Health Literacy in the Viral Media Age

October is Health Literacy Month. And even though we only have a few days left in the month, I thought squeezing in a communications related post would be a fitting first blog post for the newest addition to the Communications Committee.

According to the World Health Organization, health literacy is defined as “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Health literacy means more than being able to read pamphlets and successfully make appointments. By improving people’s access to health information and their capacity to use it effectively, health literacy is critical to empowerment.”

With health literacy playing a critical role in empowering individuals to make positive health choices, it should come as no surprise then that low levels of health literacy are associated with poor health outcomes. As such, it is our responsibility as public health professionals to promote health literacy by ensuring that the health information we disseminate is accurate, accessible, and actionable. In many ways we are already experts at this, from presenting information either orally or through pictures in low literacy settings to adapting messaging to the local culture. We understand the value of delivering contextually relevant health information.

Although many individuals still rely on health professionals for trusted health information, we cannot ignore the influence of communities on health literacy and in particular the rising role of digital communities. Digital communities have helped individuals with similar health concerns share information and support each other and have enabled the growth of viral media campaigns that raise awareness on health topics and reinforce key health messages. And while digital communities have certainly helped advance health literacy by making information more readily accessible, they have also had a detrimental effect.

In the viral media age, inaccurate health information can easily diffuse to a large number of people at lightning speed in digital communities. On top of that, social networks yield incredible power in influencing health behaviors even while taking into account individual characteristics such as income and education. This combination of factors should raise some alarms.

A recent article in The Atlantic discusses the challenges created by the spread of health misinformation and criticism in digital communities during epidemics. From the 2014 measles scare in Vietnam to SARS in China example after example demonstrates the potential harms of digital communities. Whether through exacerbating individual fears or creating mistrust between health professionals and the public, digital communities can negatively impact health literacy.

Although the author notes this is most evident in the Asia Pacific region, where the confluence of Internet users, smartphones, and infectious diseases has created the perfect storm, the problem of health misinformation among digital communities isn’t limited to epidemics or geography. The problem of health misinformation exists anywhere the Internet does. It is a problem that isn’t going away anytime soon and will only continue to grow. In 2015, over 3 billion people worldwide were using the Internet compared to 738 million in 2000. Of those users, 2 billion live in developing countries compared to only 100 million in 2000.

Projects focused on increasing global Internet access, like Facebook’s Internet.org which has brought free basic mobile Internet service to over 25 million people from India to Zambia, are gaining traction. In addition, data and mobile phones are becoming more affordable. These factors are driving the ubiquity of the Internet. Thus, it is imperative that we think about ways to limit the spread of health misinformation by staying ahead of the conversation in the days, months, and years ahead of us.

As we think about how to accomplish this, here are a few ideas to start with:

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@USAID Video: Just Bring a Chair

In today’s video, USAID shares a message of hope amidst the horrors experienced by 2.4 million Syrian refugee children.  Along with displacement from home, Syrian children experience an interruption in education from which they might never recover.  Ms. Maha, a principal for a girls’ school in Jordan, answered the desperate pleas of Syrian parents as she welcomes us and their children into her school with the sentiment: “Just Bring a Chair.”

Video Description:

“In Jordan, where the Syrian crisis has led to around 635,000 additional people taxing already overburdened schools, hospitals and social services, some people still find reasons to open their arms and make it work. Ms. Maha is one of those people.”

Without access to education, the future is bleak for many of the youngest Syrian refugees.  A recent report by Human Rights’ Watch found that nearly one-third of refugees in Jordan are between the ages of 5 and 17.  Of these children, 56% are not enrolled in school.  Lebanon is also struggling to accommodate the inundation of refugee students.  Soon, school-aged Syrian children could outnumber their Lebanese peers.

Unfortunately, the problems do not end once children are in school.  A report by UNICEF highlights the unique educational concerns of refugee children, citing violence while traveling to and from school, abusive teachers and classmates, and separation anxiety while at school.  The same report finds that even when the school is located within the refugee camp, 75% of children do not attend.

So what’s the solution?  I think an inclusive environment like Ms. Maha creates in her school is key.  Money for teachers, educational materials, and space are paramount for educating this generation of Syrian youth.  2015 saw fundraising efforts by members of the UN fall short of the $8.4 billion goal.  Will 2016 see more Syrian children returning to classrooms?

Read Ms. Maha’s story here.

@WHO Video: Reforming its emergency response

Note: This was cross-posted to my own blog.


Last week, the WHO posted a five-minute video to YouTube outlining the intended reforms to its emergency response protocols. The video opens with some fairly dramatic clips of an explosion or two and then mainly consists of clips of primary and emergency medical care being administered to a wide variety of harrowed-looking disaster refugees mixed in with people waiting in line for food and shots of damage caused by a mishmash of catastrophes. The voiceover, which sounds like somebody reading from a technical report, explains that “[g]uided by an advisory group of global emergency experts, WHO is instituting change to make the organization more adaptable, predictable, dependable, capable, and accountable in its work in outbreaks and emergencies. It is adopting game-changing measures across all levels of the organization.” The rather verbose narration contrasts oddly with the quietly urgent soundtrack.


The accompanying description reads:

WHO launched in 2015 a wide-ranging reform of the Organization’s work in outbreaks and emergencies with health and humanitarian consequences. The outputs of the reform will include creating a unified programme for WHO’s work in outbreaks and emergencies, featuring a platform for rapid response to outbreaks and emergencies, a global health emergency workforce and a Contingency Fund for Emergencies. Guiding this reform process is the objective of strengthening Organizational capacities, particularly in-country, to better prevent and prepare for, respond to and recover from outbreaks and emergencies.

I certainly do not disagree that the WHO needs reforms, but they might consider sending their social media guy to a class on how to make engaging videos (or maybe just connect him with MSF’s guy).

The WHO has actually been doing quite a bit this year in the way of assessing its response protocols and drawing up a roadmap (PDF) for improvements. They even have a newsletter! Unfortunately, none of this information is mentioned in the video or linked to in the description.

@MSF Video for World #AIDS Day: People with #HIV still face major hurdles

Note: This was cross-posted to my own blog.


Another year and another December mark the passage of another World AIDS Day. This has been an exciting year for HIV research and policy, with the WHO updating guidelines to recommend that anyone diagnosed with HIV get on ARVs, PrEP gaining traction in the US (even in my own Lone Star State!) and approval in France, new optimism in the effort to development a vaccine, and talk of ending AIDS by 2030. Aw, yeah.

Alas, we are not there yet – and World AIDS Day is an important day to remember that. While many countries have turned the tide of their HIV epidemics, it is getting worse in several others and, in South Korea’s case, presents the potential for a fast-approaching crisis. MSF is always a good resource for bringing optimists back to reality. In this video, they remind us that in order to keep up the progress we have made against AIDS by treating HIV, we need to make sure that those who are infected stay in care – which will take sustained efforts in treatment, policy, and funding.

John Oliver takes on Big Tobacco in Last Week Tonight

Many thanks to Dr. Don Zeigler, who passed this on through APHA’s Trade and Health Forum listserv. In a recent episode of Last Week Tonight (har), John Oliver explains how the tobacco industry is compensating for the fall in smoking rates here in the US by utilizing impressively convoluted international legal tactics and taking its business to developing countries in its usual style – shady as hell. The video is long (about 18 minutes), but is seriously worth every second.