by LJ Anderson
Independent journalist
Nine out of 10 US adults fall below proficiency level in health literacy, noted panelist Andrew Pleasant, Ph.D., health literacy and communication director of Canyon Ranch Institute. People often lack basic skills, for example, to navigate their way through a hospital setting.
As part of a growing health literacy movement, Pleasant is a co-author of the Calgary Charter on Health Literacy. This document defines the elements of health literacy, and its relationship to improved health.
The "old" way was to blame the patient if he or she did not understand a health message, Pleasant said, and hurdles are often greater for the disadvantaged. "We make people who have the least skills have the biggest challenge. Health literacy is the line to redistribute the power."
With regard to the role of journalists in promoting health literacy, Pleasant cited an untapped audience of those at the lowest levels of health literacy – who are not turning to journalists for clarity. "People don't trust what they don't understand. But if you make information more understandable, their trust and confidence increases."
Making complex scientific information understandable takes work, he said, but studies show that even highly educated people prefer simple and "clean" language.
Pleasant said that achieving health literacy is possible, ethically responsible, and that it strengthens community, aligns with the mission of journalism and makes financial sense.
In the context of a rehabilitation setting, Allen Heinemann, Ph.D., director of the Center for Rehabilitation Outcomes Research at the Rehabilitation Institute of Chicago, said low levels of health literacy can create "real problems," especially in patients with conditions such as stroke, traumatic brain injury, severe arthritis and spinal cord injury. "Limited patient comprehension of quality information limits its utility."
In a pilot study involving 16 rehabilitation patients, Heinemann noted that there were common errors in comprehension such as not understanding the term "cognitive function." One patient commented that "I've got two years of college, but I can't tell you what ‘cognitive function' means." Some patients did not understand what the term "community" meant in the phrase, "discharge to home or community."
In transmitting health information to the public, Heinemann suggested that journalists use summaries in articles, "what you need to do" points, and direct patients to useful web resources.
Finally, medical marketer and former television medical correspondent Michael Breen, M.D., described how aesthetic and commercial obstacles and public expectations can compromise the quality of television medical reporting. "The media is not always about public service – as much as we would like it to be. It's about money and survival."
Breen described the inherent nature of television medical reporting – about emotion and leading with the best video – as detriments to promoting health literacy. "An emotion-driven story doesn't (always) leave the viewers any better than when they started," Breen said.
Because television is appearance-focused, what people say is often less important than how they say it. And even though medicine "constantly contradicts itself, moves at a glacial pace, and a lot of stories in life don't give you an answer," said Breen, viewers often want a sense of finality – just as in the shows that they watch.
Additionally, due to commercial constraints, broad-based stories such as those concerning baldness, obesity and depression are often favored over more obscure but significant stories.
Breen suggested that full financial disclosure by researchers and limiting reporting to prospective, double-blind studies would be steps toward improving the quality of medical reporting.
