Beware of Implicit Bias: Part 2

2 smiling doodles talk to each other in an office setting.

Today, we’re going to finish our conversation about implicit (or unconscious) bias. As you may recall, we started talking about this topic last month, and it was clear right away that it was going to be a 2-parter. So, if you missed it or need a refresher, check out the first installment of this set before you read on. In that post, we discussed what implicit bias is, why it happens, and why it’s important.

We also explained how actively challenging stereotypes can help us work against implicit bias. Indeed, research suggests that when we intentionally challenge stereotypes, we can retrain our brains so that our automatic responses aren’t shaped by our implicit biases. For example, the piece we shared in part 1 from the American Academy of Family Physicians discusses the specific strategy of “counter-stereotypic imaging” — essentially, once you’ve identified a bias, you actively work against it by bringing positive, non-stereotypical images to the surface of your brain in order to replace your implicit responses. According to the piece, “as positive exemplars become more salient in your mind, they become cognitively accessible and challenge your stereotypic biases.” That’s the retraining part.

Here are a few more tips to help you check implicit bias at the door:

  • Get comfortable thinking critically about your own perspectives and sitting with tough stuff. Challenging implicit bias isn’t easy — but it’s one of the most important things we can do as health communicators and, frankly, as people. Over the last few years, there’s been a long-overdue reckoning with the damaging health effects of institutional racism and the fact that traditional public health approaches have reinforced harmful inequities. That’s why our equity-centered health comm framework includes nuggets like this: “Humility in health communication is the practice of self-reflection on how our own background and biases impact every aspect of the communication process. And this includes an examination of power dynamics and imbalances in our work.” Try to make friends with the discomfort so that challenging implicit bias becomes second nature.
  • Let your audience share their experiences and preferences. That means getting real feedback from real audience members to ensure you understand their needs and leverage the right strategies to meet them. It does not mean creating a narrative for them based on our understanding of their experiences.
  • Build in time for reflection — on your own and with your colleagues. Put simply, uncovering and challenging our own implicit biases takes, well, time! That said, the public health field isn’t known for its abundance of available resources, so we recognize that this might not always be realistic. But when you can, take time as you develop your health comm materials or design your intervention to reflect on your own and with others on your project team. Talk to each other about what’s coming up for each of you — good chance you’ll learn something (and more likely, lots of things).
  • Think carefully about intersectionality within audience segments. Effectively reaching our priority audiences often means tailoring our materials to very specific subgroups, or audience segments. But what we often overlook is the intersectionality that exists within these segments — we need to think both across and within audience segments. So if you’re working on materials tailored to Black women, are you also thinking about Black lesbians? Biracial women who identify as Black? Essentially, make sure the conversation you’re having with yourself and your colleagues is the whole conversation.
  • Read materials multiple times with different lenses. Disclaimer: There’s nothing evidence-based about this, but we find that it can make a difference. If you’re working on an original material, “assign” yourself different lenses for multiple reviews. For example, if you’re writing about diabetes among Hispanic people, read the whole material through once while thinking only about how the content might land with your audience — not about whether your plain language explanation of diabetes is getting the job done. Isolating specific things you want to focus on helps your brain do just that: focus on them. (This is also a good strategy for proofreading. But we digress.)

Before we close this one out, we want to acknowledge that this is hard. Trying to be conscious of something that literally (sometimes) has unconscious in its name is hard! But if we’re going to approach this work with empathy — and help make sure our audiences feel seen, respected, and valued — it’s a must.

The bottom line: Challenging our own implicit biases is tricky. It’s also a must for health communicators.


Tweet about it: In part 2 of a mini-series on #ImplicitBias for health communicators, the @CommunicateHlth crew shares tips to help challenge those biases in #HealthComm. Take a look: https://bit.ly/43F7MTX

The Beginning of the End of BMI?

A doodle sitting in their office typing up the AMA's new policy. A framed AMA logo is on the wall.

