TV Club: Sex Education

A doodle gestures to a TV screen showing some of the characters from Sex EducationIf you’re like us, dear readers, your consumption of TV and movies increases around this time of year. Because what’s better than a warm beverage, a cozy blanket, and a bingeable TV show? And that’s why this week, we’re bringing you a (somewhat overdue) recommendation for a show that you don’t want to miss: Netflix’s Sex Education.

The fourth and final season (or series for our friends in the UK) of this poignant and often hilarious show was released in September. It takes place in a small pastoral British town and follows an ensemble of teenagers (plus some of their corresponding adults) navigating school, family, friends, romance, and — of course — sex.

There’s a lot to like about Sex Education, but let’s start with something you might guess is top of mind for us: the show is basically an advocate for accurate, inclusive sexual health info but in the form of television! Otis, arguably the main character, learns the value of comprehensive sex ed from his sex educator mother (played by the unarguably brilliant Gillian Anderson). In the first season, Otis joins forces with edgy classmate and soon-to-be-love-interest Maeve to set up a sex ed “clinic” at his school where he talks STDs, tricky intimate relationship dynamics, how pleasure fits into sexual health, and everything in between. Things take off from there.

As mentioned, Sex Education certainly takes a comedic approach — but it also includes realistic portrayals of things that are far from funny: sexual assault, gender dysphoria, postpartum depression, disability, bullying, homophobia (internalized and not), addiction, class issues, and crises of faith to name just some. We ❤️ to see mainstream media take on these topics — many of which have traditionally been ignored entirely or represented via unrealistic and potentially harmful stereotypes. Note the intimacy scene between Isaac, who uses a wheelchair, and Maeve in season 3. We can’t think of many — any? — comparable depictions.

We’ll note that reviews of the last season have been mixed after almost universally glowing reactions to the first 3. Some critics have panned it as a parody of itself in the end — too unrealistic, too many new and underdeveloped characters whose sole purpose seems to be to represent a specific identity — essentially, too “on the nose.” We’ll let you decide what you think about that part.

For ours, we still enjoyed the vibrant, joyful, and inclusive wrap-up to this super enjoyable series that embraces tough and important topics with such spirit, charm, and care.

The bottom line: Watch Sex Education for, well, a lot of reasons. Its emphasis on the need for clear and inclusive sexual health information is a good start! 

Post about it on X: This week, @CommunicateHlth is chatting about Sex Education. If you haven’t tuned in yet, the show has a lot going for it — starting with its emphasis on the need for clear, inclusive sexual health info. Read more: #HealthLiteracy

Things We ❤️: APHA’s Climate Change, Health, and Equity Guide

A happy doodle holds up a copy of APHA's Climate Change, Health, and Equity GuideIn 2021, over 200 medical journals released a statement warning world leaders that failure to address our warming climate is the “greatest threat to global public health.” The science, the authors write, is crystal clear: Climate change puts us at risk for “catastrophic harm to health that will be impossible to reverse.”

What kind of harm are we talking about exactly? You probably already know this, dear readers, but here are just a few examples of the link between climate change and public health: Climate change can exacerbate chronic diseases, lengthen allergy season, create extreme heat and weather events, and help diseases that spread through vectors or contaminated food and water thrive.

And just as with many other public health issues, we know that the burden of climate change is not distributed evenly. Factors like where we live and what we do for work (hello, SDOH!) can impact climate resilience, or how well we can prepare for and respond to climate change-related problems. Children, pregnant people, older people, people with chronic illnesses, lower-income communities, communities of color, outdoor workers, and people living on coastlines and in floodplains are all disproportionately affected by the health implications of climate change.

With that as a backdrop, we wanted to highlight a resource from the American Public Health Association (APHA). APHA’s Climate Change, Health, and Equity Guide was written for local health departments, but it includes plenty of food for thought and helpful takeaways for public health professionals outside the health department setting, health communicators, and more.

In particular, we’d like to draw your attention to the following 2 sections, which we found to be really helpful and compelling:

  • Climate and Health Communications — Of course we’re going to be fond of this section, which is all about communicating climate health messaging to consumers and policymakers. For example, you’ll find tips for integrating messages related to climate and health into routine public health communications.
  • Health Equity and Climate Change — This section includes a framework that explores the critical connections between climate change, health, and equity. It also dives into topics like community climate resilience, intergenerational equity, and more.

