variable for experimental condition (EDF video = 1, control videos = 0) as well as interaction terms between condition and the three risk perception measures, which allowed us to test H3.

As shown in Table 4, perceived personal risk and perceived risk to Black children were associated with greater policy support (supporting H1a and H1b) as well as greater intentions (supporting H2a and H2b). Perceived risk to white children was not associated with policy support or intentions, failing to support H1c and H2c, respectively. The second blocks offered a test of H3—that the EDF video would prime the importance of perceived risk to Black children. The appropriate interaction term was significant for both policy support (B = .34, p < .001) and intentions (B = .32, p < .01). These interaction effects are visualized in Figure 1. Consistent with H3, perceived risk to Black children was more strongly predictive of policy support among participants who viewed the EDF video (B = .58, p < .001) than those who viewed the control videos (B = .26, p < .01). Similarly, perceived risk to Black children was more strongly predictive of intentions among participants who viewed the EDF video (B = .70, p < .001) than those who viewed the control videos (B = .34, p < .001). Though not hypothesized, there was also an interaction between condition and perceived personal risk on policy support (B = -.20, p < .05), visualized in the bottom panel of Figure 1. Perceived personal risk was positively associated with policy support among participants who watched the control videos (B = .24, p < .01), but this association was not significant among participants who watched the EDF video (B = .08, p = .21). In other words, the EDF video neutralized the link between personal risk and policy support.

Discussion

Consistent with major health behavior theories, perceived personal risk and especially perceived risk to Black children predicted greater policy support and behavioral intentions. These findings underscore the need for strategic communication efforts (coming from EDF or from any communication practitioners) to emphasize the heightened risks that Black children in particular face from air pollution. Additionally, EDF’s messaging is having favorable effects: Messaging that conveys how Black children are at greater risk for air pollution’s effects can make perceived risk to Black children more salient in the minds of key stakeholders, making it more likely this perception of risk to Black children will translate to greater policy support and activism intentions. In a way, these findings validate the EDF’s messaging strategy and suggest the value of educating the public about the existing racial disparities in the U.S. regarding exposure to environmental risks. These findings also support the notion that strategic communication campaigns can influence stakeholders by priming the salience of target beliefs (Fishbein & Cappella, 2006; Fishbein & Yzer, 2003)—here, the belief that Black children are at higher risk.

At the same time, our findings also suggest an unintended consequence of strategic messaging focused on the disproportionate health risks posed to Black children. Namely, exposure to the EDF video nullified the positive association between perceptions of personal risk and policy support. This pattern echoes the findings from a systematic review of 17 studies examining disparity message effects, which suggested that disparity messages tend to reduce risk perception for the less-at-risk group or for the general population (Liu & Niederdeppe, 2024). This effect likely represents a kind of contrast effect, in which a given risk estimate seems smaller (or larger) when it is juxtaposed with a larger (smaller) estimate (Kahneman, 2003). Here, respondents who viewed the disparity video appeared to incorrectly infer that air pollution matters only with regard to its impact on Black children, demotivating them from supporting clean air policies as a function of their own perceived risk (“Even if I’m at risk for air pollution, we don’t necessarily need these initiatives because I’m not the one most at risk”). This may be a costly unintended effect given that air pollution impacts most people and that policy solutions will require support from stakeholders from many demographic groups and their advocates. However, an important caveat is that perceived risk to Black children more strongly predicted policy support and intentions than did perceived personal risk, so even though the EDF video cancelled out the predictive role of perceived personal risk, this may not be as much a cause for concern because this risk perception mattered relatively less.

For communication practitioners, whether working for nonprofit organizations or designing advocacy messaging for corporations, our findings emphasize the need to understand the publics’ pre-existing risk perceptions, both for themselves and impacted groups. Moreover, disparity-framed messaging that draws attention to health inequities shows promise in calling attention to impacted groups, thus strengthening the association between risk perceptions and policy support, as well as action intentions. However, such messaging also runs the risk of weakening the relationship between perceived personal risk and policy support. Therefore, this kind of messaging may be helpful for supporting audience mobilization on behalf of marginalized groups but not in raising the importance of perceptions of personal risk from environmental health threats. Beyond strategic campaign messaging, it will also be important to educate community health leaders, who often have insufficient knowledge about air pollution to properly engage community members (Tan et al., 2023), and assemble multi-stakeholder forums that bring together community leaders, academics, and members of the public (Ward et al., 2022).

A key limitation of this study is its focus on health inequities among Black Americans exclusively, but further work could examine whether similar effects occur when multiple disproportionately affected racial and ethnic groups are discussed. Because perception is relative, members of other affected groups (e.g., Asian Americans) may perceive this kind of messaging as exclusionary, erasing their experiences from public attention. It will be necessary in future work to explore how to message sensibly about communities and to audiences that include many ethno-racial groups.

Nonetheless, this work sheds light on how strategic messaging may mobilize stakeholders to support solutions for addressing health disparities. For communication practitioners, we recommend emphasizing health disparities in strategic messaging when their main goal is fostering activism and policy support among stakeholders. However, when a campaigns’ main aim is raising the salience of stakeholders’ own vulnerability to environmental health impacts, we recommend a wider variety of messaging strategies rather than relying on disparity messaging alone, perhaps turning instead to messages that emphasize how environmental risks pose dangers to everyone. No matter the situation, our findings underscore the need to understand audience segment perceptions ahead of a campaign launch and also illustrate the value of adopting a public interest approach in strategic campaign planning.  

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Chris Skurka, Ph.D.,The Pennsylvania State University
Cassandra Troy, Ph.D., University of Illinois Urbana-Champaign
Helen Joo, Environmental Defense Fund
Rainer Romero-Canyas, Environmental Defense Fund