This post was updated Nov. 3 at 7:40 p.m.
October is Health Literacy Month.
Dr. Timothy Brewer, a professor of medicine and epidemiology at the David Geffen School of Medicine and the Fielding School of Public Health, sat down with Daily Bruin reporter Catherine Wang to discuss the importance of making scientific findings publicly accessible.
Brewer, an infectious disease physician, received his medical degree from New York Medical College and his master’s degree in public health from the Harvard T.H. Chan School of Public Health. He was previously an advisor for the World Health Organization and the United States Centers for Disease Control and Prevention.
This interview has been edited for length and clarity.
Daily Bruin: How would you define health literacy?
TB: I would define health literacy as an understanding of the causes, the prevention and the treatment of health-related issues. That involves a basic understanding of science – including biology, chemistry, physics – some understanding of human behavior, and then a grounding in sociology, because social determinants of health are very important.
Daily Bruin: How would you describe the connection between health literacy and disease prevention?
TB: The SARS-CoV-2 pandemic – the virus that caused COVID-19 – gives us a terrific example. Just take the United States. What we saw was very different responses across states, and even within states and across individuals. A lot of that reflected health literacy – people’s understanding of ‘What is a virus? How does it spread? What is our responsibility to public health and community health? What’s the government’s responsibility? How do these responsibilities interact with other rights and responsibilities?’ All of that came together in the pandemic and gave us some examples of very good and very poor health literacy.
Daily Bruin: Can you elaborate more on those good and bad examples of health literacy?
TB: On the less good side, there was a lot of misinformation. Ivermectin is a terrific drug. The person who discovered it ended up winning the Nobel Prize in medicine. Critically important for treating parasitic diseases, had absolutely no role in treating SARS-CoV-2. Yet a number of people – both within the medical profession, within politics and within the lay public – were pushing ivermectin as a treatment. There were data available to show that it was not effective. So that’s an example of poor health literacy. People aren’t actually using the appropriate information to come to good conclusions about how to maximize their health.
Daily Bruin: What have you learned from your own experiences with effectively communicating your research on disease control to the public?
TB: Most medical professionals, public health professionals and scientists, are not very good at communication. We speak too long, and we have too many caveats because we know the limitations of the data, and we don’t want to over-present what we know or what the data show. But the public has a very hard time dealing with those nuances – and one of the things I learned was to speak in shorter sentences and just be more clear and direct.
“Masks actually helped prevent the spread of respiratory diseases.” A nice, clear statement that you can accept or not accept depending on what other information that you have, but at least it’s a clear statement of my understanding of what I believe the data show.
Daily Bruin: What tips do you have for people to improve their health literacy? What should they look for?
TB: Get out of your comfort zone. I was a history major, but I went to medical school – and part of that was because I figured they would teach me everything I needed to know about medicine in medical school, and they were going to be unlikely to teach me any history in medical school. So if you’re a computational biologist, take a romantic literature course. Take something that’s out of your comfort zone, that expands your ability to think and to push your intellectual boundaries a little bit. That will help you when you confront health information – to be able to process it, and I think utilize it better.
Daily Bruin: What is an example of health literacy-related success in your career?
TB: If you look at the start of the pandemic, the U.S. CDC, the National Institutes of Health and experts like myself were not recommending that the general public wear masks, particularly a type of mask called an N-95 respirator. Part of that was because there weren’t really data to suggest that it was beneficial.
One of the things that happened out of the pandemic is a number of studies were conducted using different kinds of masks, and what we learned from that is, in fact, those masks do work. Even surgical masks work in cutting down on the transmission of respiratory viruses. It’s an example of how science works. We think we might know something, but we actually need to study it to then know for sure – ‘Did we get it right or not?’
Daily Bruin: We talked about communicating health information to the general population. What about health literacy for providers?
TB: You would think that healthcare providers have better health literacy. That’s not necessarily true. There is a saying for every PhD, there is an equal and opposite PhD, which is just a fancy way of saying you can find an expert to say pretty much whatever you want them to say.
I had been an advisor to the World Health Organization, I’ve worked with the U.S. Centers for Disease Control Prevention, so I was in a pretty good position to make statements about H1N1 influenza. Then, they would get some random doctor in Toronto, who would just say things that were completely wrong – yet, to the public, it’s just two doctors saying something, and they’re not agreeing. It’s very hard for the public to recognize, ‘Gee, maybe this person really is an expert, and this person really is not an expert.’
I think that’s one of the real challenges in health literacy, in the medical and healthcare profession – that not everybody is facile in understanding the issues, and more importantly, it doesn’t prevent them from talking about things they don’t know about.
Comments are closed.