This week, we’re discussing something we often encounter in health comm: BMI, or body mass index. As you probably know, BMI is a number calculated using a person’s height and weight. In the most basic terms, doctors (and insurance companies!) use it to put people into 1 of 4 categories: underweight, healthy weight, overweight, and obesity. This is supposed to help assess how much body fat a person has and their relative health.

But, as you also probably know, BMI has long faced criticism from experts in just about every relevant discipline — not-so-favorable characterizations have ranged from just not that useful for individuals to a racist, sexist, misused tool that’s done serious harm. Regardless, for the most part, BMI has stuck around. But a recent announcement from the American Medical Association (AMA) may be about to change that, and we’re here for it.

Last month, the AMA issued a press release detailing its new policy that clarifies how BMI should be used (with “other valid risk measures”) and aims to build that knowledge among health care providers. The release references a report that concluded BMI is “an imperfect way to measure body fat in multiple groups given that it does not account for differences across race/ethnic groups, sexes, genders, and age-span.” The press release doesn’t mince words:

Under the newly adopted policy, the AMA recognizes issues with using BMI as a measurement due to its historical harm, its use for racist exclusion, and because BMI is based primarily on data collected from previous generations of non-Hispanic white populations. … The policy noted that BMI is significantly correlated with the amount of fat mass in the general population but loses predictability when applied on the individual level. The AMA also recognizes that relative body shape and composition differences across race/ethnic groups, sexes, genders, and age-span is essential to consider when applying BMI as a measure of adiposity and that BMI should not be used as a sole criterion to deny appropriate insurance reimbursement.

Well! It certainly sounds like this could have some serious (and overdue) implications for the health care field and health communicators like us. There’s a lot to say about how this might affect the conversation about weight in health care more broadly (be on the lookout for more on that!). But for now, we’d love to hear from you: Does BMI have a place in health care? Are you celebrating its apparent demotion? What broader implications could this update have? How should we contextualize BMI in plain language health materials?

Respond to this email or find us on social (LinkedIn or Twitter) and let us know what you think! And to learn more about this topic, check out the July issue of AMA’s Journal of Ethics — it includes multiple articles that explore BMI’s history, its current use, and related ethical issues.

The bottom line: Hats off to the American Medical Association, which recently released a new policy scrutinizing BMI and clarifying its appropriate use. This could have big implications for health care (and health comm).


Tweet about it: This week, the @CommunicateHlth crew is chatting about @AmerMedicalAssn’s new #BMI policy, which could have big implications for health care (and #HealthComm): https://bit.ly/46U0Yo5 #HealthLiteracy

Things We ❤️: The MRCT Center’s Clinical Research Glossary

A doodle holds up a sign with the Multi-Regional Clinical Trials logo.

Here at We ❤️ Health Literacy Headquarters, we find ourselves writing about clinical research on the reg. That means we spend a lot (like, a lot) of time thinking about the best way to explain various clinical trial jargon terms in plain language. And frankly, sometimes we could use a little help!

Luckily, when we need an assist, we can turn to the Clinical Research Glossary from the Multi-Regional Clinical Trials (MRCT) Center of Brigham and Women’s Hospital and Harvard. It provides clear, simple definitions for a bunch of research-related jargon terms. And while we may adapt the definitions — say, to better fit the tone of a material — they can go a long way toward helping us clearly explain tricky terms.

So whether you’re writing materials for study participants, explaining vaccine trial phases to boost public confidence in the process, or reporting on the results of a specific study, give MRCT’s Clinical Research Glossary a look!

(One quick aside: While glossaries can be super helpful for health communicators like us, we generally still recommend against including them in consumer-facing materials — or at least relying on them alone to help consumers navigate jargon-y materials. Glossaries require cross-referencing, which can be hard for folks with limited literacy skills. Instead, stick with tried-and-true plain language best practices!)

The bottom line: Communicating clearly about clinical research is tricky. The MRCT Center’s Clinical Research Glossary makes it easier by providing plain language definitions for a long list of jargon terms!


