When foodborne illness strikes, the public relies on quick and clear information to stay safe. But are the warnings issued by Canada’s health authorities too difficult for most people to understand? A recent study from the University of Guelph investigates how the federal government communicates during enteric illness outbreaks and suggests that many Canadians may struggle to grasp the critical messages shared during such crises.
What are enteric illnesses and why do they matter?
Enteric illnesses are infections that affect the gut, commonly caused by consuming contaminated food or water, touching infected animals, or through person-to-person spread. Symptoms often include nausea, vomiting and diarrhoea. While many recover without medical help, some cases can lead to serious complications or even death.
Credit. The Public Health Agency of Canada.
In Canada, outbreaks that cross one or more provincial/territorial or Canada and another country are considered multi-jurisdictional. These are managed at the federal level by the Public Health Agency of Canada, which issues Public Health Notices (PHNs) (Figure 1) online to inform the public about outbreak investigation details and how to stay safe. These notices are meant to be an essential public health tool. But are they serving their purpose?
Are health warnings too hard to read?
According to the study, most PHNs are written at a reading level above Grade 12 (calculated using an online readability calculator). This is a concern because the average person in North America reads at about an eighth-grade level. In other words, the language used may be too complex for many Canadians to fully understand.
Older adults, people with lower levels of formal education and individuals whose first language isn’t English or French are especially likely to find PHNs difficult to read. That means some of the very people most at risk during an outbreak might be the least able to understand the advice they receive.
The researchers suggest that PHNs should aim for a reading level closer to Grade 5. This would ensure that more people, regardless of their education or background, can grasp the key messages quickly and easily.
Clarity is key and still a work in progress
The study used a communication evaluation tool from the US Centers for Disease Control and Prevention (CDC), known as the Clear Communication Index (CCI), to assess how well PHNs conveyed information. While many notices scored well by clearly stating their main message and including practical steps the public could take, the overall picture was mixed.
Some PHNs included complicated numerical information, such as percentages and ratios, which made it harder for readers to judge their own level of risk. For example, saying “25% of individuals exposed became ill” is less accessible than “1 in 4 people who ate the product got sick”. Offering relatable comparisons and putting numbers into plain terms could make these warnings easier to digest.
The use of visuals was another area that could be improved. While some PHNs included charts or graphs, they often lacked plain language explanations. A bar graph may not be helpful if people don’t understand what it’s showing. Adding simple captions and explanations could make the information more meaningful and useful.
Do health alerts actually change behaviour?
Beyond readability and design, there is the question of whether PHNs influence how people respond during an outbreak. The study examined how well the notices used a well-known behaviour change framework called the Health Belief Model (HBM). This model includes six constructs that affect whether someone takes action: how likely they think they are to be affected (susceptibility), how serious they believe the outcome would be (severity), whether they believe the advice will help (benefits), what obstacles they might face (barriers), whether there are cues prompting them to act (cues to action), and whether they feel confident they can take the recommended steps (self-efficacy).
Most PHNs included at least four of these six elements, particularly susceptibility, severity, cues to action and self-efficacy. However, fewer messages mentioned the benefits of taking action or the barriers people might face. Including all six elements could help make the messages more persuasive and effective. For example, simply telling people not to eat a product might not be enough. Explaining why this advice matters, how it protects them, and addressing potential
challenges (such as what to do with recalled food) can increase compliance.
Consistency builds trust
Despite the gaps, the study found that PHNs were generally consistent in how they presented information. This kind of standardisation matters. When public messages follow a familiar structure and use reliable language, people are more likely to trust them.
Consistency doesn’t just improve readability—it builds credibility. If the public knows what to expect from official notices, they are more likely to take them seriously. That consistency can also reduce confusion during a stressful time when clear thinking is already a challenge.
What should be done differently?
Based on the findings, the study recommended several improvements:
First, the reading level of each PHN should be targeted to a lower level and checked using readability tools to ensure the language is accessible. Targeting a Grade 5 level can open the door to a wider audience.
Second, the CCI should be used consistently to guide how information is organised and presented. Plain language, clear communication of numerical information, and enhanced visuals can make a big difference.
Third, future PHNs should include all elements of the Health Belief Model. This means explaining not just what people should do, but why it matters, what the benefits are, and how they can overcome any obstacles.
A public health message is only as strong as its weakest link
If important health messages are too complex, they can lose their power. The risk isn’t just confusion, it could mean people continuing to eat contaminated food or ignoring crucial safety advice.
Improving PHNs doesn’t require starting from scratch. The basic framework is sound, and many messages are already well-structured. But by simplifying language and improving visuals, and making messages more complete, Canadians may be better informed and protected.
Looking ahead: Learning from the public
The study also calls for further research, particularly on how different groups interpret and act on PHNs. Surveys and focus groups could shed light on whether Canadians find these messages clear, trustworthy and useful. Public feedback should become a regular part of refining health communications.
Understanding what works—and what doesn’t—from the perspective of real people could help build a more resilient, informed public. In a time when misinformation spreads quickly, strong and clear public health messages are more important than ever.
Conclusion: Do the warnings protect or confuse?
Clear, simple and trustworthy communication during health outbreaks is not a luxury, it’s a necessity. As foodborne illnesses continue to affect Canadians, it’s crucial that everyone, regardless of age, education or language, can understand what they need to do to stay safe.
The evidence is clear: Public Health Notices can be improved with thoughtful changes and with a focus on accessibility, Canada has an opportunity to lead the way in risk communication.
So the next time a health alert pops up on your screen, ask yourself: would your neighbour, grandparent or teenager understand what to do? If not, we all have work to do.
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Journal reference
Patel, V., Grant, L. E., Shereefdeen, H., MacKay, M., Cheng, L., Phypers, M., … & McWhirter, J. E. (2025). Evaluating multi-jurisdictional enteric illness outbreak messaging in Canada: a content analysis of Public Health Notices. Health Communication, 40(7), 1198-1212. https://doi.org/10.1080/10410236.2024.2391207
