It’s that time again, dear readers, when we say to you: happy, happy holidays! We’re grateful to have such thoughtful, passionate peeps to share our health lit-related musings with — your questions, comments, and suggestions really do make our work better. So thank you.
It’s been a strange (almost) 2 years, but if we ever needed a reminder of why people need access to clear health information… well, you know.
Wishing you all the best as we head into 2022.
Public health friends, rejoice! The Centers for Disease Control and Prevention (CDC) has strongly recommended COVID-19 boosters for all adults. And a late-breaking update — as of TODAY, teens ages 16 and 17 can get boosters, too! The news comes not a moment too soon, as many of us are getting back into the groove of festive holiday celebrations with family and friends. Now is the time to encourage your audiences to get that booster!
Easy, right? Well, mostly. You’ve heard about boosters — but what about an extra dose for immunocompromised people? Yep, some people with immune system issues may not get full protection from COVID-19 vaccines. That’s why CDC recommends an “additional primary shot” of mRNA vaccines for this group. Here’s how it works:
(At this point, there’s no additional dose for people who got the Johnson & Johnson vaccine.)
It makes sense that people with immune system problems need extra protection. But with all the focus on boosters, the additional dose can get lost in the shuffle — or confused with a standard booster. We’ve even heard from friends of the blog that some doctors aren’t making a distinction between boosters and additional doses. If that’s true, immunocompromised folks who aren’t inclined to carefully track COVID vaccine guidance may not know they need an additional shot. Yikes.
To further complicate matters, many immunocompromised people got vaccinated back when COVID-19 vaccines first became available. Because this guidance didn’t exist yet, they missed the opportunity to get the additional dose 28 days after their second shot. So in practice, this guidance may only benefit people who have just become immunocompromised (say they just started cancer treatment) and haven’t gotten their original COVID-19 vaccine yet.
So how can health communicators explain all this nuanced info to immunocompromised audiences? Don’t ask us! Kidding, dear readers. We’ve got some ideas, but — with pandemic-related guidance ever in flux — we certainly don’t have all the answers.
But for now, consider using a blurb like this to encourage immunocompromised people to talk to their doctor:
If you have serious health issues that affect your immune system (the system that fights off infections), you may be able to get an extra dose of the COVID-19 vaccine. Make an appointment to talk with your doctor about the vaccines you need to stay safe from COVID-19.
If you find yourself concerned about this approach given the mention of doctors above, gold star for paying attention! That’s why we’re also encouraging immunocompromised audiences to print out (or pull up on a smartphone) this page from CDC to discuss during the appointment. Doctors may not have all the answers either, but we certainly can’t expect patients to figure this out on their own. And while we haven’t untangled all the pieces here, helping people start a conversation with a medical professional is a solid first step.
Has the additional dose come up in your COVID-19 communication efforts? We’d love to hear your thoughts!
The bottom line: People with health conditions that affect their immune system may need an additional dose of mRNA vaccines AND a booster to protect against COVID-19 — but they may not know it. Encourage your audiences to talk to their doctors about getting the best protection.
Here at We ❤️ Health Literacy Headquarters, we’ve talked a lot about why some of the terms public health professionals use to refer to groups of people can be problematic. In recent weeks, we’ve unpacked “hard to reach,” “target audience,” and “vulnerable communities.” This week, we’re adding “minority groups” to the list.
Consider, dear readers, what we actually mean when we use “minority groups” or “minorities” to describe our audiences. Often, we’re talking about — or even directly to — racial and ethnic groups made up of people of color. We might also use “minority” to talk about the LGBTQ+ community or people from specific religious communities.
But here’s the thing: The word “minority” itself suggests that the people we’re talking about are less important than the implied “majority.” We were excited to see this captured in guidance for inclusive language from the American Academy of Pediatrics, which says that the term “minority” may be disrespectful as it “denotes belief in human hierarchy.”
Plus, when it comes to racial and ethnic groups, “minority” may be just plain inaccurate! Globally, there are more people of color than white people. And in the United States, the Pew Research Center estimates that any singular racial or ethnic group majority will be a thing of the past within the next few decades.
So what’s a health communicator to do? Well, as we’re so fond of saying, be specific about which communities you really mean. And when you’re talking about disparities among specific racial and ethnic groups, be sure to call out systemic racism when it applies. Here’s an example.
The bottom line: “Minority groups” is vague and potentially alienating — get more specific in your health materials instead.
You know we ❤️ sharing cool things we find out in the world with you, dear readers. So this week, we’re coming at you with a super interesting new project called Healthy Democracy, Healthy People.
The project started out as VoteSAFE Public Health — a collaboration between public health heavy hitters like the American Public Health Association, the Association of State and Territorial Health Officials, and more. It aimed to advance health equity by making sure everyone has the opportunity to vote safely.
The newer iteration of the initiative is a nonpartisan marriage of public health and civic engagement orgs. It focuses on the critical connection between civic participation and community health — because we know that when all people are safely able to vote, they can add their voices to policy conversations that directly impact their health. And according to the project’s website, the COVID-19 pandemic has shined a light on the need for this kind of collaboration by creating more barriers to safe and equitable participation in the electoral process.
