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2.5 Defining the Concepts and Terms High Concern and High Concern Communication

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According to the Oxford English Dictionary, the word concern means “an interest or stake in something; a matter with which a person is occupied.” The word comes from Latin, Anglo‐Norman, Middle French, and French words meaning to relate, regard, or consider. For this book, a high concern issue is a problem of great interest. The problem becomes more intense when it has high consequences (stakes), occurs repeatedly (frequency), has lasted for a significant amount of time (duration), affects many people (scope or range), disrupts personal or community life (disruptive), deprives people of their perceived legal or moral rights (equity), and has negative effects perceived to be serious enough to require attention (severity).

High concern issues can vary from individual to individual, group to group, and place to place. They may also change over time because of factors, including history and sociodemographic conditions. Understanding these factors is needed to ensure that communication strategies, messages, materials, and activities are appropriately designed and implemented.

Levels of concern about an issue can be determined through a variety of means, including surveys and interviews with stakeholders. For example, the Agency for Toxic Substances and Disease Registry, an agency within the US Centers for Disease Control and Prevention, recommends the following questions to determine levels of community concern about exposure to a toxic chemical.18

 Is exposure to the chemical involuntary, as opposed to voluntary (e.g., an accidental chemical spill vs. a workplace exposure)?

 Is exposure to the chemical perceived to be controlled by others, as opposed to under an individual’s control (e.g., in the water supply for a town vs. a place that can be easily avoided)?

 Is the exposure perceived to be unfairly distributed (e.g., affecting a certain part of town or a certain population vs. the entire town equally or randomly)?

 Is the exposure human‐made and/or deliberate (e.g., the act of terrorism or vandalism)?

 Does the exposure have dramatic, long‐lasting effects on the community (e.g., people can no longer live in a certain neighborhood or property was destroyed vs. something that can be cleaned up)?

 Is the source of exposure perceived to be an untrusted source (e.g., an industrial plant with a history of problems)?

 Does the exposure appear to affect children more than adults?

 Have there been deaths or serious illnesses that are perceived to be directly caused because of the chemical exposure or are deaths or serious illnesses expected?

 Does the media and/or the public perceive the event as the “first,” “worst,” or “biggest” of its type?

 Does the community perceive the response of public officials and others in authority to date has been inadequate or slow?

 Is a criminal investigation involved?

Concerns similar to these arise from issues other than exposures to toxic chemicals. For example, neighbors and community members often object to facilities they consider detrimental to their “backyards” or to the wider community. NIMBY (Not In My Back Yard) concerns and LULU (Locally Unwanted Land Use) concerns frequently arise following proposals to construct a new highway, casino, airport, wastewater treatment plant, garbage dump, prison, homeless shelter, wind farm, nuclear power plant, hydroelectric dam, center for the treatment of drug addiction, or half‐way home for schizophrenic adults.

Concerns about inequities often create especially high levels of concern and even outrage. The perception that some people are more exposed to risks or harm more than others aggravates perceptions of risks and harm. This is especially the case if locational decisions are based on, result from, or produce social or economic inequities.

High levels of concern can produce a strong emotional reaction, such as anxiety, worry, uncertainty, apprehension, stress, fear, and outrage. When individuals experience these intense feelings, their ability to process information declines significantly.

A high concern issue can be external (e.g., health, social, economic, or political issue or change) or internal (e.g., work or domestic issue or change). A classic example of a high concern issue is the COVID‐19 pandemic. Beginning in January and February 2020, Americans struggled to cope with the disruptions caused by COVID‐19. By the beginning of 2021, more than 30 million Americans had contracted the disease and more than 500,000 had died. Globally, more than 120 million people had contracted the disease and more than 2.5 million had died.

On December 2, 2020, the director of the Centers for Disease Control and Prevention warned an anxious nation that it would face a devastating winter. He predicted that total deaths from COVID‐19 could exceed half a million unless a large percentage of Americans followed precautions, including mask‐wearing and social distancing. He said the next few months could be “the most difficult time in the public health history of this nation.”19

According to the American Psychological Association, eight in ten adults identified COVID‐19 as a significant source of stress in their life. Two‐thirds of all adults said they had experienced increased stress over the course of the pandemic.20

High levels of concern about the COVID‐19 pandemic were compounded by societal stressors pervasive in American society. These included mass shootings, unemployment, access to health care, racism, climate change/global warming, immigration, sexual assaults, and the opioid epidemic. More than three in five adults said the number of issues America faces currently is overwhelming to them. This marks a significant increase from 2019. And more than seven in ten Americans said 2020 was the lowest point in the nation’s history they could remember.

The intensity of feelings and emotions generated by a high concern issue is determined by multiple factors. These include the perceived risk (i.e. the perceived probability and magnitude of the threat or danger) and the ability of the individual, group, or organization to cope and manage the stress associated with the issue. Feelings and emotions are also influenced by specific contextual characteristics of the perceived threat or danger, such as its intentionality.

High concern can produce a heightened state of arousal, which protects humans from threats and dangers. It is a defense and adaptive mechanism whereby parts of the brain and body typically slow down and other parts of the body and brain typically take over. It is a nervous system response that results in fight‐freeze‐flight behavior.21

Heightened arousal typically produces psychological and physiological changes. Physiological changes may include a rise in heart rate, blood pressure, a rise in body temperature, an increase in perspiration, an increase in constriction of the arteries, and secretion of neurotransmitters and hormones such as adrenaline and cortisol.

