Category: We Heart Health Literacy

Accessibility is an issue that’s near and dear to our ❤s here at We ❤ Health Literacy Headquarters. We’ve shared accessibility tips before, but today we wanted to steer your attention specifically to keyboard navigation. (Get it?!)

Keyboard navigation is when users browse a website’s links and content using the tab and enter keys instead of a mouse or touch screen. It’s used by people with physical disabilities who can’t operate a mouse — and by blind and visually impaired people who rely on screen readers. (Curious how screen readers work? Check out this demo video.)

We know that most people skim and scan web pages to quickly find what interests them. But if you’re using keyboard navigation, you don’t have that option — you have to go through each link or section of content in order. Of course, dear readers, we’re sure that your content is already in the best possible order. How about your links and page elements?

To make sure your website is smooth sailing for people using keyboard navigation, try these tips — or share them with your favorite web developer:

• Pay attention to focus order (also called tab order) — that’s the order that links and page elements “come into focus” as you tab through them. A focus order that makes sense will help users easily navigate your site.
• Include skip links, especially if you have a lot of links in your top navigation. This lets users skip to the main content without rereading the navigation on every page.
• Test, test, test! Take your hand off the mouse and try to navigate your site using the tab and enter keys. If you have access to a popular screen reader like JAWS, use it to test your site — or try the free screen reader plugin for Chrome.

The bottom line: For people who use keyboard navigation, a few small tweaks to your website can make a big difference.

This week, we’re adding to our catalog of “use simpler words” entries. Though many of the terms we address are health-specific, we also tackle overly complicated words that have worked their way into health content.

This week’s word belongs to the second category, and we unequivocally recommend skipping it altogether.

Can you spot the unapproachable non-health term in the following examples?

• Call the doctor if your child’s fever exceeds 102 °F.
• Don’t exceed 6 tablets in 24 hours.
• Try not to exceed your maximum recommended heart rate during physical activity.

Instead of “exceed,” which isn’t the plainest of words, why not just say what you mean?

• Call the doctor if your child’s fever is higher than 102 °F.
• Don’t take more than 6 tablets in 24 hours.
• Try not to go above your maximum recommended heart rate during physical activity.

As you can see, dear readers, there really is no need to use “exceed” in your health content.

The bottom line: File “exceed” in the category of words that have no place in your plain language health materials.

Since January, Zika virus has generated frenzied headlines, public health controversy, wild conspiracy theories, and a lot of anxiety — especially for women who are pregnant or considering becoming pregnant. And as summer arrives in the United States (and backyards once again fill up with mosquitoes), public interest is bound to intensify.

Emerging health threats like Zika and Ebola put health communicators in a tough spot. How can we talk about them honestly and clearly without stoking unhelpful fear? We’ve got a few ideas, dear readers.

Put the risk in context. Be clear about the danger, specifically to pregnant women in affected areas. But it’s equally important to clarify where the virus isn’t. If it’s not in the region where your readers are, say so. Point out that in most cases the virus is mild and goes away in a week or less.

Use plain language. This will be no surprise to our regular readers, but never throw around terms like “microcephaly” or “Guillain-Barré syndrome” without clearly explaining what they are.

Be honest about what we don’t know. Will Zika reach the U.S. this summer? Could it cause more serious complications in adults? No one knows yet, and that’s scary. But keep in mind that acknowledging uncertainty is a lot better than pretending it doesn’t exist. Glossing over the unknowns can make people feel suspicious or deceived, and that’s not going to help anyone.

Emphasize what people can actually do. Vague menaces like Zika can leave people feeling helpless. So always emphasize how people can take action. For example, clearly state CDC’s travel recommendations. Tell people about steps they can take to prevent mosquito bites.

Tell your audience to stay tuned for updates. When you’re dealing with uncertain dangers, encouraging people to be aware and learn more may be the most important message.

The bottom line: Take the time to think through what your readers need to know about Zika — and avoid causing panic.

