Category: We Heart Health Literacy

In September, FDA proposed new criteria for using the term “healthy” on food labels. Under the new rule, food products would need to have a certain amount of food from at least one of the food groups (like vegetables or grains) recommended in the Dietary Guidelines for Americans. Products would also have to meet specific limits for saturated fat, sodium, and added sugars. We’re sure you can figure out where our brains went: Will this new “healthy” claim on foods actually help people make informed choices at the grocery store?

We all know that product labels can be misleading. Labels are often designed to sell products, not to help people make decisions that will benefit their lives. If you’re a parent, you’ve almost certainly had to explain to your unamused, unimpressed children that — despite the name containing the word “fruit” — fruit snacks are actually candy! When it comes to people trying to make healthy choices, label lies and embellishments can be a real problem.

It’s also no secret that the way our foods are labeled is somewhat flawed. While many claims on food packaging (think “less fat” and “good source of fiber”) are regulated by FDA, they can be misleading, too. A bag of potato chips with “40% less fat” is still a processed food that’s high in calories and low in nutritional value. A “heart-healthy” breakfast cereal may be high in fiber, but it can still have tons of added sugars. And once you get to calling foods “clean” or “natural,” it’s basically the Wild West out there.

Of course, there is a label that tells it like it really is: the good old Nutrition Facts label! It’s not particularly exciting, but at least it’s honest about what’s in our food. Unfortunately, the Nutrition Facts label has a few problems of its own if you’re looking at it through a health literacy lens. In a word, it’s… confusing! To use it effectively, you need to understand numbers, like Percent Daily Value. You also need some pretty serious background knowledge to make meaning of those numbers. For example, you need to know that some foods high in total fat can be healthy if they’re low in saturated fat.

FDA also announced it will be working on a “front-of-package labeling system” that empowers people to make healthy choices by more effectively communicating nutrition info. While we don’t have any information yet on what this new labeling system might look like, we’ll be following the news closely — and we know you will, too. In the meantime, we’ll keep noodling on how we can improve our food labeling system. A look across the pond may offer some inspiration: For example, the UK has tried out a “traffic light” approach — a color-coding system that tells consumers how the product fares in terms of key nutrients like fat, sugar, and salt.

We won’t sugar coat it, dear readers — this one’s tricky. Even before getting into systemic problems or issues with nutrition science, we’re dealing with super complicated, number-heavy, very personal (ahem, what you put in your body) communication that’s supposed to be appropriate for everyone — people with very high and very low literacy and numeracy skills, people who need to follow a special diet and people who don’t, and so forth. It’s a tall order.

We certainly don’t have all the answers. So we’re curious to hear from you: What do you think needs to happen to improve food labels? How can we create understandable nutrition guidance that helps people make healthy choices? Respond to this email or tweet us @CommunicateHlth!

The bottom line: FDA has proposed new criteria for putting “healthy” on food labels, and it has us thinking about how to tame the trickiness of communicating nutrition info on food packaging.

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Tweet about it: FDA has proposed new criteria for using the word “healthy” on food packaging. Could this “healthy” claim on foods actually help people make informed choices at the grocery store? #HealthComm food for thought from @CommunicateHlth: https://bit.ly/3NSxRIQ #HealthLiteracy

As you know, dear readers, we’re all about inclusive health communication here at We ❤️ Health Literacy HQ. And one topic that we think could use a more inclusive approach is sexual health.

When it comes to sex, it’s easy to assume that everyone has the same general needs and generally experiences the same trajectory. If you think about it, we learn those expectations pretty early in life. When we hear comments like “One day, you’ll get married and have kids of your own,” or “When you get older, you’ll start having feelings for [boys/girls],” we learn that there’s a “normal” path to follow. But the fact is, those oversimplified narratives leave a lot of people out.

In reality, of course, human sexuality is incredibly diverse! And with reproductive rights and anti-LGBTQ+ legislation in the news, it’s more important than ever to create sexual health comm resources that reflect the diverse identities and experiences of our audiences. After all, when people see themselves represented in health materials, they’re more likely to connect with the messages and apply them to their own lives. So this week, we’re bringing you tips for creating inclusive sexual health content.

