Movie Club: The Invisible Shield

An enthusiastic doodle gestures to a TV showing The Invisible Shield

As you know, we’ve been bringing you the occasional We ❤️ Health Literacy Movie Club post for many years now. But in all those years, we’ve never been able to plug a docuseries that’s entirely focused on public health — what it is, how it developed, how it works, what happens when it isn’t working, and what we need to do to strengthen the U.S. public health system. Until now.

The Invisible Shield, which you can stream for free on PBS, explores these topics and more in the aftermath of the COVID emergency. Through candid interviews with public health experts and plenty of contextualizing historical footage, The Invisible Shield tells viewers that “public health saved your life today and you don’t even know it.” Interviewees make the case that public health efforts are almost always underappreciated because when they’re successful, nothing happens (we don’t get sick or hurt) — and therefore no one sees or hears about it.

Which is exactly why we want to shout about this docuseries from any and all rooftops — especially now. The last episode is called The New Playbook, and it’s abundantly clear that to move forward, we need one. To create a stronger and more sustainable public health system, for example, we need to improve how we collect and share data — and to update state and local health departments’ software and computers. And those examples are on the more straightforward side.

Of course, we also need to deal with the complex web of social conditions that create or exacerbate struggles related to disease. Since COVID, there’s a lot more talk about social determinants of health (SDOH), which is certainly progress — but we need more united action across sectors. A public health approach is inherently a multidisciplinary approach — and that can make it complicated, but it’s the only way to actually solve these complicated problems.

The third episode, Inoculation & Inequity, focuses on distrust in government, skepticism of science, and how we got here (largely through the effects of structural racism). A case study from war-on-drugs-era days in the Bronx is especially powerful in revealing the factors and social policies that add up to major health implications over time. It’s not easy to grapple with a legacy like that — but as public health professionals, we must.

To be clear, while often heavy, The Invisible Shield is also hopeful. As author Steven Johnson says in the final episode: “When we look at the … last 200 years, there is so much cause for optimism. There really has been a miraculous set of advances in our health, but that doesn’t mean we’ve eliminated all the problems or that new problems are not going to arise. So the work is not to sit back and say, ‘Look at all the progress we’ve made.’ … The work is to say, ‘Well, that progress shows us that we are capable of solving these problems if we put our minds to them.’”

It won’t be easy, but together we can solve the public health problems before us. It’s time to do the work.

The bottom line: The Invisible Shield is a powerful exploration of public health in the United States — from its earliest days to the present — and zeroes in on how we can strengthen it for the future. It couldn’t come at a more critical time, so watch and share!

Copy/paste to share on social (and tag us!): This week, we’re chatting about The Invisible Shield on PBS. This powerful exploration of #PublicHealth in the United States couldn’t come at a more critical time. Watch and share, says CommunicateHealth:

An Unsettling Trend: Rising Cancer Rates in Young People

A doodle sits in an easy chair reading a news magazine with the headline Cancer Rates on the Rise in Younger People.

Here at We ❤️ Health Literacy HQ, we like to keep a close eye on trends in the health world. And one such trend has us a bit concerned: the rising cancer rates in young(er) people.

Generally speaking, the risk of cancer goes up with age. Of course that’s hasn’t changed — but experts are warning about rising rates of “early-onset” cancer, or cancer in people ages 18 to 49. Researchers aren’t sure what’s behind this trend, but we do know this: Colorectal cancer is now the leading cause of cancer death in men younger than 50, and the second-leading cause of death for women in that age group. Rates of early-onset breast, prostate, and endometrial cancers are also increasing.

Of course this is problematic for lots of reasons, including the fact that most people don’t start getting routine cancer screenings until they’re older. The U.S. Preventive Services Task Force (USPSTF) — the org that makes evidence-based recommendations for preventive services — recently lowered the age for breast cancer screening to 40 years. And in 2021, it lowered the age for colorectal cancer screening to 45. But that might not be enough.

