When we talk about storytelling in public health, we mean bolstering your campaign or intervention using personal stories of real people who have dealt with a health issue or condition. And there are many reasons to use storytelling to support your health messages.
Research has shown that storytelling improves people’s self-efficacy to make important changes to their health behaviors. Another benefit is that storytelling has the potential to change how people feel about health organizations and the information we communicate — and that’s a big deal.
A key step toward improving health literacy is treating patients as partners in their health care. When you use storytelling in messaging and materials, you invite “non-expert” voices into the conversation.
Study after study is sending the same message: if you want your public health campaign to reach people and make a difference in their lives, it helps to include stories of real people facing real health challenges. So in your next strategy meeting for a new campaign, remember to tell your target audience what they need to hear: a story.
The bottom line: Storytelling is an effective way to communicate your public health messages. Try it out!
Affordable Care Act (ACA), ObamaCare, Socialist Death Panel Tax: We’ve been hearing these names for years now. And with the October 1 open enrollment start date fast approaching, it’s pretty much impossible to avoid talk of health care reform.
But have you heard this? About half of us don’t understand it. That’s right, according to a recent Kaiser Health Tracking Poll, almost half of Americans say they don’t have the information they need to understand how the ACA will affect them. In fact, for many Americans, the ACA might not even be on their radar: 4 in 10 don’t know that the ACA is a law that will actually be enforced.
And here’s the catch: People who don’t have health insurance or who live in low-income households are less likely to know about the big changes coming to our health care system. Essentially, the people who don’t have enough information about the law are the same people the ACA is designed to help.
Perhaps you can guess where we’re going with this (hint: what do we love?). Yep, these groups are also disproportionately affected by limited health literacy. And we’d argue that with numbers like these, the confusion about the ACA is putting the problem of health literacy in the spotlight.
So no matter what you call it, let’s keep talking about the ACA. People need to hear it.
The bottom line: A lot is riding on our ability to understand the ACA. Health literacy is more important than ever.
Have you ever had trouble choosing between using photos or illustrations for your health materials? It’s not always black and white (ha!). Here’s a nifty trick to help you decide: think about your main objective. Is it most important to make a personal connection with your readers? Or are you trying to convey something more like an abstract idea or process?
If you answer, “I want to make a personal connection with my readers,” you’re probably better off using a photo. Photos evoke emotions. If the woman on the diabetes website looks like she could be your grandmother, good. That’s the idea. Photos help people feel like they’re in familiar, friendly territory — which can help readers connect with your message.
If you answer, “I want to convey an abstract idea or process,” simple illustrations or icons may work best. At We ❤ Health Literacy Headquarters, we’re often tasked with creating visuals for concepts (like user-centered design) or multi-step actions (like how to safely wipe up lead dust). These concepts can be difficult to convey with photos.
Worried about cost? We know that creating original illustrations and icons can be pricey. The Noun Project is one of our go-to resources for a wide variety of free or low-cost icons and symbols. Whether you need an icon for happiness or a helicopter parent, there’s an option for you.
The bottom line: Visuals are really important. Use an illustration to convey an abstract idea or process. Use a photo to evoke emotion.
What was the rule in English class again? Write out all numbers under 10 as words (so, one through nine) then switch to numerals at 10? That sounds right. But wait, maybe ten should be spelled out, too…
Never mind. We’d like to introduce a new rule. When writing about health for consumers, write every number as a numeral. 1, 2, 3, 4, 5, 55, and 100 — they’re numbers, after all.
Health information involves a lot of numbers. Among others, these numbers include:
Levels (blood glucose, cholesterol)
Doses (2 tablets, 1 tablespoon)
Vital signs (heart rate, blood pressure)
Frequencies (once a week, twice a day)
And those are just the basics! People also need to make calculations (like figuring out what a 20% increase would be) and evaluate risk (like whether a 1 in 10 chance of side effects is good or bad).
When the information is complicated, we need to make it as clear, simple, and accurate as possible — including writing numbers as numerals.
The bottom line: When writing about health for a general audience, write every number as a numeral.