Tiny housekeeping note before we jump in: This post is part 1, meaning we’ll follow up with a part 2 (we just couldn’t fit it all into 1 post and we think you’ll see why) and maybe additional parts after that! This is a complex and nuanced topic, and we’re here for your opinions and insights — tweet us @CommunicateHlth or respond to this email with comments or ideas for future installments. Okay, back to our first set of tips:

Make the implicit explicit. When you’re writing about sexual health, ditch the euphemisms and offer clear info and action steps. This can look like lots of different things — calling body parts by their “real” names, for example.

Or take CDC’s behavioral recommendations for slowing the spread of monkeypox over the summer, which included mutual masturbation at a distance. And it wasn’t phrased as a vague “self-pleasuring activity” or some such. Rather, CDC said exactly what it meant: “Masturbate together at a distance of at least 6 feet, without touching each other.” How clear! And yes, you may need to explain “masturbate” in plain language depending on the context, but the point is to say what you mean. This makes your content more accessible to everyone, and it’s especially helpful for readers who didn’t have access to comprehensive sex education growing up — which, as you may know, is a rather alarming number of Americans.

Watch out for sneaky assumptions about sexual “milestones.” Many sexual health resources imply that there’s a normal-ish time to start having sex (usually in our teens or early 20s). These not-so-subtle assumptions can alienate people who start having sex later in life — or choose not to have sex at all. Plus, they may remind some readers of awkward or painful moments at the doctor’s office.

For example, asexual people have shared negative experiences with providers who made intrusive comments about their sexual history, framed their orientation as a mental health issue, or treated their asexuality as a medical problem to be solved. So watch out for language that points to a (non-existent) universal sexual experience, like “everyone” or “when you become sexually active.” Instead, frame having sex as a choice that adults can make at any age, based on their own needs and values.

Squash the shame. If there were ever a time to watch out for potentially shameful undertones/overtones/any-direction-tones from (well-intended) health content, this is it. Many of us grew up with all kinds of shame-based messages about sex. It’s easy to see how shame plays a role in religious messaging about abstinence and sexual “purity.” But purity culture affects all of us, and it shows up in public health messaging, too.

For example, some sexual health resources may imply that having sex with multiple partners is bad, or that certain people are at higher risk for STDs simply because of their LGBTQ+ identity. So think carefully about how you’re framing “risky” behaviors and watch out for those unintended shame messages — especially language that conflates a person’s identity and their behaviors. As an antidote to shame, when the context is right, consider emphasizing that sex is an important (and fun!) part of life for many people — and that’s something to celebrate.

And that’s where we’re going to leave it for today — stay tuned for part 2 coming up very soon!

The bottom line: Everyone deserves accessible information about sexual health! Try these tips to make your sexual health content more inclusive.

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Tweet about it: Everyone deserves accessible info about #SexualHealth! Check out some tips from @CommunicateHlth to make your sexual health content more inclusive — and stay tuned for more: https://bit.ly/3DAzt54 #HealthComm #HealthLiteracy

Here at We ❤️ Health Literacy HQ, we know clear communication makes everything better — but that won’t stop us from shouting it from the rooftops whenever we get the chance! And today, we’re talking about how health literacy and clear communication best practices can improve clinical trials.

The process of developing COVID-19 vaccines and treatments highlighted just how important clinical trials are to our health care system. It also revealed lots of gaps in how much people know about them and how they work. Using health literacy best practices in communication can help bridge that gap, and we can start by explaining clinical trials in plain language — from the basic definition to vaccine trial phases.

But it’s just as important to think about communication within clinical trials. That’s because using health literacy strategies can help build trust in the clinical trial process. The pandemic has shown how important it is that people not only feel it’s safe to enroll in clinical trials — but also that they trust the results of those trials. And you might (not) be surprised to hear, dear readers, that we’d say the best way to build trust is to communicate clearly and transparently about every step of the clinical trial process, starting with…

…enrollment! Research shows that when people don’t understand why clinical trials are important and how they work, they’re much less likely to consider participating in one — even if they could benefit from getting a trial treatment. Clear communication strategies can help reach and recruit people who might otherwise be left out of the process.