One reason the USPSTF’s recommendations are so important is that health insurance companies may not cover routine cancer screening for people who haven’t yet reached the recommended screening age, or who don’t meet other risk factors as defined by the recs. In addition, some health care providers may not order cancer screenings for patients who don’t meet specific criteria — or they may not even start a conversation about screening with younger patients.

So what can health communicators do? We’ve got some tips:

  • Raise awareness about the power of cancer screenings! Use your health communication outlets and materials to educate people about the importance of screenings to help find cancer early — when it’s usually easier to treat. And this doesn’t have to be only in the context of cancer-related communications. You can share info about cancer screenings along with tips for other preventive, err, healthy habits — like getting plenty of physical activity and staying up to date on vaccines.
  • Note that people can get cancer at any age. It’s not very uplifting — but if you’re writing specifically about cancer, include the fact that even young and healthy people can and do get cancer. Experts warn that early-onset cancers are often diagnosed later due to the lack of routine screening (see above!) — and also because some young people may not consider the possibility that cancer could happen to them. So they put off seeing a doctor, even if they notice unusual symptoms.
  • Educate about cancer symptoms. If you’re writing about cancer prevention and detection, don’t forget to mention early warning signs and symptoms. And while those vary for different cancers, one thing’s true for all of them: If people notice anything out of the ordinary, it’s best to get it checked out.
  • Encourage conversations about family history. One important factor in predicting cancer risk in younger people is family history. So encourage people to talk with their family members about any cancers or other health problems in close relatives — and to share that information with their doctor.
  • Empower people to take charge of their health. Emphasize to readers that they’re the experts when it comes to their bodies — and if something doesn’t feel right, or if they’re concerned about their family health history, they deserve to be taken seriously. Even if that means getting a second opinion from another health care provider.

The bottom line: Cancer rates are on the rise in young people. As health communicators, we can help by educating our audiences about the risks and empowering them to take steps to protect themselves.

Copy/paste to share on social (and tag us!): #Cancer rates are on the rise among young people. As #HealthComm professionals, there are things we can do to help, says CommunicateHealth. Check out these tips: #HealthLiteracy

Reaching Audiences in Rural Communities

A doodle stands on a porch holding a cell phone into the air, saying “Can you hear me now?!”

We’ve been doing a lot of work with health departments lately. And these projects have us thinking about an audience that’s often underserved in public health: people living in rural communities. Compared to their urban counterparts, rural communities are more likely to face certain barriers to quality health care, which can majorly impact health outcomes. For example, rural residents in the United States are more likely to:

  • Be uninsured
  • Live farther away from health care facilities
  • Have fewer options for specialty or emergency health care
  • Have fewer public transportation options to help them get to health care visits

In addition, the health departments that serve rural areas often have fewer resources than health departments in urban areas, which limits the services they can provide. Those are just a few examples that help explain some pervasive disparities in health outcomes: People in rural communities are more likely than those in urban communities to die from heart disease, cancer, unintentional injury, respiratory disease, and stroke.

And to add yet another layer, some people in rural communities may mistrust public health officials and the health care system, especially in the wake of the opioid overdose epidemic and the COVID-19 pandemic. As health communicators, it’s our job to reach these audiences with info that makes sense for them — and build trust along the way. (Say it with us, dear readers: Reject the “hard-to-reach” trap!)

Here are a few tips to help you create health comm materials for people in rural communities:

  • Team up with trusted partners. We ❤️ our trusted messengers in public health! You know the drill — messages are more likely to resonate with people if they’re coming from someone your audience already knows and trusts. So try asking community organizations, places of worship, senior centers, or other local groups that have traction with your audience for help communicating information or sharing materials.
  • Keep it local. Many people in rural communities have fewer options when it comes to doctors, hospitals, fitness programs, groceries, assistance programs, and lots of other things. When you can, do your homework to understand what your audience actually has access to and share information about those local resources. If you’re writing for a specific geographic area, you could even pick up the phone to ask a county health department or 2 — the people on the ground — about the best sources of info and services for your readers.
  • Design for limited internet access. When creating digital tools or websites, remember that about 1 in 4 people living in rural areas or on Tribal lands don’t have high-speed internet — and slow page load times make it much more likely you’ll lose your audience. Design lightweight, accessible digital experiences that don’t eat up limited data.
  • Check your own assumptions. Keep in mind that rural communities aren’t monoliths (that’s true for any community). People living in these areas represent a range of professions, education levels, gender identities, religions, races and ethnicities, beliefs, and more — you know, intersectionality and all. When creating materials for people in rural communities, have a think about any implicit bias that might be creeping into your process — and choose language and examples that challenge stigma and harmful stereotypes when you can.

