China’s emergency management of severe acute respiratory syndrome (SARS) was heavily criticized, whereas the H7N9 response was praised by the international community.

The aims of this study were to examine and compare the strengths and weaknesses of risk communication conducted in response to SARS and H7N9 and their associated social impacts on affected communities in China.

A qualitative comparative case study approach was employed in the present study, using a set of 8 risk communication principles selected from international literature to suit the Chinese context for the comparative analysis of emergency responses of SARS and H7N9.

The study found significant differences in the risk communication conducted in the 2 cases. The SARS outbreak fully exposed China’s lack of experience in public health risk communication. By contrast, the Chinese government’s risk communication strategies had improved significantly during the H7N9 outbreak.

Trust is the basis for communication. Maintaining an open and honest attitude and actively engaging stakeholders to address their risk information needs will serve to build trust and facilitate multi-sector collaborations in dealing with a public health crisis.

From SARS to H7N9, risk communication practices in China greatly improved, which, in turn, lessened adverse social impacts and improved outcomes in emergency management of public health crises.