To be clear, there are lots of systemic problems that can keep people from enrolling in clinical trials — implicit racism and bias in the health care system, lack of access to health care and insurance, and a shortage of medical centers in rural areas that can facilitate clinical trials, to name a few.

Health literacy strategies alone won’t solve these issues. But they can help people understand exactly what participating in a clinical trial entails — including possible risks and benefits. Complex, jargon-y materials are a huge barrier to clinical trial participation, especially for people who have lower literacy skills or whose first language isn’t English. Making sure consent forms and other materials are easy to understand and translated into different languages can help address these weighty — and often undiscussed — barriers.

But clear communication doesn’t only help people enroll in trials. Clear instructions throughout the trial help participants follow trial protocols, like taking a drug correctly and scheduling regular visits with their trial doctor. This leads to more reliable results — not to mention less stress and better outcomes for participants.

Finally, communicating clinical trial results in a way that’s accessible to everyone can build trust in those results. And when people trust the results of trials, they’re more likely to make research-backed health decisions, which lead to better health outcomes. We can’t think of a better reason to shout (in plain language) about clinical trials from the rooftops.

The bottom line: Health literacy and clear communication strategies can improve all aspects of clinical trials — and that’s more important than ever.

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Post about it: CommunicateHealth explains why using #HealthLiteracy strategies to communicate about — and within — clinical trials is so important. Check it out: https://bit.ly/3MLTnOZ

It’s October, which means Health Literacy Month is here! At We ❤️ Health Literacy HQ, we really ❤️ Health Literacy Month, and we can’t wait to celebrate with our fellow health lit advocates.

So this week, we’ve rounded up a few ideas for how to get involved. You can use these ideas in your own advocacy work — or share them with your audiences. After all, when it comes to celebrating health literacy, everyone’s invited to the party! Read on for Health Literacy Month inspo from your friends at CommunicateHealth:

• Recognize a (health literacy) job well done. The next time you see health lit skills in action, take a minute to explicitly acknowledge it. That might look like emailing a colleague with kudos for solving a tricky plain language conundrum or drawing attention to your creative team’s use of accessible design principles. This kind of positive reinforcement doesn’t just make people feel good — it also helps us all keep our mission top of mind while doing everyday tasks.
• Find a language accountability buddy. Over the past few years, the words we use in public health have changed quite a bit — that includes the way we refer to everything from different groups of people to the work itself. Though you might want to call it something more fun (“health comm helper”?), having a colleague help you stay accountable in this space can make a big difference. Your buddy can check your writing to make sure you’re using inclusive language (like when writing about pregnancy), remind you about terms we’re trying to banish from our vocabularies (like “target audience” and “hard to reach”), and weigh in on anything else you’d like.
• Go social. Look for ways to join the conversation on social media, like by hosting a Health Literacy Month live event or signing up for the Institute for Healthcare Advancement’s Health Literacy Discussion List to chat important health literacy topics with other passionate peeps. Also be sure to follow #HealthLiteracyMonth on your social channels to see what other folks are talking about.
• Use your skills off the clock. As a health communicator, you’re a pro at interpreting medical jargon, but most people aren’t. So use the skills you’ve honed on the job to help someone understand health information. That might look like accompanying a family member to a doctor’s appointment to help them ask questions and take notes. Or maybe you help a friend find quality info about a health issue they’re dealing with — and if you can help “interpret” that info with some plain language explanations, even better! You might be surprised by how much you can help in these situations — and it’s a powerful reminder of why we do the work we do.
• Talk about health literacy! To everyone! All the time! Okay, maybe not all the time. But the more we talk about why our work is important, the better. If you need a jumping-off point, you can explain how health literacy is a state, not a trait. Or check out our thoughts on the evolving health literacy conversation — and the next time you’re at a party, find a friendly-looking stranger and ask what they think about the role of inequitable systems in shaping how we think about health literacy. Works every time!

These are just a few of our ideas for how to celebrate this Health Literacy Month. But we’d love to hear from you, dear readers — find us on social (LinkedIn and X, formerly Twitter) and tell us what you’re up to this month!

