What’s the Best Language to Use When Addressing the Public About Public Health and Healthcare?
I’m at the annual conference of the American Public Health Association (APHA) in San Diego, California. I generally don’t like to go to conferences because they sometimes devolve into “look at me” sessions of people just blowing their own horn. What I do like, however, is the ability to see what people are putting out there in terms of science and research and see how I can apply it to my own public health practice.
In the opening session yesterday, US Surgeon General Jerome M. Adams, spoke about the disparity between speaking about public health in scientific terms and speaking about public health in terms that the public would understand. He gave a great example. He said that, if all of us there, all of us public health workers, were to live a science-based life, we’d all have gotten our flu shot, all would avoid drinking more than one cup of coffee per day, and we all would have been up at six in the morning to work out.
(I walked almost eight miles yesterday, and another eight today, thank you very much.)
He said that it goes the same way when we talk to the public about public health. We tell people that smoking is bad for them, and then we throw out a bunch of facts and figures and statistics. And, many times, we ignore the fact that maybe a person had better access to cigarettes than to books. So are they really going to understand the message, let along follow along in our recommendations?
Dr. Adams also spoke about other issues having to do with the current political climate and how we should maybe not be so angry in dealing with what politicians are doing to public health. He gave an example of having to treat a patient who was a White Supremacist. He said that he treated that patient with respect and professionalism because doing anything other than that would have enforced the White Supremacy view that African American men are inferior and such.
So what language do we use? Do we use some of the same tactics used by others to convince us that certain things are necessary, like the appeal to emotion that antivaccine people use? Do we parade children hurt by vaccine-preventable diseases to promote vaccines? Do we exaggerate the risk of vaccine-preventable diseases?
Nah, not me. I don’t like to play dirty like that, mostly because it would be very embarrassing (personally and professionally) if I get caught exaggerating something, or — as antivaxxers do — lying. Because that’s kind of what happened the other night when Dr. Offit gave his talk. The antivaxxers posted all over Facebook that nothing had been like I had written it up, or Tweeted out. Yet they had no evidence of my “exaggerations.” If anything, the video that they themselves put out there confirmed many of my claims.
But let’s get back to public health in general…
I had the privilege to be the teaching assistant at the School of Public Health to one of the best professors when it comes to health communications programs. He really knows his stuff, and he breaks down the process of how to create a communication program to address a public health problem. I learned a lot from him. You have to analyze your problem, know your audience, develop your materials, test them and re-test them, and then deploy your project. Then you re-visit your aims and evaluate your project to make sure it’s hitting all the aims you were trying to address.
But there is not much in the way of guidance on what language to use other than understanding your audience. For example, if I’m talking to teenagers at this moment, I might have more of an impact through social media and small-sized bits of information instead of lectures and documentaries. If I’m talking to parents, sharing my own concerns as a parent may help to get their attention. And if I’m at a professional conference, then it’s all in technical jargon… Assuming everyone paid attention in their Epidemiology and Biostatistics classes.
As you can probably imagine, this is easier said than done because the United States is 50 states that each have their own cultures and subcultures. Over 325 million people live in this country, and we are all more politically divided than ever. And, unfortunately for us, public health is very political. The Democrats and the Republicans, the Liberals and the Conservatives, all have their own ideas of what works and what doesn’t in public health. The Left wants condoms. The Right wants chastity belts and promise rings. The Left wants single-payer healthcare. The Right wants it too, they just don’t know it yet. (See what I did there?)
This all is certainly something to think more about for me as I am now stepping into more responsibilities in public health… What language do I speak so that people will listen and, hopefully, act? What words do I say? And, most importantly, what words do I not say?
Food for thought.
EpidemioLogical 
You address your audience and captivate them, either for professionals, data filled information, didactic method or with “civilians”, via creative metaphors and anecdotes, with data on screen and pointed to references.
With teens, I disagree, one adapts the “civilian” mode with more creative and via common expressions and references utilized by their generation, to captivate their attention repeatedly, before the attention span drifts, with pauses while they Google the reference placed on the screen (with the URL prominent in the image).
The, with “civilians” and teens alike, recite the names and images, with parental permission, of the dead this year from vaccine preventable disease in a thundering voice, quietly closing with asking for a moment of silence and contemplation for those needlessly lost and the pain for their families.
But then, I am the guy who addressed trailing edge Boomers and those younger in field sanitation classes, explaining how to purify water and how to initially determine some parts of the evaluation on clarity, turbidity and color, saying, “Is it cloudy, does it have sea monkeys in it, is it yellow?”. 20 years later, a successful field sanitation NCO approached me and reminded me of his attendance at the class and memorable to him, as intended, as eyes began to glaze after palatable and non-palatable vs potable and non-potable water and uphill going down and downhill going up water, remembered the entire session, courtesy of the antics of sea monkeys.
Still remembered clarity, color and turgidity. And sea monkeys.
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I’ve never seen sea monkeys… They’re actually a thing?
The most educated man in the town where I grew up in Mexico was the pharmacist. When I learned to read (age 2), my grandfather took me to him to show me off. Grandpa told “the doctor” that I would be a doctor one day, too. The pharmacist passed away since then, and two or three physicians work in the town since it’s grown exponentially.
Anyway, one of the things that the pharmacy always advocated for in the summer was the sale of hydrating solution (electrolytes and sugar) for people who would undoubtedly come down with diarrheal disease in the summer. They even had a local artist make all these cartoons of babies getting bottle fed with the solution. I was in high school when my grandfather asked about diarrheal diseases. I told him all about chlorinted water, boiling water, and filtering water… Well, as much as I had learned in high school bio.
I remember not having to “dumb it down” for grandpa. He was a big advocate of education, even if he and his children were not fully able to get one beyond elementary school. He bought my aunts and uncles books and magazines, and he encouraged them to read. Dad started fixing cars because of some how-to manual for an old VW beetle.
It is from these experiences that I don’t immediately assume that lack of formal education means lack of understanding. Some of the brightest people I know don’t even have a high school degree. This also makes it hard for me to give antivaxxers the benefit of the doubt when I know they’re not epidemiologists nor biostatisticians.
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Yep, sea monkeys are a real thing. They’re now an artificial hybrid species of brine shrimp.
https://en.wikipedia.org/wiki/Sea-Monkeys
The trick is to evaluate the audience continuously and adapt the presentation to meet them halfway.
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