Public Engagement and Communication - Stage 4

01 Partner with the health sector

The connection between air quality and public health belongs at the center of all communications by Stage 4. Health ministries, hospital networks, primary care providers, and community health workers are powerful communication allies because they speak to people through trusted personal relationships rather than government channels. Research has shown measurable improvements in both health sector capacity and community knowledge (Tan et al., 2023) when health care workers are trained as air quality communicators — a critical channel for reaching communities that government agencies do not reach. The WHO Air Pollution and Health Training Toolkit for Health Workers, available in all six UN languages, is a useful resource for briefing primary health care providers about the links between poor air quality and multiple diseases and conditions.

Other practical actions include establishing a joint air quality–health communication working group with the health ministry; co-developing risk communication materials with hospitals (detailed in Step 2); integrating air quality alert messaging into health facility patient communications; calculating the local health burden and economic cost of air pollution; and supporting the establishment of epidemiological surveillance systems that link pollution data to health outcomes (see Health Impact Assessment Guidance Stage 4, Step 10).  A review of the health impacts of air pollution in Japan documents how decades of locally generated epidemiological evidence, consistently shared with the public, have guided regulatory action (Shima, 2025).  Another study done in the Medellín metropolitan area used tools such as BenMAP and AirQ+ to develop health burden estimates from air pollution, and is being used for communication and advocacy to help to build political will for clean air action in other Colombian cities (CCAC, 2020). 

02 Expand the AQI to communicate health risk

With an air quality index in place that reflects national standards (see Stage 3, Step 10 of the Public Engagement and Communications Guidance), the next step is to couple it with clear information that tells people how they can protect themselves during air pollution-driven emergencies — a foundational element in establishing a practice of risk communication (WHO, 2017).  A two-way, evidence-based, actionable strategy is required (US EPA, 2021). Technical and impersonal language is among the most frequently cited reasons why air quality communication fails (US EPA, 1998); so is messaging that does not clearly convey negative consequences to exposure, A study conducted in China found strong words such as "unhealthy" or "hazardous" and specific descriptions of exactly who is at risk (i.e. outdoor workers or children) are more likely to motivate people to take action than neutral, vague wording (Wu et al., 2021).  Color-coded category systems with simple health advisories — such as the five-level system adopted by EPA Victoria in Australia — offer instant recognition, bypass language barriers, and connect poor air quality directly to immediate protective actions.  

Consider instituting an Air Quality Health Index (AQHI) to supplement an AQI. Conventional indices typically track a single pollutant, such as particulate matter or ozone, that exceeds its regulatory standard. AQHIs are based on health studies rather than standards, and involve calculating the combined health risk of exposure to multiple pollutants using locally relevant epidemiological evidence gathered over months or years. They can be more accurate at communicating the long-term, combined impacts of air pollutants, arising from the recognition that roughly 92% of premature morbidity (e.g., hospitalizations) and mortality associated with air pollution have occurred during periods when the AQI classified air quality as very good or good (Pengelly, 2002).  

Section three of the WHO report (2026) on air quality indexes and roadmaps for best practices reviews these health-based approaches in depth, highlighting the first AQHI developed in Canada, as well as other examples using different metrics to calculate health risk. These include the Hong Kong Administrative Region (China) AQHI, which is calibrated based on emergency hospital admissions and includes four pollutants: NO2, O3, PM10 and SO2; and Mexico City’s Air and Health Index and Risk Index for Susceptible Persons (IRPS) with specific recommendations for vulnerable population groups such as children, outdoor workers, pregnant women and asthma patients. Tailoring risk communications to specific communities and facilitating sustained behavior change are further detailed in Stage 3, Steps 7 and 8 of the Public Engagement and Communications Guidance.    

03 Improve public health alert notifications

At this stage, air quality managers may use ground-based observations, remote sensing data, emissions inventory data, and weather forecasts to develop sophisticated models that predict poor air quality episodes several days in advance (see Air Quality Forecasting Guidance, Stage 4, Step 6). Coordination is underway among health, transport, emergency, and other relevant agencies to develop standard protocols and pre-approved emergency response plans ready to roll out during high-pollution episodes (see Decision Support guidance, Stage 4, Steps 6–9).  