The bottom line: October is Health Literacy Month, and we’ve got some inspo to help you celebrate!

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Post about it on X: #HealthLiteracyMonth is here! @CommunicateHlth’s got ideas to help everyone celebrate our very favorite thing. Take a look: https://bit.ly/3eg5F5m #HealthLiteracy #HealthComm

Well, dear readers, it appears that fall has arrived — somehow. And if you’re anything like us, as you sip your pumpkin spice something-or-other on a walk in the crisp autumn air while sporting your coziest sweater, you simply can’t stop thinking about the very exciting event that’s just around the corner… Health Literacy Month!

Yes, every October we come together with other advocates (that’s you) to celebrate the importance of health literacy — and to get others involved in our shared cause. And what a time to be a health literacy advocate! As you’ve no doubt noticed, the COVID-19 pandemic has really put health communication on the proverbial map. (We don’t know about you, but we’ve had much more success explaining our jobs than we did pre-COVID.)

For starters, the pandemic demonstrated on a grand scale that health comm — and therefore health literacy — can be a matter of life or death. It also laid bare the tremendous impact of social determinants of health — particularly those rooted in systemic racism and discrimination. This led high-profile national public health institutions to declare en masse that racism is a public health crisis and drew mainstream attention to conversations like this one on naming racism (not race) as a disease risk factor.

Essentially, the public health community has turned up the volume on explicit acknowledgement of how inequitable systems make it more likely that people in certain groups — especially communities of color — will get sick and stay sick.

Similar convos are happening in the health literacy space, with more and more folks considering the implications of how we’ve historically defined health literacy — as the ability to access, understand, and use health information. While it’s not wrong, taken at face value this definition does leave out the role of systems and organizations, focusing only on an individual’s skills.

To be clear, health literacy advocates have pretty much always known that the onus of making sure people can access, understand, and use health information is on us — you know, the people and organizations who create and provide that information. But it’s really encouraging to see more widespread acknowledgment of this very important truth — along with the shifts we’re seeing more broadly in public health.

Anyway, you might say we’re just a little bit extra excited about Health Literacy Month this year — it continues to feel like a profound time to be in this field. And next week we’ll be bringing you some ideas for celebrating Health Literacy Month. Stay tuned!

The bottom line: Health Literacy Month is almost here, and we’re reflecting on how things are evolving in the wonderful world of health literacy.

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Tweet about it: Who else is excited for #HealthLiteracyMonth coming up in October? As we gear up to celebrate, @CommunicateHlth is reflecting on the evolving #HealthLiteracy conversation: https://bit.ly/3rltb3L  #HealthComm #PublicHealth

You probably know some people who’ve spent a lot of time during the pandemic cultivating new and fulfilling hobbies. A few of us at We ❤️ Health Literacy HQ, on the other hand, recently found ourselves staring down the reality that we must’ve spent most of our free time watching television.

This became clear during some proverbial water-cooler talk about the Emmy Awards, which aired Monday — turns out, we’d watched pretty much every featured show! Well, even the hardest-working health communicators need a little respite. (Though perhaps not that much respite.)

Anyway, on Monday, Michael Keaton took home the Emmy for best actor in a limited series or movie for his work in Dopesick. And chances are, dear readers, you have some pretty profound context for this show. It’s based on Beth Macy’s 2018 nonfiction book of the same-but-slightly-longer name: Dopesick: Dealers, Doctors, and the Drug Company That Addicted America. To be clear, the 8-part series is fiction — with dramatized details, composite characters, and the like. Unfortunately, the larger story it tells is anything but.

Dopesick chronicles the all-too-real beginning of the U.S. opioid addiction and overdose epidemic. Keaton plays a doctor treating patients in Appalachian mining country when OxyContin, Purdue Pharma’s new painkilling crown jewel, hits the scene in all its glory — its non-addictive glory, as Purdue’s claims had it. Dopesick gives a lot of screentime to what’s happening as Purdue’s owners, the now-notorious Sackler family, craft marketing strategies and incentivize their reps to make sure OxyContin levels the other painkillers of the day — in turn, making them gazillions of dollars. Those behind-the-scenes scenes are some of the hardest to stomach.