This is exactly the kind of project we think is necessary in today’s world. There are lots of connections between civic literacy and health literacy, and we’re here for it! If you’re looking for a good place to start, check out the project’s innovative Health & Democracy Index, which compares state-level public health indicators and voter turnout with how inclusive (or restrictive) that state’s voting policies are.
We don’t want to spoil anything, but if you had to guess: Are inclusive voting policies and increased civic engagement good or bad for community health?
We’ll leave it there.
The bottom line: Check out Healthy Democracy, Healthy People to learn about the crucial intersection between civic participation and public health.
Here at We ❤️ Health Literacy Headquarters, we tend to shy away from self-promotion. But this week, dear readers, we just had to let you know that CommunicateHealth President Stacy Robison recently made a podcast appearance for a very good cause: health literacy, of course!
If you haven’t heard of it, InformED is a podcast from the International Society for Medical Publication Professionals, or ISMPP. The show covers important and timely topics for health communicators and publication professionals. And in the most recent episode, Stacy joined Laurie Myers — Director of Global Health Literacy and Oncology Health Equity at Merck — to kick off a new series on equity, diversity, and inclusion.
Stacy and Laurie focus on these key public health themes through the lens of the thing we ❤️ most, and we think the result was pretty cool. It touches on racial justice, inclusive language, and social determinants of health — things that are top of mind for so many of us in health comm at the moment. And it’s not every day that public health and queer identity politics come up in the same conversation.
So give Episode 5 a listen — and a big thanks to the folks at ISMPP for putting this together!
The bottom line: Check out the most recent episode of InformED to learn about achieving equity, diversity, and inclusion through health literacy.
Allow us to open this week’s post, dear readers, with a more personal anecdote than is typical on this page. Last month, a friend of We ❤️ Health Literacy tested positive for COVID-19. A public health grad student, she was fully vaccinated and therefore assumed she was in for a mild illness — which is the public health party line for what to expect from breakthrough cases.
What followed was over a week of fever, congestion, cough, shortness of breath, and stomach problems — not to mention her growing anxiety as she kept feeling bad. When would she turn the corner? Would she turn the wrong corner and need oxygen? The anxiety got particularly bad overnight, when she’d wake up drenched in sweat from her oscillating yet unceasing fever.
Essentially, she was really sick and really scared, and she certainly never once used the word “mild” to describe her illness. Yet when she put her public health hat on, she understood that hers absolutely was a mild case of COVID — she didn’t require hospitalization, she didn’t develop any serious complications, and she fully recovered.
The situation got us thinking about the discrepancy between how people who are sick with COVID might feel and how we write about how they might feel in our health materials. Our conclusion? For the most part, talking about “mild” cases of COVID isn’t doing anyone any favors.
First, it’s both extremely vague and entirely subjective. To consumers, classifying a symptom or injury or illness as “mild” means pretty close to nothing — and one person could interpret it completely differently from another. Second, calling a sickness like the one outlined above “mild” could be undermining and confusing to someone who’s sick and scared — both things that we know can impact a person’s health literacy skills.
So what’s a health communicator to do? We say this one’s a 2-parter: get specific and bring the empathy. Instead of relying on people to interpret what you mean by “mild,” give details when you can — what do you really mean? And when appropriate, consider explicitly acknowledging the reality that any illness from COVID might feel anything but mild. This is one of those situations where doing our due diligence means using more words, but we think it’s 100 percent worth it!
Check out some examples below.
Instead of:
Try:
The bottom line: Calling a case of COVID “mild” is vague and subjective. In consumer-facing materials, get specific — and don’t forget the empathy.
Here at We ❤️ Health Literacy Headquarters, we’re all about providing need-to-know info only. So today, allow us to bring you a short and sweet one.
Let’s say you’re browsing health stats, perusing a health insurance booklet, or even (gasp!) checking out a health education material — and you stumble on the word “persons.” If you’re anything like us, dear readers, that single word could stop you in your tracks. It’s distracting because it sounds formal and antiquated — and just plain awkward.
Why on earth would you use “persons” when you can use “people”? Well, we have a simple answer. No reason at all!
While it’s true that historically, there was a distinction between the 2 words, modern style guides have agreed that at this point, it’s a moot point. Some persons people might still argue that “persons” has a rightful place in legalese (we’d still vote no), and there are some established phrases that sort of roll off the tongue (think: “persons of interest”). But we see no need to keep that word around — especially not in consumer-facing health materials, when a conversational tone can help our audiences relate to and understand critical information.
This is the point in the post where we usually give you a bunch of examples to drive the idea home, but it wasn’t all that inspiring — write “people with diabetes” instead of “persons with diabetes” and so on. So we’ll leave it here: when writing about people in your health-related materials, take “persons” out of your vocabulary. Full stop.