When it comes to climate change, there’s a lot of work to do. As health communicators, we can help by communicating clearly about how climate change is affecting our health. In our communications, we can also acknowledge that some groups are at greater risk for negative consequences due to factors outside their control. And we can advocate for solutions that give everyone their best shot at living a healthy life.

The skills we hone every day — simplifying complex info, using plain language, and communicating with empathy — will be invaluable tools as we work together to keep ourselves and future generations healthy and safe.

The bottom line: As health communicators, it’s our job to communicate clearly (and often!) about the connection between climate change and public health. APHA’s Climate Change, Health, and Equity Guide can help.

Post about it on X: #HealthComm professionals need to communicate clearly (and often!) about the link between #ClimateChange and #PublicHealth. @PublicHealth’s Climate Change, Health, and Equity Guide can help, says @CommunicateHlth:

Scary Halloween Costumes for Public Health Professionals

3 doodles are dressed up in "scary public health costumes." One is a pumpkin with jargon terms on it, one is a pathogen in disguise, and the other is an influencer chatting about the latest juice cleanse. A tiny trick-or-treating doodle child says, "twick twee."

It’s the spookiest time of year — Halloween is just around the corner! If you find yourself at a loss at what to wear to your company Halloween party, don’t despair, dear readers — we’ve got you covered. Below, you’ll find some scary costume ideas that will have all your public health and health comm colleagues screaming with fright.

  • The Pseudoscience Influencer. What the Pseudoscience Influencer lacks in scientific evidence, they make up for in conviction — passing out misinformation like Halloween candy. They have opinions on just about any health topic, which they promote confidently to their inexplicably large social media following. To create your Pseudoscience Influencer costume, pick up the trendiest lounge set you can find and keep calm and carry on “correcting” your colleagues as they try to share evidence-based info. After all, most health problems are solvable with the right juice cleanse, right?
  • The Jargon Jack-O’-Lantern. Who doesn’t love an ornately decorated pumpkin to get into the Halloween spirit? Well, in this case, possibly your colleagues. To get your Jargon Jack-O’-Lantern get-up ready, you simply need to gather an all-orange outfit of some kind, a sharpie, and a brown hat. Next, use said sharpie to cover your orange outfit in the most hair-raising, spine-chilling medical and public health jargon terms you can conjure up. Really go for it, and you’ll basically be like a traveling haunted house for health comm folks — everywhere they look it’s “contraindication” and “utilize” and “subcutaneous,” oh my!
  • The Pathogen. Perhaps the most terrifying of all, the Pathogen attaches itself to any gathering of 2 or more people — lurking, uninvited, waiting for a chance to spoil everyone’s fun. To avoid detection, the Pathogen wears neutral-colored clothing. But be ready to mutate, err, pivot at any moment — because just when people think you’re finally gone, you pop back up wearing some ever-so-slightly different accessories.

The bottom line: With our costume ideas, you’re guaranteed to be the talk of every public health Halloween party — though you might not be invited back next year.

Post about it on X: Not sure what to be for #Halloween? @CommunicateHlth’s got you covered! Check out these scary costume ideas for #PublicHealth and #HealthComm professionals: #HealthLiteracy

(Re)building Trust in Public Health

A public health professional doodle reaches out a hand to a perplexed-looking doodle.

We don’t have to tell you, dear readers, that the COVID-19 pandemic has contributed to distrust in public health. When scientific knowledge and health guidance evolve quickly, people often feel confused or misled. Plus, the rise of misinformation has made it hard to tell fact from fiction. And let’s not forget the polarized political climate and rapidly evolving technology (generative AI, anyone?). With this recipe for information overload, it’s no wonder many people have tuned out, lost trust, or both.

Systemic injustice plays a role, too. People from historically marginalized communities — including people of color, LGBTQ+ people, and people with disabilities — may have experienced discrimination and mistreatment from health care providers. And in trying to teach people about health conditions, some experts have shared harmful messages about these groups and others, contributing to stigma in our society.

So where do we go from here? The good news is that health communicators can help rebuild trust by communicating with empathy: creating communication materials that truly reflect our audiences’ perspectives, needs, and lived experiences. And though we’ve featured these tips in other contexts, we thought it was worth rounding them up here.