But then there’s not much here that’s easy to stomach — and that’s not a criticism of the show. We’re glad to see this story take center stage in an accessible format. It’s important that people understand how we got where we are today.

And where we are today is very much in an opioid overdose epidemic. That was true before COVID, and research suggests that opioid overdose deaths only increased during the pandemic due to stress, isolation, limited access to interventions, and other factors. We don’t have final numbers yet, but — thanks in large part to the skyrocketing number of fentanyl-related overdose deaths — they’re not likely to be good.

So yes, Dopesick is a tough watch, but it’s an important reminder of one of the most profound public health crises of our time. Obviously (and correctly!), the public health focus over the last few years has been on COVID. But let’s help each other keep the opioid overdose crisis top of mind. With almost 650,000 Americans dead from opioid overdoses between 1999 and 2021, it’s too important not to.

The bottom line: Dopesick explores the advent of the U.S. opioid overdose crisis. It’s a tough watch, but it’s worth it.

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Tweet about it: Dopesick explores the advent of the U.S. opioid overdose crisis. It’s a tough watch, but it’s worth it, says @CommunicateHlth: https://bit.ly/3S5y0th

A few weeks ago, CDC Director Dr. Rochelle Walensky sent her staff a video outlining some changes she plans to make to our country’s leading public health agency. The video came after 2 separate reviews that Walensky ordered back in April, one investigating CDC’s COVID response and another its internal operations and policies more broadly. “To be frank,” she said in the video, “we are responsible for some pretty dramatic, pretty public mistakes, from testing to data to communications. This is our watershed moment. We must pivot.”

If you’ve been following us for a while, you already know that one of the main strategies we recommend for building trust with our audiences is transparency. And to her credit, Walensky was pretty darn transparent. This is critical because public health depends on public trust. And right now, that trust is fractured — and not just because of the at-times disastrous COVID response. As you know, dear readers, monkeypox has been serving up yet more challenges, including some communication conundrums. So if there were ever a time for CDC to “pivot”…

What does she mean by “pivot” exactly? Writing for Politico, Krista Mahr summed up the recommendations from CDC’s pandemic response review as “a series of improvements, including releasing scientific findings and data more quickly to improve transparency, translating science into practical and easy-to-understand policy, improving communication with the public, working better with other agencies and public health partners, and training and incentivizing the agency’s workforce to respond better to public health emergencies.”

It’ll come as no surprise that we zeroed in on the communication pieces. And really, you could argue that much of what Walenksy’s talking about is communication related — take reexamining the involved data clearance process that may have prevented the timely exchange of critical information during key points of the pandemic. Or internal promotion incentives at CDC, which have focused on publishing scientific research in scientific journals (which are almost exclusively consumed by other scientific people) — not so much on using research to communicate effectively with consumers or craft actionable policy.

And of course we need to mention communication with the American public. Walensky made it very clear that one of her main goals is to build CDC’s capacity to share actionable, plain language information with (non-scientific) people who need it. Hooray!

It’s also worth noting that she provided some context for CDC’s consumer communication shortcomings more broadly — the fact that, historically, CDC didn’t do much public-facing communication. In an appearance on The Journal podcast, Walensky explained that CDC has mostly been in the business of communicating with other scientists and public health professionals (again, think researchers publishing data in scientific publications).

“I think this is an agency that is used to communicating with the scientific community, used to communicating with the public health community and not necessarily used to having to tackle mis- and disinformation in social media,” she said. However you may feel about that, the important thing is that Walensky has explicitly named this as something that needs to change: “What became very clear during the pandemic,” she said, “is that our audience is now the American people.”

Talking to PBS NewsHour, Walensky stated her communication vision in no uncertain terms: “We need to distill the science that we’re learning to the American people, so it’s actionable, and it’s implementable, it’s understandable and accessible.” Well, we couldn’t agree more — and we’re hopeful that CDC will take these important steps to help restore faith in our public health systems.

We’ll be cheering the agency on from We ❤️ Health Literacy Headquarters.