A multi-year, multi-city study in Northern China provides evidence that pollution alerts—through the interventions they trigger — can deliver significant and repeatable support for short- and long-term emission controls in cities worldwide (Dai et al., 2026). The communicator’s role is to ensure that lead time provided by air quality forecasting and emergency planning is not wasted by poor coordination and disorganized messaging. An alert protocol should specify in advance the objectives, audiences, trigger thresholds, message templates, channels, and spokespeople for each severity level, so that no one is drafting language or hunting for a spokesperson while the air is already hazardous. The most effective emergency response plans use multiple channels to inform the population in plain, accessible language and lead with health and action rather than numbers (Guarieiro, 2025). The channel mix could include a public website or mobile app as the source of record for real-time reporting and maps that news media can incorporate into their own weather reports; mass-media partnerships for the widest and most urgent reach; SMS, messaging apps and social media for direct, repeated contact; public dashboards like the London Air platform positioned along highways and at public transport stops; and targeted outreach to the emitting sectors and hardest-hit neighborhoods.  

During high-pollution episodes, draw on WHO guidance on personal interventions (WHO, 2019) or provide local residents with a template for creating their own action plan (Breathe Utah) to urge protective measures such as canceling outdoor events, rescheduling strenuous work, keeping windows closed, collecting medication or checking on a vulnerable neighbor. Where an episode triggers mandatory controls on traffic, construction or industry — such as India’s Graded Response Action Plan, Europe’s tiered smog emergency schemes or China’s tiered red-alert system — focus on explaining what is being restricted, for whom, and why, so the measures are understood, acted on quickly, and enforceable. This may involve close coordination with hospitals and public health centers to open clean air shelters and standing dust-free rooms, distribute masks to patients, and provide other specific protections to vulnerable groups such as children, older people, outdoor workers, pregnant women, and people with respiratory or heart conditions. Toolkits prepared in advance, such as those used by school systems in cities like New York City and Sacramento, California, position trusted messengers with the information they need to become frontline spokespeople at the moment an alert lands.  

04 Translate, tailor and resource air quality alerts for every community

Air pollution is not experienced equally. Gender, age, income, occupation and location all shape who is exposed and who is harmed — and, just as unevenly, who receives a warning and can act on it. A robust monitoring network and forecasting system can now show precisely which neighborhoods, occupations, and groups carry the heaviest burden, so risk communication can be targeted to evidence rather than assumptions. It can also be built into a lasting system for information dissemination, as opposed to a one-off campaign or stakeholder engagement.

Start with the data. Use exposure and source information to segment audiences deliberately — by geography (hotspot neighborhoods, roadside and industrial-adjacent communities), by susceptibility (children, older people, pregnant women, people with respiratory or heart conditions), and by occupation and circumstance (outdoor and informal workers, traffic police, market traders). A review of Mexico’s national risk-communication index (Borbet, 2018) found the clearest gains come from focusing on susceptible populations and prompting specific local action; research on how different groups engage with air quality data (Fogg-Rogers et al., 2024) — by age, education, income, and nationality — recommends engagement activities that are enjoyable, inclusive, and attractive to diverse citizens representing regional demographics.

To further tailor the messages, alerts should be translated into all major languages spoken in the local community, culturally aligned, and distributed via the most popular channels — television, radio, SMS, messaging apps, social media, community radio, and/or noticeboards. A study of foreign residents living in Tokyo (Abu-Gyamfi, 2021) found language barriers sharply cut the reception of air quality alerts; Arabic-speaking communities in Australia living with asthma preferred bilingual, audiovisual campaigns on social media over complex government dashboards (Laachir et al., 2025).  

Messages must also align with a specific cultural group’s values and beliefs and be gender inclusive. Guidance from the clean cooking sector indicates the most effective programs are co-created with the women, youth and socially excluded groups they are meant to reach and are an essential prerequisite for success (ENERGIA, 2024). Pilot programs in India, Kenya and Indonesia confirm that incorporating gender-responsive planning and community-led initiatives from the outset allows participatory governance to take root in air quality management (WRI, 2025) — the formal participation in decision-making that Stage 5 of the Public Engagement and Communication Guidance institutionalizes.  

Treat tailored risk communication as standing infrastructure: an audience-segmentation map tied to current exposure data; a shared glossary of agreed terms in the territory's main languages, so that "unhealthy for sensitive groups" means the same thing to the entire population; a regularly updated inventory of channels, digital and non-digital, with an owner for each; a widely accessible library of translated health and environmental materials in multiple languages; standing agreements with community intermediaries and trusted messengers; and greater investment in staff and budget to institutionalize the practices. Keep non-digital channels — workshops, community events, door-to-door and radio — funded and running in parallel to ensure the broadest reach. Where trust in information itself is fragile, a protection-based approach to the information ecosystem (Internews, 2023) helps deliver data and instructions through trusted routes while countering the misinformation that can derail outreach in a crisis. EPA's SALT framework offers a practical strategy, action, and learning framework, supported by tools, to implement a research-based approach to risk communication.