So if building trust is your number 1 priority, here are a few ways to get started:

  • Learn from your audience. No time for user research? Exploring resources created by and for your audience is a great way to learn.
  • Partner with trusted organizations. People are more likely to trust health info when it comes from an organization they already know and feel connected to.
  • Be honest about what we know and don’t know. To address confusing U-turns, acknowledge that our understanding of health issues is bound to change as researchers learn more about the topic.
  • Use terms your audience uses. Follow your audience’s lead on terms related to gender, sexuality, race, ethnicity, and disability. Using your audience’s preferred terms shows that you respect their identity and experience.
  • Listen with an open mind. Take time to reflect on criticism, even when it’s hard to hear. Be willing to pivot if your communication strategy isn’t resonating with your audience.
  • Acknowledge injustice. For example, when you’re writing about health risks, name how racism plays a role in health outcomes. To take this a step further, consider acknowledging harms that your audience may have experienced, like discrimination in health care.

We know trust is a complex topic, and there’s a lot to unpack here. How are you working to build (or rebuild) trust with your audiences? As always, you can respond to this email or find us on social (LinkedIn or X) and let us know what you think.

The bottom line: We can help rebuild trust in public health by communicating with empathy: creating communication materials that truly reflect our audiences’ perspectives, needs, and lived experiences.

Post about it on X: This week, @CommunicateHlth explores how health communicators can help rebuild trust in #PublicHealth by communicating with empathy: #DEI #HealthComm #HealthLiteracy

Health Comm Headlines: Generative AI

A doodle reads a newspaper showing a headline: Generative AI...

If you’re anything like us, dear readers, you have many thoughts about generative AI’s role in health comm. Generative AI (short for artificial intelligence) uses source content, like a database or websites, to create new content. And while some folks think it has great potential to improve health comm, others have serious concerns.

At this point, we have lots of questions — which is why we’ve been eagerly watching for articles that might have some answers. Today, we’re sharing a few of them with you in the latest installment of our Health Comm Headlines series. We hope that they spark discussion with your fellow health communicators. And as always, we’d love to hear what you think — so reach out if you have comments!

  • Distilling the Promises of AI in Global Health from the Hype (Johns Hopkins Center for Communication Programs)
    This piece gets real about generative AI’s potential in public health and health comm — and its limitations. The article features a fun example of AI-generated content: a song aiming to get men in the Democratic Republic of the Congo more involved in family planning. But it also discusses serious issues, particularly the fact that AI relies on data and some of that data is biased. As the author puts it: “Generative AI may provide the starting point; however, human input is still needed to quality check and provide expertise into context. It is naïve, though, to think these tools won’t factor into future content development.” We couldn’t agree more.
  • How AI Is Helping Doctors Communicate with Patients (Association of American Medical Colleges)
    This article focuses on health care’s use of chatbots — computer programs that simulate conversations with people. It notes that chatbots interacting with patients have 2 main purposes: monitoring health conditions and answering questions. For example, it describes a chatbot service that reaches out to different types of patients, like people who just returned home after surgery and people with chronic conditions. The idea is that these types of services can help make sure people are getting the care they need — like by alerting a doctor to call them for a follow-up — if their answers indicate a health concern. (While that is definitely promising, it’s also important to keep in mind that chatbots’ track record is far from perfect.)
  • A.I. May Someday Work Medical Miracles. For Now, It Helps Do Paperwork. (New York Times)
    This piece makes the case that currently, one of generative AI’s biggest benefits in health care is that it can… reduce paperwork. While that doesn’t sound overly exciting, it’s actually a pretty big deal and could potentially go a long way toward improving patient-provider communication and reducing provider burnout. As the article explains, doctors spend a lot of time — during patient visits and after hours — taking notes and logging info in electronic health records. But AI can do this for them, which can free up doctors’ time and improve the quality of doctor visits. The article describes an AI tool that not only takes notes during visits but also sends patients a plain language summary immediately afterward. You can bet that piqued our interest!
  • AI Might Be Listening During Your Next Health Appointment (Axios)
    This article is also about AI tools that can take notes during doctor visits and provide summaries, but rather than highlighting these tools’ benefits, it focuses on a potential drawback: privacy concerns. For example, the article says advocates are concerned that these tools are being released with little oversight and without standards for notifying patients about their use. Also this: “AI systems are trained on large amounts of real data, raising the question about whether patients’ data may be used for such training in the future.” These are valid concerns that we should all take seriously.