The bottom line: We’ve got some work to do to rebuild public trust in public health. Dr. Walensky’s plans for changes at CDC are a step in the right direction.

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Tweet about it: #PublicHealth depends on public trust. Dr. Walensky’s plans for changes at #CDC are a step in the right direction, says @CommunicateHlth: https://bit.ly/3QumBC0 #HealthComm #HealthCommunication

It’s that time — kids are headed back to school, and parents are breathing an end-of-summer sigh of relief. And for many parents, that sigh is especially deep this year. In a recent study, 7 in 10 working parents reported being burned out. And we’re not talking about feeling tired at the end of a long day. We’re talking about a constant state of complete exhaustion, of feeling like you have nothing left to give — and yet, you have no choice but to struggle on.

Unsurprisingly, one of the main reasons participants named for their burnout was the heightened stress and demands of parenting during the pandemic. Almost overnight, many parents had to become remote employees, teachers, and full-time playmates for little people — while social support systems fell away.

But that’s not the whole story. COVID uncovered, rather than created, an uncomfortable reality: Too often, raising kids in the U.S. means raising kids without a safety net. The U.S. offers very little structural support to parents — you know, affordable childcare and early education programs, paid family leave, and financial support that goes beyond saving a few bucks on your taxes. Impossible, you say? Other countries know better.

So what does this mean for health communicators? Well, it’s a great reminder to communicate with empathy. Parents are a pretty standard health comm audience, so there’s a good chance you’ll work on something with them in mind. When you do, remember that things are capital-H hard right now for many parents — and be really intentional about the framing and words you choose for your health messages. Here are some tips.

Explicitly acknowledge what parents may be dealing with. Sprinkling some real talk about how difficult things are into your materials can make a big difference. It helps set an empathetic tone right off the bat, which is key to connecting with your audience. When it makes sense, add that context to steps you want people to take — try something like “We know you’ve got a lot on your plate right now…” Reflecting parents’ current reality in our health materials allows them to see themselves in our content — and that makes our communications more effective.

Be extra careful not to place blame or imply criticism. Being a parent is hard under the best circumstances, and parent guilt is real. So watch out for sneaky implications of blame or criticism directed at parents. Writing about breastfeeding? Drop the “Breastfeeding is the best thing you can do to help your baby thrive” kind of messages. Breastfeeding-related decisions are extremely personal, and sometimes — due to medical reasons, lack of support, or a million other things — they aren’t “decisions” at all. Sure, it’s helpful to explain why experts recommend breastfeeding, but it’s just as important for parents to think about what’s right for their family. Chances are, they’re already feeling bad about something — and, as it turns out, guilt and shame aren’t particularly effective motivators. (Plus no one likes a breastfeeding bully.)

Help parents set manageable, realistic goals. Often, our job is to share evidence-based public health guidance. But we can’t expect parents to follow all the guidelines all the time — and now’s a great time to make sure that message is coming through loud and clear. When you’re providing health advice, focus on small, specific action steps (hello, self-efficacy). Instead of “Try to fill most of your child’s plate with fruits and vegetables each day,” try things like “Keep easy-to-grab fruits and vegetables (like carrot sticks) on hand for snacks.”

Connect parents with all the resources. As noted above, we’ve got some work to do when it comes to systemic support for parents. But be sure to point folks to resources that do exist — like these parenting mental health resources. If you’re writing for parents in a specific geographic community, do your homework and research local resources to share — like support groups for single parents, orgs offering affordable childcare, and even local public health departments. And while we’re at it, we’ll take this opportunity to remind you to remind parents that asking for help is okay — and often, a really good idea! And encourage parents to talk with other parents — sometimes just knowing that other people are in the same boat can be a game changer.

The bottom line: It’s been a tough few years, and many parents are struggling. So ground your health materials for parents in empathy — and offer encouraging, actionable, and realistic guidance.