05 Align air quality alerts with early warning systems

Air pollution episodes rarely happen in isolation. A temperature inversion traps traffic and industrial emissions; intense sunlight and low humidity can drive up ozone levels; and wildfires, dust storms, and other hazards frequently coincide with spikes in air pollution, exacerbating health impacts and complicating emergency response beyond the capacity of any single agency to manage.  

Research on paired air-quality and heat indices in Mexico finds that a combined indicator can better communicate health risks than two separate scales (Fever et al., 2022). The AirNow Fire and Smoke Map — a joint effort of the U.S. Environmental Protection Agency and the U.S. Forest Service — is one example that consolidates fire locations, smoke plume forecasts, near-real-time air quality readings from regulatory monitors and thousands of low-cost sensors, and health protective actions in a single public interface; during major transboundary smoke events, it receives more than a million page views in a single day. Canada's Air Quality Health Index also demonstrates how an index and alert system can be engineered to work together: during wildfire smoke events, the index's underlying formula automatically adjusts to compute risk hourly from fine particulate matter and issues color-coded air quality warnings triggered by significant AQHI shifts. Indonesia’s BMKG Mobile App provides information on weather, climate, air quality, and earthquakes in Indonesia in one convenient portal.

This requires coordination before the season, not during the crisis. Agree with the meteorological, health, and disaster-management agencies on who leads the messaging when hazards coincide, which thresholds trigger a joint response, what actions will be ordered, and what shared language everyone will use. Some cities, like Bangkok, have placed air quality under a single municipal command that convenes the pollution-control, health, transport, and traffic-police agencies whenever levels cross a defined threshold, so that traffic restrictions, work-from-home requests, and health measures are triggered together rather than agency by agency (C40, 2020).

Adopt the messaging practices that have been refined by the early warning community over decades. Foremost is impact-based forecasting: the World Meteorological Organization promotes a shift from “what the weather will be” to “what the weather will do” by focusing alerts on expected impacts on communities and specific actions that minimize harm (WMO, 2022). Applied to air quality, this means alerts that lead with consequences and actions (“sports should move indoors today”) rather than with pollutant concentrations, and that align with other heat, fire, or dust warnings. Use of the Common Alerting Protocol, an international standard behind most national alert platforms, allows messages from a pre-scripted playbook to reach mobile phones, television, and radio at once. Cell broadcast technology and AI-assisted targeting extend the speed and reach of warnings to mobile devices in specific affected zones. The most resilient systems layer national, local and community channels for redundancy (see also the WMO Early Warnings for All Initiative).

Above all, keep the system people-centered. Guidance on designing inclusive early warning systems (World Bank, 2023) and multi-hazard experience from the Global South (Budimir et al., 2025) converge on one lesson: alerts work only when they are trusted, understood, and reach everyone — including those without smartphones or fluency in the dominant language. The systems people act on are the ones co-created with the communities most at risk. Involve them in designing the alerts, not just in receiving them.

06 Establish a citizen complaint and response system

A website portal or app for citizens to report local pollution issues converts public concern into actionable intelligence — complementing air quality alert systems by providing real-time, hyperlocal information on pollution hotspots or exceedances. An analysis of environmental complaint reporting in 295 cities in China (Xiafei et al., 2024) found that citizen reporting, delivered first through writing letters or visiting the authorities, and more recently through hotlines and smartphone apps, significantly improved air quality. Another study of over 130,000 environmental citizen complaints in the U.S. state of Texas found a 75-percentage-point increase in the likelihood of investigation within two months, delivering more regulatory response than routine monitoring (LSE, 2024).  

Design for accessibility and standardization. Effective systems combine digital tools — mobile apps and online forms that capture location, time, photographs, and pollution type in a structured format — with telephone hotlines that remain available to people without digital access and simple communications like this fact sheet to guide them on what to report and how. The defining feature of systems that foster trust is a built-in response protocol. Complainants receive feedback on what was found and what was done, and aggregate complaint statistics — volumes, categories, response times, enforcement outcomes — are published on a regular schedule. It is important to connect the complaint system to enforcement action (see Stage 4, Step 9 of the Legal Framework and Policy Design guidance) and to accountability reporting, which becomes central in Stage 5 of the Public Engagement and Communications Guidance.   