Post about it on X: In their latest #HealthComm Headlines post, the @CommunicateHlth team rounds up food for thought on generative #AI and the future of #HealthCommunication:

Things We ❤️: The Debunking Handbook

A happy doodle shows off the Debunking HandbookIf you’ve been following us for a while, dear readers, you know we’re always thinking about ways to improve health communication. Recently, that’s included a lot of noodling about how to effectively fight misinformation. That’s why we ❤️ The Debunking Handbook 2020 — a guide with actionable tips for disproving false claims and dispelling myths.

Written by a group of 22 international scholars (and available in many languages), the handbook describes misinformation as “sticky,” or hard to get rid of. Alternately, you might think of misinformation the way you think of weeds in the garden: Once it takes root, it’s notoriously hard to get rid of — even if it’s been corrected.

That’s why the best thing to do, according to The Debunking Handbook, is prevent misinformation from taking root in the first place — by prebunking false claims before they start circulating. With prebunking, you explain the techniques that people who spread false information use, which can help your audience spot misinformation in the future.

If misinformation has already taken root, though, don’t despair — that’s when the debunking part comes in. But first, the handbook suggests that you consider these questions:

  • Is the myth circulating widely? Does it have the potential to cause serious harm? If not, your energy may be better spent battling other “weeds.”
  • Can you provide accurate information without directly debunking (and thereby mentioning) the myth? For example, you might be able to highlight a vaccine’s success and safety rate without bringing up any misinformation related to it — and by doing so, drawing attention to a false claim.

That said, sometimes you won’t be able to avoid mentioning the falsehood you’re trying to debunk. If you find that it’s time to pull misinformation out by the root, The Debunking Handbook has a solution. To our long-time readers, that solution will sound familiar: You wrap the myth in facts — also known as a truth sandwich! That way, you’re guiding your audience’s attention toward the correct information, not the falsehood.

The bottom line: The Debunking Handbook offers hands-on strategies that can help health communicators weed out misinformation and plant the seeds of fact-based, accurate health info.

Tweet about it: The Debunking Handbook offers actionable strategies to fight misinformation. @CommunicateHlth has the details: #HealthComm

Who’s Left Out of the Clinical Trial Diversity Convo?

A clinical trial participant doodle sits in their wheelchair and chats happily with a researcher doodle at the researcher doodle’s desk.

Here at We ❤️ Health Literacy HQ, we’re excited to see many research institutions and pharmaceutical companies working to increase diversity, equity, and inclusion in clinical trials. These efforts often focus on enrolling participants from underrepresented groups — like people of color, women, and LGBTQ+ people.

But did you notice anyone missing from that list, dear readers? Although 1 in 4 people in this country have a disability, people with disabilities are often left out of clinical trials and the conversation about diversity in clinical trials. That means researchers miss out on data about how treatments affect people with disabilities, creating gaps in medical knowledge. Here’s a great example from the STAT piece linked above: Although many people with Down syndrome develop Alzheimer’s disease or dementia later in life, few clinical trials for Alzheimer’s treatments include people with Down syndrome.

So why don’t more people with disabilities participate in clinical trials? Eligibility criteria are a big factor. Some trials have criteria that specifically exclude people with certain disabilities. And some trials exclude wide swaths of people, like anyone who has cognitive challenges, can’t drive to study appointments, or seems unlikely to successfully complete the study. Subjective criteria leave room for implicit bias to sneak into the selection process — if a researcher has negative beliefs about disability (even subconsciously!), they may be more likely to exclude people with disabilities based on vague criteria.

Most clinical trials don’t seek out people with disabilities or offer the accommodations they need to participate. Accommodations like having an ASL interpreter on site, making consent forms easier to read, or allowing participants to bring a support person to appointments would enable more people with disabilities to join clinical trials. On top of these barriers, many trials don’t include disability in their participant stats. So even when people with disabilities do participate, researchers are missing opportunities to analyze the data through the lens of disability.

The work of making clinical research more inclusive is complex, and it’s important to acknowledge some nuances here. Of course, there are situations where disabilities can prevent people from completing clinical trial activities. Plus, researchers aim to eliminate confounding variables — outside factors that may affect study results. In practice, this often leads researchers to exclude people with “complex” medical histories.