Tweet about it: Looking for a #HealthComm resource to help you write #PlainLanguage content about clinical research? Check out @MRCTCenter’s Clinical Research Glossary, says @CommunicateHlth: https://bit.ly/3pufzpw #HealthLiteracy

TV Club: Ted Lasso

A Ted Lasso doodle with his signature mustache and whistle presents a screen with the Ted Lasso title screen.

Here at We ❤️ Health Literacy HQ, Ted Lasso has been one of our fave binges. It’s got it all: sporty spirit, lotsa laughs, trendy mustaches, feelgood vibes, realistic depictions of panic attacks, wait a second… yep, that’s right! Ted Lasso also brings some important lessons about mental health to the proverbial table. And we’re not the only ones who have been thinking about — and appreciating — that part of the show. In fact, a few months ago, some of the cast visited the White House to talk about mental health.

“No matter who you are, no matter where you live, no matter who you voted for,” said Lasso (aka Jason Sudeikis) at a press briefing during the visit, “we all know someone — or have been that someone — that’s struggled, that’s felt isolated, that’s felt anxious, that has felt alone. And it’s actually one of the many things that — believe it or not — that we all have in common as human beings. And it’s something that we should all talk about.”

We couldn’t agree more, dear readers! And we ❤️ to see messages like this coming from pop culture superstars like our friend Ted. Here are 3 key mental health lessons we’re taking from Ted Lasso:

  1. It’s okay not to be okay. The show normalizes depression, anxiety, and panic attacks in a way that few pieces of fiction do — without theatrics, but with empathy, honesty, and authenticity. It sends the message that it’s human to struggle, as most of us do at some point in our lives. And if that’s not an important message right about now, we don’t know what is.
  2. It’s okay to ask for help. At first, Ted rejects the idea of getting counseling to deal with his panic attacks and past trauma. He’s not alone in his initial skepticism — mental health problems, and services designed to address them, still come with a lot of stigma. By learning to embrace his therapy sessions with Dr. Sharon, and opening up about his struggles, Ted sets an example for all of us.
  3. It’s okay not to be perfect. The show is full of imperfect characters. They’re jealous, vindictive, and grumpy. They make questionable decisions that hurt the people they love. They are, in Ted’s words, a “work in prog-mess”. But they’re trying — and at least in Ted Lasso’s world, that’s enough.

Is Ted Lasso going to miraculously solve the mental health crisis in this country? Sadly, no. Conditions like anxiety, depression, and panic disorders (and the issues that cause them) are very real, and a TV show isn’t going to change that. But the way mental health issues are portrayed in the media matters, and it’s nice to see a show do this realistically, accessibly, and with kindness. And maybe, just maybe, watching Ted Lasso can make some of us feel just a little less alone.

To close with the words of our protagonist: “There is something worse out there than being sad, and that is being alone and being sad. Ain’t nobody in this room alone. Let’s be sad now. Let’s be sad together.”

The bottom line: We’re long overdue in terms of normalizing talking about mental health. Popular TV shows like Ted Lasso — with realistic and empathetic depictions of mental health issues — can really help.


Tweet about it: Ted Lasso brings the feelgood vibes — and a few lessons on talking about #MentalHealth. @CommunicateHlth is here for it: https://bit.ly/3qXgfEi #HealthComm

Beware of Implicit Bias: Part 1

Back view of a doodle looking at a board with a list that has "Nurse," "CEO," "Doctor," and "Secr." The doodle is covering the rest of the last word. The doodle has a thought bubble above them with a smiling doctor doodle.

Lately, we’ve been drilling down into nuanced audience-related topics (see recent-ish thoughts on audience segmentation and intersectionality) and it has us returning again and again to an important truth: No one knows the lived experiences of your audience better than… the people in your audience! As health communicators, it’s our job to create opportunities to listen to their beliefs and experiences — and use that information to craft tailored health messages that meet people where they are.