07 Move people from awareness to action

Data alone rarely compels people to avoid exposure to air pollution or to stop their polluting activities. A 2025 review of 79 air quality communication interventions (Cibin et al., 2025) found that behavior change requires two things awareness cannot supply: capability — knowing exactly what to do and having the means to do it — and motivation, which is shaped by social norms and trusted messengers.

Social and behavior change communication (SBCC) applies behavioral science to address this gap. Whereas risk communication (introduced in Stage 4, Step 2) is an urgent, real-time exchange of information to help people make immediate, protective decisions, SBCC takes a long-term, evidence-based approach to shift the attitudes, social norms and everyday behaviors that drive exposure and emissions. Communication is only one lever. UNICEF's SBCC guidance recommends a combination of approaches, including community engagement, changes in public policy, and the redesign of services to overcome barriers due to cost or access rather than lack of information.

For air quality communicators, that means pairing messages with changes that make the cleaner choice easier not only to understand but also to adopt. Give people a repertoire of concrete actions rather than a single instruction.  A systematic review of 37 studies across 28 behaviors (Riley et al., 2021) found that offering a range of options builds self-efficacy and heads off the fatalism that sets in when a problem feels too large to affect. Design each campaign around a specific behavior and the barriers and cues that govern it; set a baseline and measure behavior change rather than reach (an important measurement for the evaluation published in Stage 5). Deploy through the channels people already use and trust — popular drama, social media, school talks, community events, faith networks — to shift norms rather than broadcast facts and let emerging AI-assisted tools such as the Hong Kong Personalized Real-time Air Quality Forecasting System (PRAISE-HK) tailor exposure and risk information to a person's location and daily routine (Chi et al., 2020).

The people a campaign aims to reach already know what will work locally. Design with them, not for them. A pilot that co-designed behavior-change tools with people living with asthma  (McCarron et al., 2024) achieved higher uptake than top-down equivalents, and a ten-city accelerator in India builds SBCC into city action planning by letting communities decide which messages, channels and messengers land. Repetition over time is also important: norms shift slowly, and clean-air messaging holds only when it is sustained and woven into the everyday settings where people live, learn and gather.

08 Embed clean air into institutions and everyday life

Lasting change comes from building air quality and health education into the institutions people rely on every day — schools, clinics, workplaces and government —so that public support for clean air is constant, rather than surfacing only during severe pollution alerts. Start by providing consistent cost-benefit and health messaging to all of the agencies enforcing air regulations or standards, including the health, environment, energy, and transport ministries. The European Commission's toolkit on communicating on air quality and health provides ready-made frameworks for that cross-government coordination.  

Work with education departments, universities and schools to embed these communication materials into the classroom and campus life. Embedding air quality in secondary education and linking schools to national and international air quality research builds a multi-generational constituency for clean air — and a population that understands air quality as a lifelong health issue, not just as a seasonal nuisance. Online tools like the Clean Air for Schools Framework, developed by Global Action Plan, provide a model for creating a tailored clean-air action plan for schools. Additional entry points include hands-on training of teachers and students with low-cost sensors, flag programs to signal daily air quality, and anti-idling campaigns in school drop-off lanes.  

Community-scale events are another way to deepen public engagement. Jakarta's weekly Car Free Day,  Bogotá's Día sin Carro y sin Moto and Kigali's twice-monthly car-free Sundays have all reduced PM2.5 near closed roads on event days while drawing thousands of residents to walk, cycle and get free health checks.  Addis Ababa's monthly Menged Le Sew ("streets for people") has spread to some 20 Ethiopian cities and helped reshape national transport policy. Cycling events, such as the American Lung Association's bike treks across scenic landscapes in the United States, have raised awareness and funds to fight lung disease for more than 40 years. Anchoring such events to shared dates — World Environment Day on 5 June, the International Day of Clean Air for blue skies on 7 September — ties local action to a global calendar and gives communicators a recurring, high-visibility moment to mobilize schools, employers and media. Their value for embedding lies less in the one-day emissions dip than in the constituency they build: recurring, visible occasions that turn clean air from an abstract regulatory goal into something residents experience, anticipate and come to expect from their city.