The bottom line: Avoid “persons” in your health materials (and in general!) — “people” is a much better choice.
Here at We ❤️ Health Literacy Headquarters, we’ve been thinking a lot about insider public health phrases — the terms we use with each other to talk about our work. Recently, we’ve unpacked “vulnerable” and “hard to reach.” And this week, we’re taking a closer look at “at-risk.”
Public health professionals often use “at-risk” to describe people who are more likely to have poor health outcomes (think “at-risk youth” or “at-risk populations”). You may also be familiar with the term in, er, terms of education — people often use “at-risk students” to refer to those who are less likely to finish school.
Well, dear readers, we think it’s about time we phase out “at-risk” when used like that (you know, as an adjective). It’s a vague label that says nothing about what people are at risk for — and too often it shifts the focus away from systemic problems that cause people to be “at-risk” in the first place. Our solution? Be specific by naming the risk you’re talking about. Here are a couple examples:
As we’ve discussed before, it’s also important to get to the root causes that increase the risk of disease and other poor health outcomes in certain groups — like institutional racism — whenever possible. So, sticking with the COVID example, you might say: “Black communities that are at risk for worse health outcomes from COVID-19 due to the effects of racism.”
And a final aside: if you’re writing for a consumer audience, it’s often best to ditch the jargon-y “at risk” for a more plain language alternative. “More likely to” is a good conversational option that often works (think “people who smoke are more likely to get lung cancer”).
The bottom line: Labeling people as “at-risk” is super vague, and it can even help perpetuate stigma. Instead, get specific and say what you really mean.
Post about it on X: Is it time to rethink how we use “at-risk”? @CommunicateHlth unpacks this common #PublicHealth term: https://bit.ly/2YrdcpI #HealthComm #HealthLiteracy
In today’s edition of We ❤️ Health Literacy Book Club, we’re diving into a must-read book on autism: We’re Not Broken: Changing the Autism Conversation. Drawing from his personal experience, autistic political journalist Eric Garcia explores what it’s really like to be autistic in America. Garcia makes a bold suggestion: instead of talking about autism as a problem to be solved, let’s focus on supporting and accommodating the needs of autistic people.
Garcia explains how the “autism epidemic” narrative of the 1990s and early 2000s often framed autism as a tragic fate or a battle to fight. While our understanding of autism has (thankfully) evolved, that messaging contributed to lasting stigma and misconceptions about the condition. Concerns about rising autism cases also opened the door to harmful pseudoscientific treatments and theories — including the longstanding myth that vaccines cause autism. And the COVID-19 pandemic has made it clear that we have a long way to go to rebuild public trust in vaccines.
Garcia argues that efforts to find causes and cures for autism have done little to improve the everyday lives of autistic people. Yet major research initiatives continue to focus on identifying genetic causes of autism. To autistic people, this can send the message that politicians, researchers, and health care professionals care more about curing autism than addressing the systemic issues that affect their well-being. For example, 85 percent of college-educated autistic adults in the United States are unemployed or underemployed, contributing to housing insecurity among autistic people.
Autistic people also face barriers within the health care system. For example, autistic women, transgender and nonbinary people, and people of color often struggle to get an official diagnosis, which they need to qualify for disability accommodations at school or work. And some autistic people have reported traumatic experiences with applied behavior analysis (ABA) therapy, a treatment that’s considered the gold standard in the United States and is often the only service covered by health insurance.
We know, dear readers, that these issues are surrounded by intense debate. But as health communicators, we have an opportunity to build trust with audiences who often feel unheard and alienated by public health messaging. When you’re creating materials about autism, keep these tips in mind:
The bottom line: Eric Garcia’s We’re Not Broken: Changing the Autism Conversation is a must-read for health communicators everywhere.
Here at We ❤️ Health Literacy HQ, we write about HIV a lot. After all, preventing HIV is a public health priority.
Not long ago, we covered how to explain medicines that can prevent HIV in plain language. And when we did, we got a request from one of you, dear readers, to cover “viral load” next. (Here’s your reminder to always reach out with post ideas or requests!)
Why do we need to talk about viral load, you ask? For people with HIV, viral load is a key indicator of how healthy they are. That means they’re likely to hear the term from their doctors. And that means it’s important to make sure they understand it.
So here’s how to give a quick but clear explanation of “viral load”:
Our eagle-eyed readers may notice that we recently shared thoughts on avoiding “detect” and other forms of the word. So it’s worth noting that we’d make an exception for “undetectable” since people who have HIV are so likely to hear the term that it’s important to teach it.
Also, you may have heard people refer to the info in that second bullet above as “U=U,” or “undetectable=untransmittable.” While it’s a super important concept (and also a social marketing campaign!), we’d generally recommend against using it in plain language consumer materials. We know that users with limited literacy may struggle to interpret symbols, and the terms themselves aren’t particularly plain language anyway. If you do want to go that route, be sure to contextualize it in plain language.
The bottom line: When you’re writing materials for people who have HIV, make sure to explain “viral load” in plain language.