Today, we’re going to talk about another piece of the puzzle that’s a bit trickier to get at: implicit (or unconscious) bias. In this helpful feature, the American Academy of Family Physicians defines implicit bias as “the unconscious collection of stereotypes and attitudes that we develop toward certain groups of people.”

Essentially, our brains assemble what we’ve heard/read/somehow absorbed about certain groups and form below-the-surface preferences or dislikes in response to the stereotypical (often inaccurate and potentially damaging) info they’ve collected. This happens to everyone — it’s a byproduct of the fact that our conscious minds can’t process all the information they get. Instead, our brains take shortcuts and establish these super sneaky biases that we really may have zero awareness of. (The awareness piece is what differentiates implicit bias from other forms of bias, like discrimination, racism, or sexism.)

Let’s do a simple exercise. The idea is to read the items in the following list one at a time and for each item, let your brain form a quick picture. Try not to overthink it or challenge your instincts:

  • Nurse
  • CEO
  • Doctor
  • Secretary

Now pause to reflect. Is it possible that your implicitly biased brain — despite how you consciously feel about things like feminism, employment equity, and the like — presented you with images of men for CEO and doctor and images of women for nurse or secretary? If so, that’s implicit bias creeping in. 

And while it’s normal to carry around implicit biases, we have to be careful because implicit biases tend to lead to unconscious behaviors, and those behaviors can be harmful. Plus, our role as health communicators means we need to take extra care — after all, we’re often writing things for specific groups of people about very sensitive topics. The last thing we want is for our implicit biases to sneak in there and help reinforce harmful narratives and contribute to inequities. As health communicators, we have to be aware of these realities in our society and hold ourselves accountable.

That sets the stage for a nice example of how we might encounter — and work to intentionally disrupt — our own biases in health comm. When we choose stock photography for our health materials, we often show interactions between patients and health care providers. So if we know that we bring implicit biases to the table in terms of gender and professions (see above), we can actively work against that by, say, choosing a photo of a male nurse and a female doctor treating a patient.

And that’s where we’re going to leave it for today, dear readers. In part 2, we’ll be sharing more tips for challenging implicit biases in our health comm work. Stay tuned!

The bottom line: Implicit biases have a way of sneaking into everything, including our health comm materials. But we can work against that to help all audiences feel included and respected in our work. 


Tweet about it: This week, @CommunicateHlth is digging into #ImplicitBias and what it means for #HealthComm professionals. Check out the first installment of this 2-parter: https://bit.ly/3J2VhtG

Let’s Celebrate Pride… and Gender-Conscious Language!

Here at We ❤️ Health Literacy Headquarters, we always look forward to celebrating Pride. And what better time to talk about making health communications for LGBTQ+ communities more inclusive, respectful, and effective?! It’s one of our very favorite topics, and it’s why we recently released our Inclusive Language Playbook: Writing for LGBTQ+ Communities. The playbook is all about choosing inclusive language that reflects diverse identities and experiences — and we hope you’ve had a chance to check it out!

With that in mind, today we’re featuring our recommendation from the playbook to use gender-conscious language. We’ve touched on this topic before, but we think it’s a good one to highlight on its own, too. Because even when it doesn’t show up super directly, the way health communicators view gender can influence our materials in lots of different ways. For example, you often see doctors portrayed as men and caretakers as women. Then there are gendered terms like “male condom” or “women’s health.” Though they’re common and might not give you much pause, these terms inherently exclude trans, nonbinary, and intersex people.

And that’s why it’s important to use gender-conscious language, which means being thoughtful and intentional about using gendered language when gender is important — and using gender-neutral language when it’s not.

So for example, if you’re working on a testimonial about a real patient’s experience with a treatment, it’s important to respect that person by correctly capturing their pronouns. In that case, you’d want to ask directly about their pronouns (not their preferred pronouns) and use the appropriate language. That’s you being conscious about gender.