Also consider moving beyond information delivery to cultural engagement. Commission bolder creative work: artists and photographers documenting how pollution affects daily life; partnerships with sports teams and cultural institutions that carry clean air into major public events; storytelling built around the places people live and the health of their children. Chapter 5 of UNEP's Actions on Air Quality report and the Air Quality Communications Network compile examples of public engagement across regions. 

09 Deepen collaboration with business and industry

At Stage 4, credibility and relationships are strong enough to engage business and industry as durable partners in managing both acute pollution episodes and chronic emissions — while maintaining accountability. Companies and businesses across all sectors are most likely quantifying their air pollutant emissions and reporting them to governments using methods such as the Greenhouse Gas Protocol, Science Based Targets, the Climate Action Aggregation Tool (CAAT), or the Practical Guide for Business Air Pollutant Emission Assessment (CCAC/SEI, 2022).  

Communicators must differentiate between audiences. Regulated emitters should be clearly informed of the steps they need to take to meet standards and respond to enforcement actions; the broader business community can be mobilized as champions, investors, and co-designers of clean air solutions. Mexico City’s air quality turnaround (Molina et al., 2006) is one example of how structured public-private engagement, sustained over more than a decade, reshaped both communications and policy. The UNDP toolkit for developing multi-sectoral, multi-stakeholder city air quality action plans provides frameworks for public-private engagement in city-level planning, including stakeholder mapping tools and communication strategy development for industry partners. Use these structured processes to convert individual corporate commitments into specific, measurable public pledges. When made public, they become a form of accountability that serves the jurisdiction and businesses alike. Communicating the economic co-benefits of clean air — avoided health costs, productivity gains, and competitiveness — builds the shared understanding that sustains participation.  

For episodic pollution, industry partnerships built in advance pay off during emergencies. Pre-negotiated protocols for voluntary or mandated curtailment during forecast episodes (see Step 4 above and Stage 4, Steps 6 and 8 of the Decision Support Guidance) work better when the communications groundwork — shared data, agreed terminology, established points of contact — has been planned and widely disseminated in advance.  

For chronic pollution, sustained, two-way engagement around emissions inventories, compliance reporting and sectoral roadmaps is also needed to turn an adversarial dynamic into a managed, public process. An extensive communication campaign that builds awareness of regulations affecting the private sector, along with enforcement education, is a must. A 1999 US EPA survey found that the most common causes of noncompliance were that businesses and agencies had trouble communicating with each other, reporting and notification steps were unclear, and state and federal rules were interpreted in conflicting ways—an information failure that good communication can address. Useful ways to ensure adherence to regulations include: setting up compliance assistance centers in collaboration with industry associations, universities, and local government; providing businesses with clear, easy-to-read information, such as fact sheets and regular alerts; and running a hotline where people can report concerns.   

10 Support citizen science as a governance tool

Citizen-based air quality monitoring initiatives have multiplied in recent years, evolving rapidly from being chiefly awareness-building activities to serving as a powerful force for expanding coverage, democratizing data, influencing government decisions, and directly engaging people in protecting their right to clean air (CCAC, 2025). Community-collected data now informs urban planning, zoning decisions, regulatory enforcement, and litigation. In Nepal, citizen-generated data empowered civil society networks to engage local officials in informed discussions about improving e-cooking initiatives and upgrading electrical infrastructure (FHI360, 2025). The EU funded CompAir platform, a multi-city European project that equips citizens with air quality sensors and contributed directly to a public-space redesign that reduced traffic-related pollution. Another is the Breathe London community monitoring program. It distributed 400 free, calibrated sensors to 60 community groups to incorporate local knowledge and boost data actionability around the city’s Ultra Low Emission Zone (ULEZ). Ultimately, community monitoring provided direct evidence of the ULEZ's success in dramatically lowering nitrogen oxide levels—and the initiative has been instrumental in sustaining long-term support (Schulte et al., 2025, Mayor of London, 2024).

But citizen science’s reach into decision-making remains uneven — a global review of participatory air-quality sensing notes that translating citizen data into policy influence depends heavily on whether institutions are ready to take in that input (Mahajan et al., 2022). Communicators can help strengthen the formal relationships that enable institutions to receive and act on community evidence by creating advisory seats, data-review panels, and consultation windows for citizen scientists. They can foster dialogues between citizens and decision-makers so that they understand and value citizen science rather than dismiss it. And they can publicly credit community contributions whenever they shape an outcome: nothing sustains participation like visible evidence that participation works.