“Health Lit Live” is our series of interviews with the movers and shakers on the health literacy scene. This week, our imaginary illustrated host Doug Doodleman sits down with Stacy Bailey, PhD, MPH and Gang Fang, PharmD, PhD from the Eshelman School of Pharmacy at the University of North Carolina, Chapel Hill. They’re here to talk about the new Health Literacy Data Map they developed.

Doug: What an exciting day, readers — 2 guests at once! Double combo! We had to steal our intern’s stool so they could both sit down! So, Dr. Bailey and Dr. Fang, tell me about this Health Literacy Data Map you’ve been working on.

Dr. Bailey: I’d be happy to, Doug. It’s an online, searchable map of health literacy estimates for the entire United States.

Doug: I like the sound of it. But speaking as the beloved host of an award-winning health literacy focused talk show — I’ve noticed one glaring problem. Why can’t I find the Health Lit Live studio on this map?

Dr. Fang: Actually —

Doug: I mean, if you’re talking health literacy, that’s kind of like leaving Mount Rushmore off a —

Dr. Fang: Let me clarify that it’s not a map to the monuments of health literacy. It’s a tool for researchers and policymakers.

Dr. Bailey: Doug, we already know that low health literacy is associated with serious health disparities. By mapping estimated health literacy levels, we can identify communities that might be at risk and then target interventions there — like increasing access to health care services.

Doug: Oh, I get it! But how do you collect information about the health literacy of so many people? Health-seeking satellites? Self-driving car-tographers? Or did you just go door to door quizzing people, asking them what words like “pruritus” mean?

Dr. Bailey: No, we —

Doug: It means itching. Pruritus. I’m extremely health literate. I must show up super glowy on your map right now!

Dr. Fang: That’s not how it works, Doug.

Dr. Bailey: We didn’t assess people individually. It’s an estimate of an area’s health literacy at a census block group level, based on data from the U.S. Census and 5-year American Community Surveys (ACS) summary files.

Dr. Fang: We used variables like age, the language people speak at home, their income, education, and other factors in a model that predicts the health literacy of people living in census block groups. The map ranks areas using the well-known National Assessment of Adult Literacy (NAAL) categories as well as some others, like quartiles.

Doug: That is genius! So how do you use the map?

Dr. Bailey: Just go to the site, choose a state on the interactive map, and zoom in all the way to a specific area. Health literacy levels are color-coded, with high shown as green, low as red. You can compare specific areas within a state and nationally.

Dr. Fang: When you’re done, you can download the data you need for your research.

Doug: Well that’s pretty amazing! I guess I could say that you 2 are really putting health literacy on the map? Am I right?

Dr. Fang: I suppose you could say that, Doug.

Doug: Thanks to both of you! And readers — go check out the Health Literacy Data Map!

The bottom line: Use the Health Literacy Data Map to plan your next health literacy intervention or research study.

Some health issues are really hard to talk about — and even harder to live with. As health writers, it’s part of our job to recognize when health topics require an especially empathetic and compassionate tone (think incontinence, sexually transmitted diseases, depression, or memory problems).

Here are some of our tried-and-true tips for writing about sensitive health topics.

Start by putting yourself in the other person’s shoes. What would it be like to live with a health issue you don’t fully understand? What if you were too nervous to talk about it with friends, family, and doctors? What type of information would ease your concerns? What information could increase your knowledge about how to cope with or improve the condition?

Frame it as a common concern. People who are sick or uncomfortable are often scared, too. Try saying something like, “Many people who’ve been abused by a partner have…” or “Some people with herpes find they…” Making an experience seem more common can help it seem less scary.

Acknowledge emotions. Negative emotions like fear and shame can get in the way of clear thinking and making healthy choices. You can make things a little easier for your readers by acknowledging their feelings. You could say: “It may be hard to talk with your doctor about your concerns, but it’s important.”

Be encouraging. You certainly want to keep things positive when writing about a sensitive health topic. Think about including a larger message of hope like, “It’s normal to feel overwhelmed at first, but lots of people have learned to live with a colostomy bag — and you can, too.”

The bottom line: Help people face sensitive health issues by letting them know they’re not alone.