And in a fact sheet content development situation, gender-conscious language is the logic behind gender-neutral choices like:

In those scenarios, you’re still being conscious of gender — but you’re deciding that a neutral approach is more inclusive of more people.

Whichever way it takes you, using gender-conscious language is one strategy to make sure that your writing honors your audiences’ genders while still being as inclusive as possible. What’s not to ❤️ about that?

The bottom line: Use gender-conscious language to keep your content respectful and inclusive. (And Happy Pride!)


Tweet about it: Happy #PrideMonth to all! This week, @CommunicateHlth is talking about the benefits of gender-conscious language in #HealthComm materials. Check it out! https://rb.gy/ejy3j #HealthLiteracy

This Wasn’t Written by a Bot

A seated doodle using ChatGPT on their laptop visibly suspicious

Here at We ❤️ Health Literacy HQ, we’ve been talking a lot about generative AI (short for artificial intelligence). By now, you’ve surely heard about — and maybe even tried — programs like ChatGPT or Bard. Generative AI uses source content, like a database or websites, to create new content based on a prompt or question you “ask” it. The results can be quite entertaining: Try asking ChatGPT to write a song about project management, for example. It’ll raise the roof at your next company party. (We speak from experience.)

Aside from being a fun diversion, generative AI has the potential to change the way we work and communicate with each other. For some, that’s great news. Others aren’t so sure: “Never trust anything that can think for itself if you can’t see where it keeps its brain,” as Arthur Weasley once said, probably in anticipation of 21st century AI.

It’s impossible to predict what impact generative AI will have over the coming years on things like, you know, our jobs as health writers and communicators. What we do know is that there are a few things to keep in mind if you’re going to use generative AI in health comm in 2023:

    • Don’t use generative AI as a replacement for audience research, plain language work, or translation. We can’t emphasize this enough: There’s no substitute for involving actual humans when it comes to the nuances of creating clear, trustworthy, and culturally appropriate health information.
    • Be transparent. If you’re using content that’s been generated by a generative AI program, say so — even if you put your own spin on it.
    • Check for accuracy. Remember that ChatGPT & Co. are only as good as the sources they draw from — which are vast in number and vary in quality. So as with any information you find online, check your facts by consulting other credible sources.
    • Watch out for bias. The source content for generative AI programs was created by humans. And as such, it carries over some of our biases, stereotypes, and misconceptions. Check your content carefully for non-inclusive language, harmful stereotypes, and the like.

Think of generative AI like that classmate in high school who let everyone copy their homework. Sure, it was easy. Especially if you spent the night before playing Sonic the Hedgehog instead of writing that paper on The Great Gatsby. But it also meant that you copied some of their mistakes — and besides, the work never quite felt like yours.

It’ll certainly be interesting to see what happens here in the long term — and how (if?) regulations will play a key role. If you’re anything like us, you’ve been thinking a lot about the types of policies that might have prevented some of the less savory implications of social media back in the day. Of course we all know what they say about hindsight…

If you have thoughts about generative AI and the future of health comm, dear readers, we want to hear them! As always, you can respond to this email or find us on LinkedIn or Twitter.   

The bottom line: Generative AI, like ChatGPT or Bard, can make some parts of our work easier. But remember that they’re just another tool for our communicator toolbox. 


Tweet about it: Read @CommunicateHlth’s take on generative AI and its impact on our work as #HealthComm professionals: https://rb.gy/ijcwz

Announcing… Our New Playbook on Writing for LGBTQ+ Communities!

Three excited doodles presenting CommunicateHealth's new Inclusive Language Playbook: Writing for LGBTQ+ Communities resource. One of doodles is holding a progress pride flag.

As you probably know, dear readers, we recently released our Framework for Equity-Centered Health Communication. And we’re so excited to follow it up with another CommunicateHealth publication launching today: our Inclusive Language Playbook: Writing for LGBTQ+ Communities.