The bottom line: People living in rural areas face many barriers when it comes to accessing quality health care. As health communicators, it’s our job to make sure we’re reaching this audience with information to help them stay healthy.

Copy and paste to share on social (and tag us!): This week on the We ❤️ Health Literacy blog, CommunicateHealth is featuring tips for creating #HealthComm materials for rural audiences: #HealthLiteracy

Temptation Bundling

A doodle walks on a home treadmill while watching an episode of Dateline on television.

Here at We ❤️ Health Literacy HQ, our ears always perk up at the mention of techniques that can help encourage behavior change. Which is why, not too long ago, we shared a post about habit stacking. This week, we’re building on stacking (get it?) to bring you some thoughts about its very useful relative: temptation bundling.

As far as we can tell, “temptation bundling” was originally coined by Katherine Milkman, who also studied it. So what is it exactly? Temptation bundling is when you combine an instantly gratifying behavior that you want to do with something you don’t want to do but know you should do to get long-term benefits. Put more simply, it’s pairing something you have to do with something you want to do. The idea is that the immediate reward of getting to do the “want” behavior makes the “should” behavior more palatable — and therefore more achievable.

Here’s a version of the most common temptation bundling example: You’re trying to fit more physical activity in your daily routine — but all you really want to do is watch reruns of Dateline. If you were using temptation bundling, you could make a rule for yourself that you can only watch Dateline reruns while you’re at the gym. Essentially, the temptation of getting to watch your favorite show helps overcome your lack of motivation to get to the gym. 

So the next time you’re encouraging your readers to do something that you know may take some extra motivation, think about whether the concept of temptation bundling could help. Sticking with a physical activity example: “Struggling with the motivation to fit physical activity into your busy schedule? You’re not alone! You could try combining your physical activity time with something you love, like by listening to your favorite podcast or audiobook while you’re walking on the treadmill. If you keep this up, your brain may start to connect the 2 activities — and that can help you push past the lack of motivation and develop healthier habits over time.”

As with habit stacking, James Clear covers temptation bundling in his very popular book, Atomic Habits, which is a great resource to learn more about putting temptation bundling (and habit stacking!) into practice. You can also check out this excerpt

The bottom line: Temptation bundling — or pairing a “want” behavior with a “should” behavior —  is another great tool for the health communicator’s behavior change toolbox.

Copy and paste to share on social (and tag us!): Temptation bundling —  when you pair a “want” behavior with a “should” behavior —  is a great tool for the #HealthComm professional’s behavior change toolbox. CommunicateHealth explains: #HealthCommunication #HealthLiteracy

We’re All Getting Older

A group of happy older doodles. One doodle uses a wheelchair and is holding hands with another doodle. The other 2 are waving. In the current conversation about health equity and social determinants of health, there’s a lot of focus on racial and ethnic groups, LGBTQ+ communities, and people with disabilities — populations that have been discriminated against in ways that have harmed their health. Today, we want to focus on older adults, a group that sometimes gets left out of this critical equity convo. And the timing of the convo really is critical.

That’s because right now, the United States is older than ever before. And experts expect that trend to continue — by 2050, predictions put the number of U.S. adults age 65 and older at 82 million. That’s a whopping 47% increase from 2022, when there were 58 million. Essentially, we’re getting older, and that’s not going to change anytime soon.