Dear readers, it’s time to return to our unofficial “use simpler words” series. Today’s word is a card-carrying member of the just-plain-vague club: “impaired.”

Most of the time, you can replace “impaired” with a specific description of what is actually impaired — and what that means for your reader. This will make your writing easier to understand, and you know how much we ❤ that.

Consider these examples:

• Drinking alcohol impairs a driver’s ability to react to things quickly, which can increase the risk of car accidents.
• This medicine may cause impaired kidney function.

Instead, try:

• Drinking alcohol causes you to react to things more slowly, which can make it more likely that you’ll be in a car accident.
• When you’re taking this medicine, your kidneys may not work as well.

But what about specific phrases that include “impaired” — like “people who are visually or hearing impaired”? In these cases, use the language that your audience uses. That might be “people who are blind or visually impaired” or “people who are deaf or hard of hearing.”

And, as always, if you absolutely must use the word “impaired,” be sure to explain or define it.

The bottom line: Don’t let “impaired” get in the way of clear writing.

You know we can’t help celebrating when we find a new health communication resource we ❤. So this week, we’re giving a very enthusiastic We ❤ Health Literacy plug to CDC’s latest plain language resource: Everyday Words for Public Health Communication.

Aimed at people developing health content for consumers, this resource includes everyday, plain language alternatives for common public health terms — everything from “abstinence” to “virus.” For plain language nerds like us, it’s almost as good as it gets.

But this resource even takes it a step further! It uses the plain language alternatives in sentences so you can really get a feel for how to use them. And the example sentences come from real-life health content on CDC.gov.

That, dear readers, is some pretty authentic stuff.

The bottom line: Use CDC’s Everyday Words for Public Health Communication to find plain language alternatives for commonly used public health terms.

Today, dear readers, we’re talking about a system of the body that comes up pretty regularly in health communication (especially during cold and flu season!). Yep, you guessed it: the immune system — basically a private army that fights infections to keep us healthy. And really, who doesn’t ❤ that?

The thing is, it’s not always easy to explain the immune system to readers. That’s why we always pause to ask ourselves: Do we need to use the term or can we simply explain what happens instead?

Some readers do need to know the term “immune system” — like people living with HIV or getting treatment for cancer. Since their immune systems are so relevant to their care, you’ll want to teach these readers exactly what the term means. Consider saying something like:

The medicine you get during chemotherapy can weaken your immune system (the system that helps your body fight infections). When your immune system is weak, you’re more likely to get sick — and it can take longer for you to get better.

For readers who don’t need to know the ins and outs of the immune system, you may not need to use the term. Instead, you could say something like:

During chemotherapy, your loved one is more likely to get sick — and it can take longer for them to get better.

The bottom line: Teach the term “immune system” to readers who will be hearing it often and skip it with those who won’t.

We don’t have to tell you, dear readers, that disease prevention is the backbone of public health. But when it comes to plain language, words like “preventable” and “preventive” sound like — yup, you guessed it — jargon (gasp!).

As much as we ❤ them as concepts, the truth is these terms tend to complicate simple ideas. If what we’re really saying is that people can take steps to avoid getting sick, let’s say that. Like many words,“preventable” and “preventive” can often be swapped out for plain language alternatives.

Consider these sentences:

Vaccines are important in addressing preventable diseases, like measles.

Preventive care is important for your health.

Instead, opt for:

Vaccines (shots) protect people from serious diseases, like measles.

Health care isn’t just for when you’re sick. Ask your doctor about screenings and other services that can keep you healthy.

Sometimes, you just can’t prevent using “preventive.” Say you’re a health insurer explaining that you cover a specific category of care called “preventive services.” Instead of getting rid of this term, teach it to people: “We now cover all preventive services, which include check ups, screenings, and counseling to prevent health problems.”

And whatever you do, dear reader, please steer clear of “preventative.” It’s “preventive” dressed up with an extra syllable (and you can guess how we feel about extra syllables).

The bottom line: In plain language writing, you can usually skip “preventable” and “preventive.”