Want to know the quickest way to upset a writer at We❤︎Health Literacy Headquarters? Say that writing health content in plain language is “dumbing down” the information. This not only upsets us, but it insults the 9 out of 10 Americans who struggle with understanding and using health information.
A big part of the “dumbing down” myth stems from the need to limit information. Deciding between need-to-know and nice-to-know information is an important step in developing clear health communication materials. We often hear medical experts say that if we don’t give people all the information, we’re doing them a disservice. But we argue that the disservice is in overwhelming people with so much information that they miss the key message.
If your mechanic gave you a detailed explanation of how your car engine worked every time you went for an oil change, you would probably:
Have no idea what she was talking about
Zone out
Start looking for a new mechanic
Most people just want to know whether their car is okay, and if not, how much it will cost to fix it. If they want to know more, they’ll ask.
Being clear, straightforward, and easy to understand isn’t dumb. In fact, it’s really quite smart — and a challenge to do well. If it were easy, everyone would be doing it!
The bottom line: Plain language is smart. And when you use it to write health information, there are big payoffs for readers.
Let’s be honest — how many times have you gotten an email written in all caps that has left you with a positive impression? Never, right? Except maybe that email letting you know YOU WON THE LOTTERY!
Fantasies aside, a quick survey of folks at We ❤︎ Health Literacy Headquarters shows that getting an email in all caps leaves the reader feeling that the author:
Is angry and yelling
Doesn’t have the vocabulary to get his point across
Must be working on an ancient computer that doesn’t have different font styles to indicate emphasis
Accidentally hit the “caps lock” button when she fell asleep on her keyboard
In addition to leaving us with an all-around yucky feeling, the consensus is that using all caps negatively affects readability and legibility. Most people read by scanning the shapes of letters. Using all capital letters removes a lot of that variation — forcing the reader to work harder to understand the text.
Don’t believe us? Compare these examples:
If you need a nurse right away, dial 111 on your bedside phone.
IF YOU NEED A NURSE RIGHT AWAY, DIAL 111 ON YOUR BEDSIDE PHONE.
Now ask yourself:
Which one of those would you prefer to read when you’re sick, stressed, and confused?
Which version makes it easier to scan and find the emergency number?
The bottom line: Do your readers a favor and unlock your caps.
Here at We ❤︎ Health Literacy Headquarters, our goal is clear communication. Whenever we use a medical term or other jargon in consumer materials, we offer a plain language definition using everyday words. Most of the time, this is a fun and interesting challenge.
But then there are the times we need to define things that people don’t like to talk about — like bodily functions (even that term is problematic!). When it comes to our bodies and what comes out of them, we’re faced with 3 categories of terms:
Medical/clinical (like defecate, urinate, and vomit)
Words for kids (think poop, pee, or puke)
4-letter words for grown-ups that we won’t print here
What’s a plain language health writer to do? Using only medical terms sounds impersonal and detached — and your audience might not know what you’re talking about. Using the words for kids may give the impression that you’re talking down to your audience. And using the 4-letter words… well, we like having clients, so we don’t see that as an option.
The answer is to keep it simple. Usually this means providing the medical term and then using familiar words from childhood to define it. For example:
Diarrhea (watery poop)
Vomiting (throwing up)
Is it ideal? No, but it gets your point across! After all, it’s better to be understood than to be demure.
The bottom line (no pun intended): Always give a plain language definition for medical terms, even if it means using slang or words from childhood.
If you’re communicating about environmental health, it’s likely that you’ve encountered the word “exposure” many times. Environmental health professionals just love it. But the rest of us? Not so much.
The term tends to conjure up images of trench coats and scandal. If you’re into photography, “exposure” means something else entirely. Or perhaps, if you were old enough to stay up past 9 p.m. in the early 1990s, it makes you think of a really great TV show set in Alaska. And if you actually live in Alaska, you might picture someone shivering outside in the snow.
Must we use this complicated and problematic term? No! There are lots of ways around using “exposure” when you write about health. Here are a few common uses of the word with suggested alternatives.
