Last summer the U.S. Department of Health and Human Services requested comments from the public to update the official definition of “Health Literacy.” With some reticence, I will share their “working definition” of health literacy with you here: “Health literacy occurs when a society provides accurate health information and services that people can easily find, understand, and use to inform their decisions and actions.” As we tackle the challenges of the COVID-19 pandemic, it is worth considering how this definition of health literacy misses an opportunity to highlight the importance of what, for lack of a better term, we will call ”public health literacy.”
Think back to what you learned in primary and secondary school about health. Most of us recall sex education in high school, lessons about handwashing in life skills classes, first aid and perhaps some work in a science lab with petri dishes and moldy bread. To the credit of our dedicated educational leaders, tobacco control, anti-bullying and social tolerance efforts have been expanded in recent decades. The Affordable Care Act emphasized the importance of learning the vocabulary of health insurance, to prepare the public for an obstacle course of words like “insurance premiums,” “deductibles,” and “co-insurance.” But most of what is learned is focused on personal health education. While we address learning about our own personal health needs, an even larger gap in knowledge about public health widens.
Consider the kinds of knowledge that could buttress our communities as we face the spread of the COVID-19 virus. How many understand the difference between a virus and a bacterium, and what do those differences mean to an outbreak response? What is the difference between contact, droplet and aerosol transmission of different diseases? How does the incubation period, infectious period and the presence or absence of symptoms affect the transmission of diseases? These questions pertain not only to the COVID-19 virus, but also to long-term foes like chlamydia, HIV and influenza.
In 2019 the California Department of Education adopted a revised Health Education Framework to guide K-12th grade health education in California schools. Because California health education standards were separated from the science standards in the early 1990s, diligent efforts are required to maintain bridges between cross-cutting topics in science and health. A broad range of opportunities exist to further expand science-based insights into community health. How are the principles of natural selection at play as organisms evolve and become resistant to antibiotics? How do such principles relate to the ability of a virus like the COVID-19 virus to leap from one species to another?
It is also important to keep in perspective the maladies that will continue to have the greatest impact on public health. What is the difference between grief and depression? What powerful marketing strategies are used to promote e-cigarettes, sugar-fortified foods and drug use? How can you recognize reliable, science-based health information on traditional or social media? How have vaccines and community planning effectively changed life expectancy and quality of life in the last century? What statistics are important measures of community health, and how is our community measuring up?
Shortcomings in public health literacy lead to misguided beliefs. While humble skepticism is a welcome foundation of science, irrational skepticism about vaccine recommendations and climate change undermines our social responsibilities.
The best lessons build long-term reasoning skills to help an individual come to rational conclusions as life throws us new challenges. Advancing public health literacy through a team effort by statewide health, science and educational experts can do just that. Such a prescription represents perhaps the most effective remedy for current and future pandemics.