Health Literacy Insights for Health Crises

Typically, the authorities and experts on public health practices are public health officials. The public expects these officials to offer important health information and guidelines to prevent disease and promote good health strategies. In times of public health crisis, their authoritative voices become even more important. Those who speak for public health—being interviewed by journalists, preparing public health alerts, producing written materials, using the broad reach of social media, or presenting at community meetings—are clearly conscious of the importance of communication not only for raising awareness and providing needed action steps, but also for earning and maintaining trust. The careful crafting of accurate, consistent, and meaningful messages can calm the public in uncertain times, avoid perceptions of chaos, and build trust. This paper highlights principles of clear communication and insights from several decades of health literacy studies to support such efforts. A recent NAM Perspectives paper, “Improving Collaboration among Health Communication, Health Education, and Health Literacy,” noted the importance of interplay among the disciplines of health communication, health education, and health literacy. This collaboration is particularly important during a public health emergency. Several tenets of health communication—which is defined as “the study and use of communication strategies to inform and influence individual decisions that enhance health”—emphasize clearly knowing your audience; focusing your message; and knowing where, when, to whom, and how to deliver key information [1]. A core element of any good health communication effort is having continuous evaluation built into the design to improve the strategies and tactics. Health communication efforts in medicine have long focused on the importance of adhering to rigorous standards while embracing developing science. Scientists, researchers, educators, and spokespersons stay in their “lane of expertise” and do not infuse the discussion with hypothetical situations that may cause fear or need to be walked back. The authors’ advice is, in short: Say only what you know for sure and only when you know it. Say it together. Be collaborative. Communication specialists have highlighted the limitations as well as the strengths of awareness and education efforts [2]. Communications cannot compensate for inadequate health systems or resources, nor can they produce sustained change in complex behaviors without support from a larger programmatic effort. Furthermore, communications may be complicated by an intended audience’s preconceptions about the topic or the communicator. For example, Barry Schwartz notes in The Paradox of Choice that people may compare an experience to what they hoped it would be, to what they expected it to be, to other experiences they have had in the recent past, or to experiences others have had and reported [3]. Many of these challenges may arise during a public health crisis. Consequently, it becomes even more critical to understand the intended audiences and to make sure the information provided is credible and accurate.