We’re very proud to be a company with LGBTQ+ leadership, and this is a topic that’s close to our collective ❤️. The timing is significant, too: Over the past few years, there’s been an upsetting trend of anti-LGBTQ+ legislation, including bans on gender-affirming health care for trans youth. This is exactly the type of thing that could lead to health disparities for LGBTQ+ communities in the future.

As public health communicators, it’s crucial that we do our part to help LGBTQ+ audiences feel seen, respected, and included. We acknowledge up front that there’s no one-size-fits-all guidance when it comes to writing for LGBTQ+ audiences, and we certainly don’t pretend to have all the “answers.” But we hope you’ll find the playbook useful — and that it might inspire some thoughts, ideas, and conversations.

Finally, as we noted with the equity-centered framework, we’d appreciate your feedback on this new resource. Feel free to reply to this email and tell us what you think!

The bottom line: Check out our latest resource on inclusive writing for LGBTQ+ communities and let us know what you think!


Tweet about it: NEW! @CommunicateHlth has just released a #HealthComm playbook on inclusive writing for #LGBTQ+ audiences. Check it out: https://bit.ly/41scBPd #PublicHealth

Book Club: Demon Copperhead

A doodle gestures to a copy of Barbara Kingsolver's Demon Copperhead.In today’s edition of the We ❤️ Health Literacy Book Club, we’re highlighting a novel that we absolutely can’t stop thinking about: Demon Copperhead by Barbara Kingsolver. Set in rural Appalachia during the early days of the opioid epidemic, it’s a critique on the damaging effects of institutional poverty and a pharmaceutical company’s aggressive push to sell a new painkiller that it claimed wasn’t addictive.

Demon Copperhead is actually a modern retelling of Charles Dickens’ David Copperfield. But rather than an English boy born in the mid-19th century, the eponymous protagonist in Demon was born in the mountains of Virginia in the 1980s to a teenage mother living on her own and struggling with addiction. From the moment Demon enters the world, addiction is an overarching theme in his life, affecting nearly everyone he knows in one way or another.

The book is a heart-wrenching story told in Demon’s own voice — and you’d be hard-pressed not to love him. He’s full of sharp and often hilarious one-liners (“People love to believe in danger, as long as it’s you in harm’s way, and them saying bless your heart”), and he’s wise and insightful beyond his years (“The wonder is that you could start life with nothing, end with nothing, and lose so much in between.”)

One of our favorite parts about the book is how Kingsolver, herself from Appalachia, writes with unmistakable empathy — something we ❤️ to see as health communicators. Kingsolver builds connection with her characters, in large part by laying bare the many systemic barriers they’re up against — generational poverty, struggling schools, a broken foster care system, and limited access to high-quality health care among them.

She also calls out — and continually counteracts — a damaging stereotype (which is of course a key part of empathetic communication!). As Demon says: “This is what I would say if I could, to all the smart people of the world with their dumb hillbilly jokes. …We can actually hear you.”

Demon isn’t an easy read — it’s full of tragedy and loss and heartbreak. And of course it’s about a very real crisis that’s far from over. But it’s an important reminder of how the opioid crisis came to be and how profoundly it has harmed a population that many are quick to overlook. Kingsolver ends her author’s note by directly addressing real-life kids like Demon:

“For the kids who wake up hungry in those dark places every day, who’ve lost their families to poverty and pain pills, whose caseworkers keep losing their files, who feel invisible, or wish they were: this book is for you.”

The bottom line: Demon Copperhead is a heart-wrenching novel about the early days of the opioid epidemic in rural Appalachia. The subject matter is tough, but the author writes with empathy to build connection with her characters — and leave a lasting impression.