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Tweet about it: #COVID19 has been particularly hard on #parents — a recent study reported that nearly 7 in 10 working parents are burned out. What does this mean for our parent-focused #HealthComm materials? @CommunicateHlth has thoughts: https://bit.ly/3QbRYkJ #HealthLiteracy

First, excuse the cheeky title. But if you stick with us, we think you’ll appreciate its intent — after all, we always try to practice what we preach. Actually, “preach” might be the wrong term here. We’re not so much preaching as opining on this one — and we’d ❤️ to hear what you think! As always, you can tweet @CommunicateHlth.

Now let’s get into it: If you’re anything like us, you’re scouring the interwebs daily for the latest updates on the tricky-to-communicate-about monkeypox outbreak. And we can’t help noticing that there are a ton of materials taking on both monkeypox and another illness that’s been top of mind for, you know, almost 3 (3?!) years: COVID-19. Yep, the internet is currently chock-full of articles with names like COVID-19 vs. Monkeypox, What’s the Difference Between Monkeypox and COVID?, and COVID-19 and Monkeypox: What You Need to Know.

And at face value, this makes sense. Monkeypox and COVID-19 are both diseases caused by viruses that are actively spreading in the United States, and public health officials are urging people to take protective steps against them. But the thing is, that’s about where the similarities end — besides those broad strokes, COVID and monkeypox have pretty much nothing in common! They come from different virus families, they spread in different ways (and with varying degrees of ease), they cause different symptoms, the testing/treatment/vaccines used to deal with them are different… shall we go on?

So with that in mind, let’s revisit those sample titles above — specifically, what those types of articles might tacitly communicate to readers. Even when you’re explicitly talking about the differences between monkeypox and COVID, we’d posit that covering both in one material could unintentionally create inaccurate associations. Frankly, just seeing these headlines over and over — even without reading the full articles — could cause folks to subconsciously link the 2 diseases.

In addition — and also related to the point above (this stuff is tricky to tease apart!) — think about some of the things we know about people with limited literacy (and health literacy) skills. For example, readers with limited literacy skills may:

• Get overwhelmed by lots of information
• Jump around a material as they read
• Struggle with working memory

Just think about these factors in the context of a health education material about 2 totally different — and complicated — diseases! There’s a lot of room for message muddling, mix-ups, and mistakes — and when we’re talking about current disease outbreaks, that matters. We don’t want someone to walk away from a material thinking monkeypox is an airborne respiratory illness, for instance. And that’s a benign example — as we’ve seen over the last few years, health (mis)information really can be a matter of life and death.

To be transparent, we haven’t had an opportunity to test this yet — for now, it’s a health comm hypothesis. And maybe you disagree! Perhaps you’ll consider this scenario and conclude that the combo approach is consistent with consumer mental models about newsworthy disease outbreaks. If there are 2 going on at the same time, you might argue, of course people will compare them — so why not meet people where they’re at? If you want to make this or another case, dear readers, we’re here for it!

But in most cases, we recommend keeping your COVID comms separate from your monkeypox comms. This actually reminds us of one of our very favorite classic novels: A Tale of Two Viral Outbreaks, er, Cities! And just as London and Paris — the 2 metropolises in question in the novel — are entirely different cities, so too are COVID and monkeypox entirely different diseases. Let’s treat them that way in our health comm materials.

The bottom line: COVID-19 and monkeypox are totally different diseases. Let’s avoid potentially harmful health comm mix-ups by keeping them separate in our materials.

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Tweet about it: #COVID19 and #monkeypox are totally different diseases. @CommunicateHlth says keep them separate in your #HealthComm materials to avoid potentially harmful mix-ups: https://bit.ly/3CezEUI #HealthLiteracy

In the most recent edition of our Health Comm Headlines series, we rounded up some pieces on communicating about monkeypox. Which, it turns out, is pretty complicated! So this week, we’re focusing on what we previously dubbed the million-dollar question, as raised by Jason Mast in STAT: How do you get tools and information about the disease to those who need it without wrongly implying that only that group is at risk, or publicly associating an unfamiliar disease with an already stigmatized community?

This, of course, is in reference to the fact that many cases in this particular outbreak of monkeypox are in men who have sex with men. Some trans women and non-binary folks may be at increased risk as well. (Quick aside: We know that “men who have sex with men” can be problematic, and we’re thinking about how to address it in a future post.) And lots of people are drawing comparisons to the early days of the AIDS crisis, making this an especially fraught communication conundrum. We’ve been doing some pretty serious thinking on this topic — and judging by our inbox, dear readers, so have you!