One thing that’s well documented is that older adults are more likely to have limited literacy skills than many other groups. Some things that happen naturally when we age (think: vision and hearing issues) play a role — so does the fact that older adults, understandably, may have trouble keeping up with our incredibly fast-moving technological landscape. Older adults also have higher rates of chronic diseases, meaning they generally need more health care.

So it’s a tricky equation: people with complex health care needs who are likely, due to factors outside their control, to have trouble understanding health info and accessing health care. What’s a health communicator to do? We’ve got a few ideas:

  • Always use respectful language when communicating to and about older adults. We’ve shared tips for addressing older adults before, and now’s a great time for a refresher. In general, swap terms like “the elderly” or “seniors” for “older adults” — or get specific about age ranges. We also ❤️ this blog post on avoiding ageism in your writing from the National Institute on Aging, particularly the tip to use first-person (“we/us”) instead of third-person (“they/them”) when writing about older populations. As the author astutely points out, we’re all aging! So when appropriate, let’s take this opportunity not to “other” this group.
  • Tailor your materials and your outreach/dissemination strategies. This is an across-the-board best practice, but it bears repeating. Strategies like increasing font size in a material can go a long way toward making it more accessible to older people with vision loss, for example. Older adults may also prefer reading health info in print, so think about whether you need to provide print versions of materials (and if you’re writing digital content for older adults, make sure it’s print-friendly). We also know that older adults may rely heavily on caregivers to get information, so make sure they’ve got a place at the table, too. These are just a couple examples, and there are many more (including a few in our post on health literacy and older adults).
  • Explicitly call out barriers specific to older adults and offer “next-best” options. We know that older adults often have trouble getting to health care appointments. So if you’re working on a material for older audiences or their caregivers, name the barrier: “It’s normal to have trouble getting to in-person doctor visits as we age. If you’re worried about getting to the doctor, it might help to set up a phone call appointment to discuss it with your doctor. There may also be programs in your community that can help you get to appointments — try calling your local senior or community center to find out more.”
  • Be mindful of intersectionality within this audience. If you refer to the first paragraph of this post, we named “racial and ethnic groups, LGBTQ+ communities, and people with disabilities” as groups often affected by health disparities. And guess what? An older adult could be all 3 of those things! Just as the number of older adults is increasing, so is diversity within the audience. It’s far past time that we start accounting for intersectionality within the older population by creating communications and interventions that speak to the diversity of our aging population.

One last thought: As we know, health comm strategies alone can’t fix systemic issues. That’s why it’s important to advocate for bigger changes that can improve quality of life for all of us as we age. This report from Justice in Aging has a great list of 5 key areas that we can invest in to advance equity for older adults (note it’s specifically for older adults with lower incomes, but the areas stand), like improving anti-discrimination laws and policies. This could also look like naming ageism as a social determinant of health when it comes up in your work.

The bottom line: The U.S. population is getting older, and that’s not going to change anytime soon. As health communicators, there are steps we can take to help advance equity for older adults.

Copy and paste to share on social (and tag us!): The U.S. population is getting older. CommunicateHealth has some ideas for #HealthComm professionals to help advance equity for older adults. Take a look: #HealthLiteracy #HealthEquity

Beware the Singular “Community” (Sometimes)

A group of doodles are in a box labeled Community. A perplexed doodle on the outside of the box says, I don't think we'll all fit.

If there’s 1 word we say a lot in public health, it’s “community.” In addition to how it comes up anecdotally in our work, the word is baked into key public health concepts — think “community health,” “community-based orgs,” “community-based participatory research,” and the like. This makes perfect sense, as oftentimes public health professionals do work in a single, specific community.

But today we want to talk about a different use of the word “community” that we’ve been noodling on here at We ❤️ Health Literacy HQ: when health comm and public health professionals use the singular form of “community” to write (and talk) at a high level about our audiences. So, the LGBTQ+ community. The Black community. The autistic community.

Though it’s not uncommon to use the word like this (we’ve all done it!), let’s pause and think about what it implies when we “singular community” those groups of people. (And yes, we just used “singular community” as a verb, which it’s not — but stick with us.) There certainly isn’t only 1 LGBTQ+ community, is there? What about a single Black community? One set of autistic people comprising 1 autistic community? Absolutely not!