So where do we go from here? Researchers can structure eligibility criteria to include as many people as possible, proactively seek out participants with disabilities, and provide necessary accommodations. Of course, these changes won’t happen overnight. In the meantime, health communicators can do what we do best: make clinical trial materials easier to read and understand. And we can amplify the work of people with disabilities who are advocating for a more equitable world.

The bottom line: People with disabilities are often left out of clinical trials and the conversation about diversity in clinical trials. Making clinical research more inclusive is a complex task, but it’s a critical step toward health equity.

Tweet about it: This week, @CommunicateHlth explores why people with disabilities are often left out of #ClinicalTrials — and why inclusive research is an important step toward #HealthEquity: #DEI #HealthComm #HealthLiteracy

Explaining Wastewater Surveillance

2 scientist doodles look at a water sample in a test tubeBack in pre-COVID times, “wastewater surveillance” wasn’t a term we came across much (ever?). But that all changed due to the pandemic — and the launch of CDC’s National Wastewater Surveillance System (NWSS). Now it’s quite common to see casual mentions of wastewater surveillance, like in a news report about rising COVID cases.

As many of you know, wastewater surveillance is a way that public health professionals can track community levels of COVID. But unless you’re writing for, say, wastewater treatment plant employees (and we’re guessing most of you aren’t, dear readers), it’s a safe bet that’s lots of folks in your audience don’t know what the term “wastewater surveillance” means.

So if you find yourself mentioning wastewater surveillance in your COVID health comm materials, it’s important to clearly explain it. Here’s the gist:

Wastewater surveillance means tracking the level of COVID virus in samples of wastewater — the water that goes down the drain in our homes and businesses. It works because people with COVID (and other diseases caused by viruses) can shed very small amounts of the virus in their pee, poop, and other bodily waste. And that happens even if they don’t have symptoms. (Want to know how exactly wastewater surveillance works? Check out this nifty infographic.)

Wastewater surveillance gives public health professionals important information about how COVID and other diseases are spreading in our communities, even if people who are sick don’t go to a doctor’s office or clinic to get tested. This is very important because many people now use at-home test kits to test for COVID (if they test at all!) — meaning lots of cases aren’t reported to local health authorities. And that means official case counts may not paint an accurate picture of COVID case rates in a community.

Adding wastewater surveillance to the mix can help us get a much clearer idea of what’s going on in a community at any given time. And local public health officials can use that info to make recommendations about protective measures for their community, like mask wearing. CDC has a tool to look up wastewater reports by county and monitor trends in COVID levels over time. Put it in your health comm toolbox — and consider sharing it with your audiences as appropriate to help them stay informed and take steps to protect their health.

The bottom line: Wastewater surveillance is an important public health tool make sure you’re clear on how to explain it in plain language if you need to.

Tweet about it: Wastewater surveillance is an important #PublicHealth tool. Make sure you know how to explain it in #PlainLanguage, says @CommunicateHlth: #HealthComm

Book Club: The Invisible Kingdom

A doodle gestures to a copy of Meghan O’Rourke’s The Invisible Kingdom.

Today, we’re shining the spotlight on a book that illuminates what it’s like to live with a hard-to-diagnose disease: The Invisible Kingdom: Reimagining Chronic Illness by Meghan O’Rourke. Part memoir, part highly researched nonfiction, it’s an eye-opening read about the experiences of people on the margins of medicine: those with a so-called “invisible illness” not easily identified or treated.

For over a decade, O’Rourke dealt with intermittent but debilitating symptoms: brain fog, vertigo, fatigue, rashes, and what she calls “electric shocks” — stabbing sensations in her arms and legs. Her symptoms were wreaking havoc on her relationships, career, and sense of self. But despite the serious impact of her illness, O’Rourke struggled to find a doctor who would take her seriously. Again and again, her symptoms were dismissed or derided, and test results and appointments often left her with more questions than answers.

The Invisible Kingdom also explores how modern medicine is contending with chronic diseases and autoimmune disorders (spoiler alert: not all that well), both of which have a lot of overlap with hard-to-diagnose conditions. We ❤️ that the author draws attention to what’s working against those with invisible illness — among other barriers to proper care, she names social determinants of health, gender bias, harmful “problem patient” stereotypes, an inefficient health care system, lack of understanding of autoimmunity, and physician burnout.