Neurological changes that most affect communications in high concern situations are (1) increased activation of the brain’s amygdala and hypothalamus, which are central to the brain’s system for the early detection of a threat or danger; and (2) decreased activation of the brain’s frontal lobe, which is central to the brain’s system for rational thought. Because of these changes, heightened arousal can decrease a person’s ability to take in information, listen, and be empathic.

Heightened arousal is closely linked to what Nobel Prize winner Daniel Kahneman called System 1 Thinking.22 System 1 thinking is heavily influenced by activation of the amygdala and the fight‐freeze‐flight response. It is fast, automatic, intuitive, and relies heavily on emotions. Kahneman contrasts System 1 thinking with System 2 Thinking. System 2 Thinking is heavily influenced by activation of the frontal lobes of the brain. It is slow, analytical, and relies on reasoning and logic. In high concern situations, System 1 thinking often dominates and can cause biased decision‐making and dysfunctional communications.

Based on these observations, high concern communications can be defined as the transfer and exchange of information in emotionally charged situations where people are worried, upset, angry, stressed, or anxious. High concern communication encompasses virtually any situation involving risk or threat to the things people value. The goals of high concern communication are the same as the goals of risk communication: to build trust, promote knowledge, and encourage supportive relationships and constructive dialog.

At the personal level, individuals may use high concern communication practices to transfer and exchange information about rejections, discrimination, failures, major life changes (e.g., job changes, locational changes, divorce, sickness, scandals, arrests, births, deaths), and worries about health, children, and other family members. Individual high concern communications may be as basic as the exchange of information by a person communicating why they are late for a meeting or why they missed a deadline.

For groups and organizations, high concern communications may involve the exchange of information about mergers, restructuring, re‐organization, budget cuts, cost overruns, missed deadlines, facility closures, performance failures, performance reviews, job interviews, reputational attacks, protests, and employee complaints. For organizations or business units (e.g., Customer Service Departments) that serve people who are worried or anxious or have an issue to resolve, high concern communications should begin at the front door. For example, at a hospital, high concern communications should begin with exchanges of information between a patient or visitor and the hospital parking lot attendant, security guard, information desk, reception desk, and nurse’s desk.

For organizations, one of the major precipitators of high concern is organizational change. For example, proposed changes to the organizational structure typically lead to high levels of concerns about job security, mission, services, budget, workplace relationships, and job assignments. It may lead to any or all of the following questions: Why do we need the proposed change? Why now? Who decided these changes are needed? What is the full extent of the proposed change? What are the imperatives driving the proposed change? Why are existing procedures and strategies no longer good enough? Are you sure the proposed change will improve the situation?

The organizational change also often leads to questions of a more personal nature. For example: What will happen to my job because of the change? Will this affect my pay? Will I lose my benefits package? Will I lose my seniority? Will I need to master new skills? Will I have the same team and coworkers? Will I have to relocate? If I have to relocate, will the organization pay my relocating expenses? What will happen to me if I don’t want to relocate? Who will be my supervisor? Will I have to travel more?

Equivocal answers to these questions introduce uncertainty about the future. The concept of uncertainty is central to the definition of the term high concern. For employees, organizational change threatens and risks many of the things they value, including the five key domains identified in the neuroscience‐based SCARF model: 23

 Status – perceptions regarding their importance to others

 Certainty – perceptions regarding their ability to predict the future

 Autonomy – perceptions regarding their ability to control events

 Relatedness – perceptions regarding how they relate to others and how safe they feel in these relationships

 Fairness – perceptions regarding their being treated fairly and equitably

Neuroscience research underlying the SCARF model shows that negative perceptions regarding any of the SCARF domains can activate the same threat and reward responses in the brain as does a physical threat. Negative perceptions of the SCARF domains can also produce a strong emotional reaction and the body’s release of cortisol, adrenaline, and epinephrine – chemicals associated with the flight‐freeze‐fight response. These chemical releases can severely affect the ability of a person to focus, solve problems, communicate, cooperate, and think rationally and logically – functions performed largely by the prefrontal cortex of the brain.

From a psychological and neurological perspective, whether and to what degree a person, group, or organization experiences high arousal, the fight‐freeze‐flight response, or stress from a situation is determined in part by what an individual, group, or organization defines as high concern. Based on cultural factors, people, groups, and organizations have different tendencies toward fight‐freeze‐flight. People, groups, and organizations use different lenses to determine what is of high concern. The level of concern felt and assigned to a situation depends on personalities, worldview, beliefs, and culture. What is defined as high concern matters to a specific individual, group, organization, culture, or society.

High concern, as in stress, is often seen as a negative. However, high concern and stress can have positive and helpful effects, such as when it motivates people to accomplish more. It is when high concern and stress become excessive and overload the capacity of a person or group to cope that it becomes mentally and physically dangerous. What makes high concern and stress excessive is often fear. It is therefore not enough to give the facts about a risk or threat. Fear is real and can keep individuals and communities from making informed decisions. However, through effective communication, fear can be channeled into productive behaviors. For example, if not excessive, fear can lead to information‐seeking. People are often more accepting of fear when it is acknowledged.

Communicating in Risk, Crisis, and High Stress Situations: Evidence-Based Strategies and Practice

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