Rather, we know that our audiences reflect and include the diverse identities of all the individuals within those audiences. Which is exactly why we think it’s time to banish these massively oversimplified catchall terms from our health comm vocabularies! Sometimes, this is as simple as switching to plural:

  • Instead of: The Black community in the United States has been disproportionately affected by COVID-19.
  • Use: Black communities in the United States have been disproportionately affected by COVID-19.

And other times, you might want to skip “community” altogether:

  • Instead of: The autistic community often prefers identity-first language.
  • Use: Many autistic people prefer identity-first language.

One more thing: In addition to being reductive, normalizing use of the singular form of “community” to refer to our audiences can have sneaky implications. Words are powerful, and when we acknowledge through the language we use that there isn’t just 1 LGBTQ+ or Black or autistic community — even when talking to each other — it can serve as a reminder to keep the needs of our diverse audiences top of mind (hello, audience segmentation and intersectionality!). And that, dear readers, is a critical part of our job as health communicators.

The bottom line: Beware of the singular “community” when writing and talking about your audiences. Groups of individual people are never monolithic.

Copy and paste to share on social (and tag us!): Think twice before you use the singular “community” to refer to your #HealthComm audiences, says CommunicateHealth. Remember, groups of individual people are never monolithic! Read more: #HealthLiteracy #HealthCommunication

Inclusive Language Tips for Writing About Families

3 happy, diverse doodle families: one adoptive family, one with grandparents raising a small child, and a single-parent household.

Love is (still) in the air — but don’t worry, we’re not here to talk about romance via overpriced chocolates and flowers. Instead, we wanted to chat about another kind of emotional bond: family relationships. More specifically, we’ve been thinking about the language we use to talk about families — and how we, as health communicators, can make that language as inclusive as possible.

Fortunately, the days of assuming that a “family” comprises a mom, a dad, and biological children (the “nuclear” family) are long gone. There are tons of different family models — single-parent households, adoptive or foster parents, grandparents raising kids, “blended” families… the list goes on.

In most public health communication materials, the classic “parent” has been replaced by “parent or caregiver” in an effort to include other family models. That’s a good start — but we can take it further. When writing for and about families, think carefully before using the terms below — and if in doubt, swap them out for more inclusive options:

  • “Mom,” “dad,” or “parent.” Depending on context and your audience, consider using “caregiver,” “adult,” or “grown-up” instead. It also may be worth giving some thought to whether you want a plural or singular term, since there may only be 1 person caring for a child at home.
  • “Daughter” or “son.” Opt for more inclusive terms like “child” or “kid,” which have the added benefit of being gender neutral.
  • “Household members” or “members of a household.” If you’re using this term to mean families, keep in mind that families don’t always live together — they may have parents who are divorced or incarcerated, for example. Instead, just say “family members.”
  • “Extended family.” This is usually meant to include grandparents, aunts, uncles, and cousins. But in many cultures, this isn’t “extended” family — it’s just family.

And one more thing to keep in mind: Avoid making assumptions about who does what in a family. Consider this header: “5 quick and healthy recipes for busy moms.” This assumes not only that mom does the cooking — but that there’s a mom in the family to do it in the first place. Instead, you might say: “5 quick and healthy recipes for busy families.”

The bottom line: When we model respect for families by using inclusive language, we create a connection — and that makes our public health communications more effective.

Copy and paste to share on social: In #HealthComm materials, we sometimes write about families. Let’s make sure we do that using inclusive language! CommunicateHealth has some thoughts: #HealthLiteracy

15 Favorites (for the 15th!)

2 doodles with birthday hats on hold up a 15th birthday candle

As we told you last week, dear readers, February 9 marked CH’s 15th birthday! So to keep the celebration going just a bit longer, in lieu of our standard archive post this week (which just happens to fall on the 15th), we’re rounding up 15 favorites from the archive.

