Putting health science into health education.

In his News & Analysis story “Educators, lawmakers question proposed reorganization” (14 June, p. [1274][1]), J. Mervis discusses our efforts to prevent an end to funding for the Science Education Partnership Award (SEPA) program. The tiny SEPA program and its smaller siblings at the National Institute of Allergy and Infectious Diseases and the National Institute on Drug Abuse do much more than, as Mervis says, “shar[e] the latest health science results with the public.” In fact, they are the only federal programs that put health science into health education at the K–12 level. In most schools, health education is not taught as part of the science curriculum, and even though standard health education emphasizes behavior modification, the traditional approach has historically failed to affect health literacy: More than 50% of U.S. adults remain functionally health illiterate ([ 1 ][2]). ![Figure][3] CREDIT: JULNICHOLS/ISTOCKPHOTO One of our SEPA programs (led by K.F.M. and B.J.) illustrates the difference between science-focused and traditional behavior-focused health education. Standard high school health classes about nutrition and obesity focus on behavior modification such as “eat your vegetables,” “eat fewer carbs,” and “eat low fat.” These messages are constantly changing and are often contradictory. As a result, many people (not only students) are confused about what to believe and end up ignoring guidelines. In contrast, our Metabolic Disease curriculum asks the question, “What information do I need to make a judgment about which nutritional advice I should follow?” We teach 10th- to 12th-grade students how to distinguish correlative from causative information, identify what criteria a study should meet to produce reliable information, and determine whether a comparison between two different studies is valid. Our goal is to give students tools they can use to evaluate the science underlying health information, as opposed to merely giving them the information itself. Another of our SEPA programs (led by J.M.W.) teaches high school students about genetic and environmental factors that influence complex diseases like diabetes, hypertension, and cancers, subjects that are never addressed in traditional health education. A nuanced understanding of these topics will become increasingly crucial in the coming decades as the fruits of the National Institutes of Health (NIH) investment in genomic sequencing are finally harvested. It is therefore troubling that NIH elected to eliminate funding for these programs entirely rather than subject them to cuts, even though neither the continuing resolution nor the sequester pressured them to do so. Why? In the News story, NIH Deputy Director Lawrence Tabak says that NIH plans to provide only technical expertise after the reorganization, implying that NIH's higher administration believes that NIH has no responsibility to fund K–12 health education that is firmly rooted in science. This seems disingenuous given the NIH mission to “apply knowledge about the nature and behavior of living systems to enhance health, lengthen life, and reduce the burdens of illness and disability” ([ 2 ][4]). Preparing STEM workers for the workforce and educating the U.S. citizenry in health literacy are different tasks that were clearly erroneously conflated by the STEM consolidation committee. In contrast, health science is legitimately intertwined with health science literacy in the 21st century. The agency responsible for health science should also be responsible for health science education. 1. [↵][5] Institute of Medicine, Committee on Health Literacy ([www.iom.edu/Activities/PublicHealth/RtblHealthLiteracy.aspx][6]). 2. [↵][7] NIH, Mission ([www.nih.gov/about/mission.htm][8]). [1]: /lookup/doi/10.1126/science.340.6138.1274 [2]: #ref-1 [3]: pending:yes [4]: #ref-2 [5]: #xref-ref-1-1 "View reference 1 in text" [6]: http://www.iom.edu/Activities/PublicHealth/RtblHealthLiteracy.aspx [7]: #xref-ref-2-1 "View reference 2 in text" [8]: http://www.nih.gov/about/mission.htm