While O’Rourke eventually received diagnoses and treatments that helped, she writes that she’s never fully free from her symptoms. Health and illness are often framed as mutually exclusive states — someone is either well or unwell. But O’Rourke explains that for her and many others, the options just aren’t so clear cut. Instead, they “live in a gray area between health and disease for years … between feeling well and being symptomatic.”

There are so many important health comm takeaways from this book that we couldn’t possibly include them all. So, dear readers, here are 3:

  1. Empathy is key. Of the countless doctors that O’Rourke saw, only a handful treated her with respect or took her symptoms seriously — especially after the first rounds of tests failed to identify the problem. Unsurprisingly, it’s the doctors who were willing to connect with and listen to O’Rourke that were finally able to offer some relief. Empathy, empathy, empathy!
  2. Illness is isolating. O’Rourke emphasized how lonely her illness made her feel: “One of the hardest things about being ill with a poorly understood disease is that most people find what you’re going through incomprehensible — if they even believe you are going through it.” As health communicators, we can acknowledge that isolation, as well as offer guidance on how to get social support and reminders that patients deserve doctors who take their concerns seriously.
  3. It’s okay (and critical!) to acknowledge what we don’t know. The Invisible Kingdom reminds us that there’s still plenty of uncertainty in medicine — particularly related to concepts like autoimmunity. And if there’s one thing we learned from the last few years, when it comes to health comm, it’s that acknowledging what we don’t know is always best.

The bottom line: Check out The Invisible Kingdom for the story of one woman’s experience with invisible illness — plus powerful health comm lessons about empathy, isolation, and uncertainty.

Tweet about it: Check out @CommunicateHlth’s latest pick for the We ❤️ Health Literacy Book Club, The Invisible Kingdom by @meghanor. Part memoir, part nonfiction, this powerful read has powerful lessons for #HealthComm professionals:

Let’s Talk About “Noncompliant”

A doctor doodle hands a name tag that says “noncompliant” to their patient. The patient doodle looks puzzled.

Here at We ❤️ Health Literacy HQ, we’re fond of rethinking terms that have been hanging around for a while — but, for one reason or another, aren’t getting the job done anymore. Today, we’re pondering a term that often comes up in health care: “noncompliant.”

Health care providers and other professionals may label a patient “noncompliant” if the patient isn’t following instructions or taking steps to care for their health at home (like taking medicine consistently or making changes to their eating habits). Well, we think it’s time to ditch “noncompliant,” whether you’re talking to consumers or professionals.

First, “noncompliant” paints people as rulebreakers. The word reminds us of a student getting sent to the principal’s office — or someone who has “failed to comply” with a judge’s order. It sets up an us-vs.-them dynamic, painting doctors as the authority figure and “noncompliant” patients as people who choose not to follow their simple instructions. This dynamic brings shame into the conversation — and we know, dear readers, that shame isn’t an effective tool for behavior change.

“Noncompliant” also fails to acknowledge the many reasons why people may struggle to follow health advice. Sure, it’s possible that some people just don’t like being told what to do. But we’d argue that many more people “fail to comply” for reasons outside their control. For example, if a doctor tells their patient to eat more fruits and veggies, but the patient lives in a food desert, they’re going to have a hard time finding those healthy options.

Or let’s say a doctor tells a patient who’s struggling with depression to get more physical activity. A 15-minute walk might boost the patient’s mood, but when you’re depressed, it can feel impossible to leave the couch. Similarly, many people with ADHD and other neurological conditions struggle with executive function— basically, the skills you need to plan ahead and stick to your plan. AND lest we forget that the instructions may have been so convoluted and jargon-y that the patient wasn’t clear on what they were supposed to do in the first place!

The way we talk about people influences how we treat them. Taking “noncompliant” out of our vocabulary reminds us to look at the whole picture, consider how social determinants of health play a role in individual well-being, and build respectful relationships with our audiences. Now that’s something we can get behind.

The bottom line: We think it’s time to ditch “noncompliant,” whether you’re talking to consumers or professionals.

Tweet about it: This week, @CommunicateHlth explores why it’s time to ditch “noncompliant,” whether you’re talking to consumers or professionals: #HealthComm #HealthLiteracy