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How to Better Communicate Health Risks and Improve Health Outcomes: Story-telling for More Impact

“If we don’t intervene, then you’ll die. If we do intervene, the risk of complications is very low.”

St. Louis, MO (January 24, 2018) – Sometimes decisions about health risks are easy. Administering CPR to save a life makes sense. But sometimes the risks result from behaviors a person is taking or a complicated combination of factors, as with diabetes or a heart attack. How do people think about and respond to these risks?

What if you could reduce the risk of getting diabetes by 50 percent by losing weight? What sort of trade-offs would you be willing to make? What other information would you want before making that decision? How would you feel? Understanding risk matters for decisions about medication, surgery, and our everyday behaviors when it comes to our health.

We’re running a three-part blog series about risk communication in health, walking through psychological pitfalls, and offering behavioral science solutions.

In Part III, we’re using story-telling and narratives to create context.

As we’ve covered in Part I and Part II of this series, risk appeals often include several different elements that work together to shape how they are interpreted. When people respond to risk information, they are mentally calculating how likely and how severe the outcome would be, trying to control their emotions, and trying to figure out what to do next. That’s a lot to balance! Weaving health information into a story instead of just presenting numbers can make it easier for people to follow along. Centering that story on the individual or on someone they know emphasizes its meaning.

Psychological pitfalls of risk communication

Some risks are more psychologically distant.

Things that are psychologically distant are construed more abstractly than things that are psychologically close. Events that are far away in time, space, happening to another person, or are hypothetical are more psychologically distant, and therefore thought of in more abstract terms. For example, someone with a relatively high risk of a cardiac event probably still has a less than 50 percent chance of having a cardiac event. As a result, the poor health outcome to avoid may be construed more abstractly without the nuance that might help people understand the major impact to their lives. In other contexts, we may want someone to take a health action to benefit someone else’s health (e.g., getting a flu vaccine to protect an immuno-compromised relative). In this case, again, the outcome will be viewed more abstractly because it would occur for someone else and not the self.

Solutions to help people respond better to risk information

Tell a story: Make health information personalized and put it in context.

People tell and remember stories because they offer context, nuance, norms, and ideals. Presenting risk information outside of any context can be hard for people to understand how a particular statistic or value fits into their lives. Communicating risk information through a story about a single individual can be more effective and meaningful. Stories could be about another similar person or even about the patient.

For example, it may be more powerful to tell an obese person at risk of diabetes about what losing 35 pounds might mean for his/her life besides the single diagnosis, instead focusing on the quality and longevity of his/her life: raising children, staying independent, avoiding medical bills, and overall greater wellbeing.

Presenting health information in a logical sequence, in context, centered on the patient or his/her loved ones can make health decisions easier.

Story telling can also be an effective way to encourage pro-social health behaviors. Loyal viewers of the TV show “Grey’s Anatomy” were more knowledgeable about the organ donation process and more willing to sign up as donors after popular character Denny Duquette received a heart transplant. Information is easier to process and better remembered when woven into an engaging narrative.   


Talking about health risks can be, well, risky! There are potential pitfalls in the way information is presented and how people react to that information. But, behavioral science suggests several ways to smooth that process and make it easier for people to make healthy, informed choices.

  • 1) Start with clear, easy-to-understand numbers and figures
  • 2) Self-affirm before presenting risk information and offer clear solutions
  • 3) Tell a story and make it personal

Simple tweaks to the way we talk about health risks can improve outcomes across all domains.

Translating research into the real world.

The Envolve Center for Health Behavior Change is a partnership between the Brown School at Washington University in St. Louis, The Center for Advanced Hindsight at Duke University and Centene Corporation. The Envolve Center projects use behavioral science insights to improve health outcomes, working for evidence-based changes at every stage in the process.

Lindsay Juarez – Senior Behavioral Scientist

Lindsay Juarez is a senior behavioral scientist in the Center for Advanced Hindsight at Duke University. She has a Ph.D. in social psychology and specializes in goal pursuit and self-control. She works with the Envolve Center’s Behavioral Economics (BE) team, which incorporates BE and social science into health-related behavioral modification programs.

Julia O’Brien – Principal Behavioral Scientist

Julia O’Brien is a principal behavioral scientist and leads the Better Living and Health Group at the Center for Advanced Hindsight at Duke University. She has a Ph.D. in social psychology and a background in product research. Julia loves behavioral science and believes it has the potential to solve lots of the world’s problems – especially when paired with technology and bold ideas. 

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