Before: Every day, millions of Americans are exposed to secondhand smoke. After: Every day, millions of Americans breathe in secondhand smoke.
Before: Exposure to mercury can cause serious health problems. After: If you come into contact with mercury (by touching it or breathing in fumes), it can cause serious health problems.
Before: More than half of our exposure to radiation comes from radon. After: People are around radiation every day. Surprisingly, most of this radiation doesn’t come from microwaves or x-rays. It comes from radon gas.
The next time you’re tempted to use the word “exposure,” try one of these more decent alternatives instead.
The bottom line: “Exposure” isn’t a word we use in everyday conversation, so skip it when you can!
Alt: Doodles hold signs that say, “OK with they!” and “Word of the year!”
Update (January 2020): Since we wrote this post more than 7 years ago, the scrappy underdog singular “they” has made great strides (insert inspirational training montage here). In 2017, the Associated Press and Chicago Manual of Style welcomed “they” into the fold. In 2019, the American Psychological Association gave “they” its blessing. And to really seal the deal, Merriam-Webster named “they” 2019’s Word of the Year.
If you need to follow a style guide that hasn’t gotten the “they” memo, you can find some alternative solutions below — but you can count us as officially officially okay with “they.” Hooray! The great debate is finally over!
Writing about health means writing about people. And people need pronouns. So if you’re a health writer, at some point you’ve probably asked yourself: Which pronoun do I use for a generic individual, like “your doctor” or “the patient”? He? She? He/she? They? Something else entirely?
Despite a long history of “they” as a gender-neutral personal pronoun, many academics and traditionalists still use masculine pronouns (he/his) when writing about a generic someone. But using “he” throughout is outdated, inaccurate, and frankly a little cringey at this point. So what are the other options?
Saying “he or she” all the time is clunky. Writing “s/he” or “(s)he” looks awkward and can trip up readers with limited literacy skills. Rephrasing sentences so they’re plural often works. But if your entire website reads that way, it can sound impersonal and distant.
One solution is to alternate feminine and masculine pronouns — or shake things up with unexpected pronouns. For example, you could sidestep gender stereotypes by saying, “Ask your doctor what she would recommend.” Or, “Make sure your caregiver knows you want him to call 911 if this happens.” This approach is a step in the right direction, but it ignores the needs of gender non-binary people.
The truth is, people already use “they” as a gender-neutral pronoun in everyday speech. Like, “Whenever someone at the office brings me a cookie, I give them a great big smile.” And one of the first rules of writing for health literacy is to write the way your audience speaks. Get where we’re going with this, dear readers? We thought so.
The bottom line: When faced with the pronoun dilemma, the choice is yours. We choose team “they.”
For our first edition of We ❤ Health Literacy, we thought it would be fun to do a little experiment. Consider the following introductions:
Intro A
The writing team frequently discusses strategies to effectively facilitate the composition of content that readers will find engaging and attractive. In their work, they have found that consumers of materials containing health-related information respond more positively to content that is written in an informal, conversational tone — as opposed to content expressed utilizing a more formal, academic approach.
Tired yet? Now, be honest: Would you ever say any of this out loud? Do you routinely speak about yourself in the third person? (Doing it to be funny doesn’t count.)
Intro B
We talk a lot about how to create materials that our readers will actually want to read. Again and again, we’ve found that people respond better to content written in the same way we’d talk to them. No one wants health information that reads like an encyclopedia.
Isn’t that better?
When you write health information — particularly when you’re writing for behavior change — be conversational. Think about how you’d communicate to someone sitting right in front of you:
Use second-person pronouns (like “you”) to personalize content
Use contractions (like “can’t” or “doesn’t”) because that’s how we talk
Use colloquial terms when those are the words that your readers are comfortable and familiar with
And yes, that sentence ended with a preposition. Technically correct? Perhaps not. But again, dear reader, we’d ask you this: Would you normally say, “Those are the words with which readers are comfortable and familiar”?
The bottom line: Write how you speak. Your readers will thank you.