Tweet about it: The latest installment of @CommunicateHlth’s We ❤️ Health Literacy Book Club is all about Barbara Kingsolver’s #DemonCopperhead. Check it out, and be sure to pick up this super powerful read: https://bit.ly/42ny0tR

Reclaiming Our Time

Frazzled doodle on the phone, holding a pen among piles of paperwork

This week, we’re proud to offer our platform to Jennifer Sclar and Kathryn Wollan — Co-founders and CEOs of Clear Health Analytics, a women-owned small business built on the shared belief that everyone deserves access to clear, accurate, unbiased information about health insurance. And we certainly don’t have to tell you, dear readers, that health literacy is a hugely important part of that puzzle. You can see why we get along.

 With the COVID-19 pandemic as a backdrop, Jennifer and Kathryn wrote this op-ed on the disproportionate burden of health care-related administrative tasks on women. And as a women-owned small business ourselves, we wanted to help get this important message out there. We hope you’ll read and share!


In the United States, a novel virus places novel burdens on our complex, for-profit, health care system and creates novel challenges for those responsible for the health care-related administrative tasks of a household. Not surprisingly, women are responsible for 80% of household health care decisions, and the vast majority of the invisible, uncompensated hours spent interacting with the health care system falls to women.

During the COVID pandemic, millions of women in the United States spent millions of hours locating and scheduling COVID tests and vaccines — and managing the related logistics and paperwork. As many learned the hard way, not all facilities are created equal in terms of the cost of a “free” COVID PCR test, and not all health plans are created equal in terms of how to seek reimbursement for this “free” test. This is yet another example of the heavy toll that the health care system takes on women.

Complicated by Design
If you’ve ever seen a doctor in the United States, you know that reconciling the complicated, untimely, and often erroneous billing and insurance paperwork is tedious and time-consuming. Every single medical service results in at least one bill from the provider and at least one (but typically multiple) Explanation of Benefits (EOBs). These communications often arrive weeks after the service and weeks apart from one another. As family health care leaders, and patients themselves, this administrative burden falls disproportionately to women.

The complexity of our health care system is no accident — time consumption and consumer fatigue are the entire rationale for administrative complexity.The effort to “administrate into submission” has been wildly successful, as people routinely limit or forego health care for fear of out-of-pocket costs and coverage denials. And many people avoid appealing an insurer’s denial of care despite the fact that when they do, they often win.

A recent study published in the Annals of Internal Medicine details that the combined cost of health care administration to U.S. insurers and health care providers in 2017 was almost $2,500 per capita, or $812 billion. That’s nearly 35% of total health care spending and enough to cover health care for every American. And these numbers don’t begin to account for the cost of this administrative complexity to consumers. Not in dollars, not in time lost.

In his 2020 book Priced Out, late renowned health care economist Uwe Reinhardt meticulously recounts the costs of the health care administrative-industrial complex to private and public insurers, hospitals, and physicians. But when it comes to patients, he points out that no “…empirical estimates on administrative expense includes the value of the time American consumers devote to choosing health insurance products or, as patients, to process usually incomprehensible medical bills from the providers of health care or claims from health insurers.”

Women’s Work
Women bear the brunt of this growing burden in households of every type, regardless of their education or profession. And like most caretaking and household responsibilities, women’s contributions to their family’s health care administration are invisible and unpaid.

Reinhardt himself admitted that in his household, his wife handles the health insurance claims. “This goes beyond the capacity of a Ph.D. in economics,” he said. “So, she does it, and she tells me that claiming for health insurance is far more time intensive and complex than the income tax, which she also does.” (Reinhardt’s wife, Tsung Mei Cheng, is also a brilliant health policy researcher.)

This administrative morass devours our time and produces untold stress and anxiety, often with devastating effects on financial and physical well-being. So why is it allowed to continue? Because it’s women’s work.

It’s Our Time
It’s time to name and quantify the burden that health care administration puts on the resources of American women. Let’s advocate for changes to our health care system. Let’s make sure that our legislators recognize and address this crushing burden that threatens the physical and financial health of women and their families and steals untold hours from their lives. Women don’t have this kind of time to spare.

Let’s reclaim our time.

Jennifer Sclar and Kathryn Wollan are the Co-founders and CEOs of Clear Health Analytics.