And it wasn’t easy to choose just 15! A couple were pretty clear off the bat — of course we had to include the launch of our Equity-Centered Health Communication Framework, for example. There have also been a handful of posts that feel similarly foundational to our work and our company, like those on the importance of empathy in health comm and how health literacy, as we ❤️ to say, is a state and not a trait.

We also wanted to include a few posts from our unofficial series on common public health industry terms that we think need to go. We’re looking at you “target audience,” “hard-to-reach populations,” and “vulnerable communities!”

And in perhaps the understatement of the century, COVID gave us a lot to think and write about. You could even say that the pandemic put health comm on the proverbial map (we did say that, actually), and it put massively important conversations — like how we need to name racism (not race) as a risk factor for disease — on display in the mainstream, where they belong.

COVID also had us thinking a lot about how to dispel harmful myths, even how to get ahead of those myths before they get too much traction. And although the post is from pre-COVID times, tips for writing about U-turns in health guidance proved useful again and again.

It seems wrong not to include at least a couple of posts on more technical writing topics, so here we’ll remind plain language writers everywhere of 2 of your very best friends: the Oxford comma (superpower: ensuring clarity) and also zombies (superpower: fighting passive voice).

Finally, we’re going to close this post out with a bit of an outlier — but we enjoyed researching and writing it so much that we want to make sure you caught our celebration of LGBTQ+ public health/health comm heroes!

Whew, we’re pretty worn out after all that reminiscing. Time to relax with a movie. Perhaps we’ll throw on… Contagion?

Copy and paste to share on social: This week, to keep the 15th birthday celebration going, the CommunicateHealth team is rounding up 15 favorite We ❤️ Health Literacy posts (and on the 15th no less!): #HealthLiteracy #HealthComm

CommunicateHealth Is 15

A 15th anniversary celebratory version of CommunicateHealth's logo appears on a stage

This week, we’re deviating from our regular programming (and regular schedule) to bring you an exciting update from our main Headquarters: Today, CommunicateHealth is 15 years old. 15! That’s 15 years of work based on a single, shared belief: Everyone deserves clear and simple information about their health. Huge shout out to the stellar clients and inspiring colleagues who made this possible. We’re very proud — and even more thankful.

As you may have noticed over the years, we try to keep this blog focused on actionable content for health communicators. But it feels important to share this milestone anniversary with you, dear readers. After all, some of you have been with us for 11 of those 15 years (the inaugural We ❤️ Health Literacy post ran in July of 2013)!

And with that in mind, you probably know what we’re going to say next. But since it’s both true and important to us, we’re going to say it anyway: You make our work better, and for that we thank you sincerely.

Oh, and keep an eye out — especially on our LinkedIn page — over the next few months for some anniversary-themed content!

With gratitude (and unwavering ❤️ for health literacy),
Your friends at CommunicateHealth

Things We ❤️: Science Vs.

A doodle wearing headphones holds their phone showing Science Vs. podcast branding.

Here at We ❤️ Health Literacy Headquarters, we’re avid podcast listeners — and you won’t be surprised to learn that health, medicine, and science podcasts are at the top of our listening lists. So you can imagine how excited we were when we discovered a science podcast that presents the facts about a huge variety of (often health-related) topics in a way that’s easy to understand and super fun!

Science Vs. regularly tackles new fads and trends (should we guzzle tons of water to stay healthy?) and dives into long-running debates (do we really need to floss?) The host and producers don’t shy away from more serious topics either (like the misinformation surrounding gender-affirming health care for transgender kids).

No matter the topic, the folks at Science Vs. are pros at explaining it in plain language. In fact, we’ve turned to Science Vs. episodes more than once to help us explain something to our own audiences!

The bottom line: Science Vs. is an entertaining podcast that clearly explains what the science says about a whole host of topics. It’s well worth a listen!

Copy and paste this post to share: Looking for a new podcast? Science Vs. serves up entertaining #PlainLanguage explanations of tricky science-y (and often health-related) topics, says CommunicateHealth: @sciencevs #HealthComm #HealthLiteracy