So we’re bringing you ideas for sharing critical information about monkeypox with the people who need it most — without perpetuating harmful stigma and stereotypes. But before we dive in, we should note that we intend to continue this monkeypox communication convo as the current outbreak evolves — and we’re here for your insights! If you have ideas related to this communication challenge, tweet @CommunicateHlth. Now, for some preliminary thoughts:

Consider leading with the fact that anyone can get monkeypox. This is a slight departure from what we might recommend for a less complicated topic, but consider starting your messaging with a super straightforward statement that anyone can get it. This helps avoid inferences that only some people can get the virus and establishes a non-stigmatizing tone right from the get-go. Then get into the facts about who’s most at risk right now: men who have sex with men. This is a balancing act. Obviously we need to be conscious of stigma, but we also need to get men who have sex with men the info they need to understand their personal risk and how to reduce it — and fast. No doubt this is tricky and potentially a bit uncomfortable, but we don’t want to let perfect be the enemy of good when “good” means getting crucial info to a community that needs it.

Include contextualized info and stats about this outbreak. Lean on objectively stated facts, and explicitly say they’re the facts we have now (more on that below). Tell your readers that monkeypox is spreading in tight social networks of men who have sex with men, largely through sexual contact. And scientists are trying to understand why this is happening. Use numbers (if they’re available) to help keep things neutral, and avoid any temptation to editorialize the narrative of this outbreak. Fact is, we don’t yet know what that narrative is. Speaking of which…

Clearly state what we don’t know — and what might change. If we could take just one lesson from COVID communication calamities, it’s that we must be transparent about what we know and what we don’t. We’ve talked about how this can help us avoid credibility-damaging U-turns in public health guidance before, but after the last few years it’s taken on health comm scripture status. So be really explicit here: This is what we’re seeing from the data that’s available now. We still don’t know [how easily monkeypox spreads through contact with towels or surfaces, if we’ll see outbreaks at colleges as students head back to their close-contact dorms, or what have you]. Here are the protective steps we recommend based on what we know at this point. You might even consider a “what we know vs. what we don’t” kind of structure for a fact sheet. The more clear we can make it that not everything is clear yet, the better off we’ll all be.

Emphasize the good news about monkeypox. Okay, “good news” in the context of a(nother) global disease outbreak might seem optimistic, but stick with us. Compared to the early days of the COVID and AIDS outbreaks, monkeypox has a couple good things going for it, one of which is an existing vaccine. Of course, you’ll need to be careful with vaccine info due to current supply issues — do your homework and tailor materials in terms of eligibility criteria and geographic location. Aside from the vaccine, we can easily test for monkeypox and experts have identified antivirals that can help treat it. This is all very positive, and thank goodness — people are tired in general, and they’re tired of pandemics. Don’t be afraid to highlight what we’ve got on our side.

Segment segment segment! We know what you’re thinking: Audience segmentation is health comm 101. And that’s true, but we think it’s worth emphasizing. As discussed above, we don’t want to imply things that aren’t true or add to existing stigma about the group most at risk. One way to avoid that messaging murkiness is to tailor — and we mean really tailor — materials to specific audiences. Just think about how different a material that’s only for men who have sex with men would be compared to one for the general public. The former would likely focus on reducing risk through vaccination and other behavioral recs, accessing testing and treatment, and managing painful symptoms — while the latter would be about understanding the evolving situation more generally. Of course, creating multiple materials on a topic has resource implications — but if there was ever a time to push for that out of health comm integrity, surely this is it.

The bottom line: When you’re communicating about monkeypox, avoid perpetuating stigma by stating up front that anyone can get it and then explaining who’s most at risk. After that, stick with tried-and-true health comm best practices. 

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Tweet about it: The current #monkeypox outbreak is serving up some serious #HealthComm challenges. @CommunicateHlth shares thoughts on clear messaging sans stigma: https://bit.ly/3JOScg6 #HealthLiteracy