Are you playing up to your ability?

In a previous column I discussed the environment as one of three legs of the disease triangle. The triangle analogy is relevant to another scenario, one that has been played out many times across the country. That scenario is the cleanup of a Superfund site.

The methods by which liquid chemical waste was managed in the era before the Resource Conservation and Recovery Act (RCRA) resulted in a legacy of contaminated sites placed on the National Priorities List; these sites are better known as Superfund sites. By definition, Superfund sites represent current or potential risks to the health of the surrounding community. Regulatory agencies and parties responsible for the contamination at Superfund sites have not always invited early participation by the public in the analysis of risks and evaluation of remedies. The result has been public distrust of their motives as well as fear and uncertainty about future health consequences. Often, agencies and responsible parties simply explain the results of their assessment to the public. Then they become frustrated because the citizens do not seem to trust that community health protection is the primary goal. Even after an assessment has led to a Record of Decision that specifies the details of cleanup, the issue of trust in the protectiveness of the remedy may not have been resolved. Responsible parties and government regulators often are subjected to public criticism that continues throughout the process of remediation.

This scenario does not have to be repeated at each Superfund site if agencies, responsible parties, and citizens all play up to their abilities. The three legs of the triangle are credibility, responsibility, and accountability. An agency must believe in these principles and must demonstrate that belief. Also, the three principles are interdependent: Responsibility and accountability provide the currency with which credibility can be measured and assigned value. Indeed, accountability and responsibility are the keys to successful relationships among stakeholders, agencies, and responsible parties.

As environmental health professionals, we may find it easy to focus attention on the myriad technical issues associated with a given Superfund site. Such issues are often complex and full of uncertainties. They may necessitate the use of experienced technical experts to recommend effective risk-management policies that protect the health of the community. In the effort to be responsive to the risks, the context within which technical decisions are made is often lost. Staffs of health and environmental agencies assume that citizens value that expertise and trust the agency to make the right decision on their behalf. Furthermore, agency personnel often believe their credibility should not be questioned since they are charged by statute with protecting public health and the environment. Agencies may also believe that if they justify their actions with analysis of the facts and application of public health expertise, they are being responsive to the public. Those assumptions often result in ineffective communication between stakeholders and agencies. Citizens, however, want to know that their voices are being heard and that they can influence the decision-making process. A failure to communicate means a failure to establish and maintain credibility - for parties on any side of the issue.

Experience suggests that when communities, responsible parties, and agencies are in conflict about how to clean up a site, trust and credibility are missing. The dysfunction is usually resolved when the parties explicitly bring the issue of credibility to the discussion table. Solutions often involve a considerable investment of extra effort; that effort should have been applied at the beginning of the process. For example, in one case the responsible party engaged in a lengthy and detailed process with stakeholders to present and discuss each element of the alternative remedies that had been rejected to arrive at the preferred alternative. That willingness to share and discuss details of their previous work increased credibility. What may have been even more important was responsiveness to community questions that required some reconsideration of previously rejected alternatives. The parties were also afforded the opportunity to experience the depth of interest and understanding in the community. Respect and credibility increased on both sides of the discussion table.

The best science and the most compelling public health rationale may not be sufficient to gain community support for a given action unless it is built on a foundation of trust and credibility. A conscious and deliberate effort must begin early in the process through an open dialogue with stakeholders. Contemporary models of stakeholder involvement recommend immediate communication with the public after an issue has been identified. There are now many success stories about improved relationships between communities and responsible parties as a result of that early involvement.

Responsibility, the second leg of the triangle, often seems to get shifted so that accountability can be avoided. At another Superfund site, community representatives insisted upon clear and detailed procedures for the handling of unexpected events during remediation. The responsible parties and agencies suggested a general framework with the details reserved for the specific incident. The general framework probably offered the greatest flexibility in the response to unexpected events. Stakeholders, however, were concerned that unless specific obligations were identified ahead of time, the parties would inhibit timely response by arguing about who was responsible for what. Once again, trust emerged as the source of the stakeholders' concern while the agencies and parties thought it was just a tactic to stall completion of the response plan. In this case, when the parties recognized why the stakeholders insisted on clear assignments, they were able to satisfy the need while preserving the flexibility that was important to an effective response. Credibility is enhanced when the plan is initiated and the parties respond as prescribed. Stakeholders, too, must be sensitive to credibility and responsibility issues. Individual stakeholders have lost credibility and the respect of their peers - and others - when their motives have been seen as obstructive rather than constructive.

The third leg of the triangle, accountability, is the ultimate measure of value in this discussion. In another Superfund case, stakeholders felt considerable skepticism about plans by the responsible party to use incineration technology during remediation. The plan moved forward when the responsible party invited stakeholders to hold that party accountable for the results. The ultimate demonstration of responsibility is to be held accountable for results. Those who propose a course of action and are willing to be held accountable are more likely to have a higher level of certainty. They have often risked considerable resources on the solution and cannot afford failure. Accountability - or lack of it - also means that stakeholders can afford to be more idealistic in their expectations for a cleanup. They have not risked resources or reputation on a solution that may fail. They can make demands without having to be responsible for their ineffectiveness in solving the problem.

Credibility, responsibility, and accountability are a team. Without one, the other two have little meaning. Each step in problem solving should involve analysis of whether a particular response will enhance or damage credibility. Furthermore, who is responsible for each step and how will accountability be measured and reported? In case there was any doubt about the model - and to carry on the theme of threes - just as the three legs of this triangle fit together, they are also equally applicable to the three types of groups: stakeholders, agencies, and responsible parties.

It is interesting to note that the catalyst for this discussion did not come from official sources like risk-communication experts, mediation professionals, or state and local health or environmental officials. It came during a meeting whose purpose was to build trust among community, regulatory agencies, and a responsible party so that a problem at a Superfund site could be resolved. A community member and outspoken activist summarized his presentation about the work he thought remained by saying, "If everyone will just strive to have three things in common, we can move forward and resolve this issue. Those things are credibility, responsibility, and accountability." That triangle became the foundation for discussion during the rest of that day - and a productive day it was.